Factor associated with tobacco use among the adult population in Sarawak, Malaysia: a cross sectional study

Introduction: Consumption of tobacco in any form is one of the leading causes of preventable mortality. The World Health Organization recommends that it should be monitored regularly.  This study was designed to estimate the prevalence of tobacco use among the rural adult population in Sarawak and factors associated with it. Methods: This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability sampling method was adopted to select the villages. All the households of the villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software SPSS 19.0 version. Results: Analysis showed that 30.9% of the respondents were current tobacco users and 11% were past tobacco users. The mean age (SD) at starting tobacco was 18.1 (6.48) years. The frequency of tobacco use was 14 times per day.  Hierarchical Logistic regression analysis revealed that age with male sex (OR=1. 064, 95% CI: 1.052, 1.076), secondary education (OR=-2.712; 95% CI: 1.122, 6.555), higher secondary and above (OR=3. 571; 95% CI: 1.641,7.774), occupation as business (OR=3. 152; 95% CI: 1.732, 5.735) and environmental exposure such as smoking at working place (OR=2. 754;95% CI: 1.895,4.002), coffee house (OR=2. 274;95% CI: 1.32,3.919) and at home (OR=1. 827;95% CI: 1.242,2.687) appeared to be  important predictors of tobacco use (p<0.05). Conclusion: A large proportion of males use tobacco products. Though tobacco use was negligible among females, but they would be potential users. Environmental exposure to tobacco appeared to be important predictors. Tobacco control campaigns should target banning of tobacco use in closed and open areas and also to intensify the monitoring of all forms of tobacco used by the population

Factor associated with tobacco use among the adult population in Sarawak, Malaysia: a cross sectional study

Introduction: Consumption of tobacco in any form is one of the leading causes of preventable mortality. The World Health Organization recommends that it should be monitored regularly. This study was designed to estimate the prevalence of tobacco use among the rural adult population in Sarawak and factors associated with it. Methods: This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability sampling method was adopted to select the villages. All the households of the villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software SPSS 19.0 version. Results: Analysis showed that 30.9% of the respondents were current tobacco users and 11% were past tobacco users. The mean age (SD) at starting tobacco was 18.1 (6.48) years. The frequency of tobacco use was 14 times per day. Hierarchical Logistic regression analysis revealed that age with male sex (OR=1. 064, 95% CI: 1.052, 1.076), secondary education (OR=-2.712; 95% CI: 1.122, 6.555), higher secondary and above (OR=3. 571; 95% CI: 1.641,7.774), occupation as business (OR=3. 152; 95% CI: 1.732, 5.735) and environmental exposure such as smoking at working place (OR=2. 754;95% CI: 1.895,4.002), coffee house (OR=2. 274;95% CI: 1.32,3.919) and at home (OR=1. 827;95% CI: 1.242,2.687) appeared to be important predictors of tobacco use (p<0.05). Conclusion: A large proportion of males use tobacco products. Though tobacco use was negligible among females, but they would be potential users. Environmental exposure to tobacco appeared to be important predictors. Tobacco control campaigns should target banning of tobacco use in closed and open areas and also to intensify the monitoring of all forms of tobacco used by the population

Factors Affecting Smoking Menthol Brand Cigarette Among The Adult Population In Sarawak, Malaysia

Menthol brand cigarette has been found to be linked with early initiation of smoking and addiction of nicotine. This study was designed to find out the factors associated with smoking menthol brand cigarettes among adult population in Sarawak. This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability purposive sampling method was adopted to select the villages. All the households of the villages were visited, and an adult member was selected randomly from each household irrespective of sex. After missing value imputation, 1000 data sets were analysed using statistical software SPSS 19.0 version. Analysis showed that 28.8% of the respondents were current smokers, and 7.8% were past smokers. Among the smokers, 56.3% were habituated with menthol brand cigarette. Logistic regression analysis revealed that age at initiation of smoking before 15 years of age (OR=11. 68, 95% CI: 4.25, 32.10), smoking within five minutes of wake up from sleep (OR=3. 20, 95% CI: 1.35, 7.54), nature of job as business (OR=4. 81, 95% CI: 2.13, 10.86) and service holders (OR= 3.85, 95% CI: 2.07, 7.16) and family size 5 and above (OR=2. 22, 95% CI: 1.25, 3.94) appeared to be important determinants of smoking any menthol brand cigarette (p<0.05). Menthol is a prominent design feature to attract and retain younger smokers. It does not necessarily make the transition from experimenting with cigarettes, but to encourage early smokers to become a confirmed smoker. So, anti-tobacco public health programme should focus on age-specific community approach

The relevant intervention strategies for improving medication adherence of diabetic patients.

Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus(DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved

The relationship between diabetic patients' health beliefs and medication adherence among local ethnic groups in Kota samarahan and Sarikei

oiabetes mellitus (DM) is a chronic disease that results from defects in insulin secretion, insulin action, or both. The disease has both acute and long-term complications. DM cannot be treated. However, it can be controlled if patients adhere toward the prescribed treatment to prevent the complications of the disease. This cross-sectional study aims to examine the relationship between diabetic patients' health beliefs and medication adherence using the Health Belief Model (HBM) framewor0 Data collection was done by guided interview using pretested questionnaire, for which its internal reliability was tested using the Cronbach' s alpha. Information on the patients' socio-demographic and economic characteristics, medication adherence, characteristics of DM, perceptions on the disease, and health beliefs of 442 respondents was obtained. More than half of the respondents (6l.6%) were 51 years old and above, females (63 .8%), and were Malays (63.1%). Most of them (98.4%) were married, and 40.3% have no formal education. They were mostly self-employed or housewives (92.1 %). About 47.1% have family size of 4-5 persons, and more than half (61.7%) have monthly household income between RM500 to RM999. There was statistically significant difference (p<0.01) in terms of the respondents' age, gender, race, marital status, education level, occupation, family size, and monthly household income. The medication adherence rate was the lowest for follow-up treatment (24.2%). The adherence rates were also low for other treatment indicators such as taking amount of medication (3l.7%), frequency (38.9%), and duration of treatment (26%). The respondents' socio-demographic and economic aspects such as age, race, education level, occupation, household IIlcome, clinic distance, and transportation costs had statistically significant associations (p<0.05) with medication adherence. However, there was no statistically significant association (p>0.05) between gender, marital status, family size and medication adherence. Low level of education, poor income, clinic distance, and transportation costs have resulted in poor access to health care among the respondents. There was statistically significant association (p<0.05) between the respondents' perceptions about diabetic condition, diabetic control, seriousness of DM and its complications with medication adherence. The respondents aged 60 years and above have poorer adherence than others. Forgetfulness and complex treatment regimen were the main causes for non-adherence. Health beliefs about the seriousness of OM, benefits of treatment, barriers, and self-efficacy in taking medication have statistically significant association (p<0.05) with medication adherence. There was also statistically significant association (p<0.05) between cues to action in taking medication with medication adherence. The study has found that belief about the seriousness of OM was the strongest predictor of medication adherence. The other predictors were beliefs about the benefits of treatment and self-efficacy in taking medication. Medication adherence may be improved by modifying the relevant health beliefs about the disease and its management. Adherence may also be improved by addressing the problems of poor access to health care among the respondents

Factors affecting discrimination toward people with HIV/AIDS in Sarawak, Malaysia

Introduction: The issue of discrimination is related not only to people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWH), but also the community around them. The study aimed to determine the perceived level of discrimination toward people with HIV/AIDS among the adult people in Sarawak, Malaysia and also to determine the factors associated with it. Material and methods: This was a community-based cross-sectional study conducted in rural areas of Sarawak. A total of 900 adults aged 18 years and above were selected by gender-stratified multistage cluster sampling technique. Data were collected by face-to-face interview using interviewer-guided questionnaires. Stepwise multiple linear regression analysis was performed using SPSS version 22.0 to identify the factors associated with HIV/AIDS-related discrimination towards PLWH. A p-value less than 0.05 was considered to be statistically significant. Results: The mean (SD) age for male and female respondents was 41.57 (13.45) and 38.99 (13.09) years respectively. The composite mean score for total discrimination was higher among female (mean = 2.66, SD = 0.6) than male (mean = 2.47, SD = 0.6) respondents. Domain-wise discrimination of HIV/AIDS found that isolation, verbal discrimination, loss of resources, loss of services and total discrimination were significantly high among the females (p < 0.05) compared to males. Stepwise multiple linear regression analysis revealed that ethnicity, religion, knowledge on HIV, an acquaintance of HIV and household income appeared to be potential predictors for discrimination towards peoples living with HIV/AIDS (p < 0.05). Conclusions: HIV/AIDS-related discrimination towards 0 coexisted among the community in Sarawak, and this called for a specific socio-culturally accepted intervention to eliminate the discrimination against people with HIV/AIDS