Knowledge, beliefs and behaviours related to second-hand smoke and smoking in the home: a qualitative study with men in Malaysia

Introduction Despite the health risks associated with second-hand smoke (SHS) exposure, smoking in the home is common in Malaysia, and almost exclusively a male behaviour. This study explored male smokers’ knowledge, beliefs and behaviours related to SHS exposure and smoking in the home, to guide future intervention development. Methods Twenty-four men who smoked and lived in Klang Valley, Kuantan or Kuala Terengganu took part in semi-structured interviews which explored knowledge and beliefs regarding SHS in the home, and associated home smoking behaviours. Data were managed and analysed using the framework approach. Results There was limited knowledge regarding the health risks associated with SHS: the smell of SHS in the home was a more prominent concern in most cases. Many had no rules in place restricting home-smoking, and some suggested that smoking in specific rooms and/or near windows meant SHS was not ‘shared’ with other household members. A few fathers had created but not maintained a smoke-free home prior to and/or after their children were born. Desire to smoke in the home conflicted with men’s sense of responsibility as the head of the household to protect others and set a good example to their children. Conclusions Men’s home-smoking behaviours are shaped by a lack of understanding of the health risks associated with SHS exposure. Gaining a broader understanding of the factors that shape men’s decisions to create a smoke-free home is important to facilitate the development of culturally-appropriate interventions that address their responsibility to protect other household members from SHS exposure. Implications Our findings highlight the need for public information campaigns in Malaysia to educate men who smoke regarding the health harms associated with SHS in the home and the ways in which SHS travels and lingers in household air. This is important given men’s concerns about SHS often focus on the smell of cigarette smoke in the home. Our findings suggest a number of potential avenues for future intervention development, including household and community-level initiatives which could build on men’s sense of responsibility as the head of the household and/or their general desire to protect their family.Output Status: Forthcoming/Available Onlin

Prevalence of anti-Leptospira antibodies and associated risk factors in the Malaysian refugee communities

BackgroundRefugees in Malaysia, who are afflicted by poverty, conflict and poor health, are vulnerable to a range of zoonotic infections in the deprived environmental and social conditions under which they live. Exposure to infections such as leptospirosis, for which rodents are primary hosts, is of particular concern.MethodsA wellness program was conducted to determine the presence of antibodies against Leptospira (seroprevalence) in 11 refugee community schools and centers in the Klang Valley, Malaysia. A total of 433 samples were assessed for IgG and IgM antibodies against Leptospira, using enzyme-linked immunosorbent assays (ELISA).ResultsOverall Leptospira seroprevalence was 24.7%, with 3.0% being seropositive for anti-Leptospira IgG and 21.7% for anti-Leptospira IgM. Factors significantly associated with overall Leptospira seroprevalence included: age, ethnicity, pet ownership, knowledge of disease and awareness of disease fatality. For IgM seroprevalence, significant risk factors included sex, ethnicity, eating habits with hands, pet ownership, the presence of rats, walking in bare feet and water recreation visits.ConclusionsThese findings highlight the need for improvements in health and well-being among the refugee community through disease awareness programs and provision of healthy behavior programs, particularly in hygiene and sanitation through community engagement activities

Measuring secondhand smoke in homes in Malaysia: A feasibility study comparing indoor fine particulate (PM2.5) concentrations following an educational feedback intervention to create smoke-free homes during the COVID-19 pandemic

Introduction Extensive regulations have been introduced to reduce secondhand smoke (SHS) exposure among non-smokers in Malaysia. However, there is still a need to encourage behavior change of smokers in relation to making homes smokefree. This feasibility study aimed to use low-cost air pollution monitors to quantify SHS concentrations in Malaysian households and to explore the practicality of using personalized feedback in educating families to make their homes smoke-free. Methods A total of 35 smokers in three states in Malaysia were recruited via snowball and convenience sampling methods. Indoor fine particulate (PM 2.5 ) concentrations in participants’ homes were measured for 7 days before and after educational intervention using a pre-defined template, which included personalized airquality feedback, and information on SHS impacts were given. The feedback was delivered over two 20-minute phone calls or in-person sessions following the completion of the air-quality measurements. Data were corrected for outdoor PM 2.5 concentrations from the nearest environmental monitor. Results Despite the challenges in conducting the project during COVID-19 pandemic, the delivery of the intervention was found to be feasible. Twenty-seven (77%) out of 35 participants completed PM 2.5 measurements and received a complete intervention. The median (IQR: 25th –75th percentile concentrations) SHS-PM 2.5 concentrations at baseline and follow-up were 18.3 μg/m 3 (IQR: 13.3–28.3) and 16.2 μg/m 3 (IQR: 10.4 – 25.6), respectively. There was a reduction of SHS-PM 2.5 concentrations at follow-up measurement in the houses of 17 participants (63%). The change in corrected indoor PM 2.5 concentrations between baseline and followup was not statistically significant (Z= -1.01, p=0.29). Conclusions This educational intervention, combining the use of a low-cost air particle counter with personalized air-quality feedback, was found to be feasible in the Malaysian setting. It has potential to trigger behavior change among smokers, reducing indoor smoking and consequent SHS concentrations, and increasing smoke-free home implementation. A large-scale trial is needed