Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers

Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of this study was to determine the prevalence of EC use and the socio-demographic and smoking characteristics associated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among ex- smokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups

Perception of harms and benefits of electronic cigarettes among adult Malaysian men: a comparison by electronic cigarette use and smoking status

Little is known about the perceptions of harm and benefit associated with the use of e-cigarettes in Malaysia. This was a cross-sectional analysis of a nationally representative sample comprising 1987 males (≥18 years of age). Current, former, and never users of conventional cigarettes and/or e-cigarettes participated in a questionnaire study conducted via face-to-face interviews. The relationship between participant characteristics and perceptions of harm and benefit of e-cigarettes were determined with multivariable logistic regression. There were 950 current, 377 former, and 660 never users of e-cigarettes. Government employees (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.29-2.66, P = .001), private sector employees (OR = 1.67, 95% CI = 1.27-2.18, P = .001), and the self-employed people (OR = 1.68, 95% CI = 1.312.17, P = .001) were more likely to perceive e-cigarettes as more harmful than conventional cigarettes compared with respondents who were not wage earners. All current users in the form of e-cigarette users (OR = 7.87, 95% CI = 3.23-19.18), conventional cigarette smokers (OR = 1.80, 95% CI = 1.39-2.33), and dual users (OR = 8.59, 95% CI = 4.76-15.52) were more likely to perceive e-cigarettes as useful in quitting conventional cigarette smoking compared with former and never users. Our findings constitute an important snapshot into the perceptions of e-cigarette harms and benefits, which could inform targeted public health messaging strategies

Gaps in the management of diabetes in Asia: A need for improved awareness and strategies in men's sexual health

Abstract Sexual dysfunction, which is defined as ‘difficulty during any stage of the sexual encounter that prevents or impairs the individual or couple from enjoying sexual activity’, is globally prevalent in males with prediabetes and diabetes. It is an early harbinger of cardiovascular diseases and has a profound impact on one's physical, mental, and social health. Among patients with either prediabetes or diabetes, the most common male sexual dysfunctions are hypogonadism, erectile dysfunction, and premature ejaculation. In Asia, although sexual health is an important factor of men's health, it is rarely discussed freely in real‐life practice. Addressing sexual health in Asian males has always been challenging with multiple barriers at the levels of patients and health care providers. Therefore, the assessment and management of sexual dysfunction in routine clinical practice should involve a holistic approach with effective patient–provider communication. In this review, we discuss the epidemiology, pathophysiology, and the management of hypogonadism, erectile dysfunction, and premature ejaculation among males with either prediabetes or diabetes (type 1 and type 2), as well as the evidence gaps across Asia

Perceptions of electronic cigarette between current and former users: Findings from the national electronic cigarette survey among Malaysian adults 2016

Introduction: The use of electronic cigarettes (e-cigarettes) has increased rapidly around the world. In Malaysia, apart from tobacco smoking, the use of e-cigarette has emerged as an alternative habit among the population. Among the reasons given by the users are to help them to quit or to cut down tobacco smoking. The objective of this study is to identify differences in the perceptions about e-cigarette between the former and the current users. Method: A nationwide household survey was conducted in 2016 to study the use of electronic cigarettes among Malaysian adults. A multistage stratified sampling method was used and about 3500 Living Quarters (LQs) were sampled. All eligible respondents aged 18 years and above were included in the survey. Respondents were asked on e-cigarette use and their perceptions about e-cigarettes. Analysis were done to identify differences in the perceptions about e-cigarette between the former and the current e-cigarette users. Results: A total of 4,288 adults participated in the survey, where 110 and 289 were identified as current and former e-cigarette users respectively. Compared to the current e-cigarette users, the former e-cigarette users were more likely to disagree that e-cigarette helps people to quit tobacco smoking (OR: 2.6), helps people to maintain cigarette abstinence (OR: 2.7), helps people to cut down tobacco smoking (OR: 2.5), is less harmful to health of the user compared to tobacco smoking (OR: 2.6), is less addictive than tobacco cigarette (OR: 2.6), the vapour is less harmful to others compared to tobacco smoke (OR: 2.4) should be allowed in places where smoking is banned (OR: 2.5) and should be regulated rather than banned completely (OR: 1.8). Conclusion: Significant differences in the perceptions about e-cigarette were observed between the former and the current e-cigarette users. Continuous health education should be given to change the perceptions about e-cigarette among the users

Tailoring the Chemical and Structural Properties of Graphene Oxide Nanoplatelets Synthesised at Room Temperature with Different Processing Times

© Penerbit Universiti Sains Malaysia, 2017. A simplified Hummer\u27s method was successfully used in synthesising graphene oxide nanoplatelets. These nanoplatelets were synthesised at room temperature at various processing times (24 h, 72 h, and 120 h). Ultraviolet visible spectroscopy (UVvis) showed that all synthesised graphene oxide nanoplatelets suspensions have similar broad shoulder absorbance at a wavelength of 300 nm. Furthermore, similar functional groups were detected by Fourier transform infrared spectroscopy (FTIR) across all types of graphene oxide nanoplatelets structures. The effect of processing time on the thickness of the sheet size was interpreted through topology using atomic force microscopy (AFM). The structural properties of graphene oxide nanoplatelets were evaluated using X-ray diffraction (XRD). The results showed a slight increase in the interlayer spacing with no sharp distinction in the crystallinity for graphene oxide nanoplatelets at longer processing times. The ratio of carbon to oxygen composition on the surface of each synthesised graphene oxide nanoplatelet was computed using the X-ray photoelectron spectroscopy (XPS). Field emission scanning electron microscopy (FESEM) was used to determine the morphology of the nanoplatelets. Three steps of degradation occurred during the thermogravimetric analysis (TGA). Degradation peaks were identified using differential scanning calorimetry (DSC). Electrical properties were characterised using the four-probe conductivity method. It can be concluded that properties such as sheet size, thickness, morphology and electrical conductivity of the graphene oxide nanoplatelets can be tuned by varying the processing time while maintaining its chemical characteristics

A comparison of electronic cigarette smokers among urban and rural Malaysia

Introduction: The increasing popularity of electronic cigarettes (ECV) in Malaysia, has made it important to find out its pattern of use. The objective of this study was to determine the pattern of ECV use among urban and rural ECV users in Malaysia. Methods: A household population survey was designed to represent Malaysian adults >18 years old by urbanity at national level. A multistage stratified cluster random sampling with probabilities proportional to size (PPS), stratified by state and by urban/rural areas was done. Respondents were from six zones (North, Central, South, East, Sabah and Sarawak) who answered the NECS Questionnaire Survey Form on demographics and characteristics of ECV use. Results: A total of 4,288 individuals (72% urban) were recruited. Majority were 25-44 years old (44%), Malay (73%), Muslim (79%), married (68%) and educated to secondary education (69%). Majority (86.5%) of current ECV users started ECV use at age) =19 years old. The main reason to use ECV was to experiment (47.0%), to quit tobacco cigarette smoking (16.2%), to reduce tobacco cigarette consumption (9.6%), to reduce the cost of smoking (7.3%), and to replace tobacco smoking (5.4%). Most of the current ECV users preferred third generation devices or mechanical mods (71.9%). Overall, 55.2% of current ECV users shared their ECV liquid among friends, 48.3% obtained ECV liquid from vape shops, 7.7% from online sources, 6.0% from kiosks at shopping centres, and 2.8% from night markets. Chi Square test indicated that the only significant different predictor between urban and rural ECV users was age (p=0.03). Discussion: The majority of ECV users are young Malay Muslim males who preferred third generation devices and obtained ECV liquid from vape shops. Predictors of ECV use is important when planning public health policy for the prevention of further and future ECV use

Perception of e-cigarette harm and benefit - a nationwide survey comparing characteristics between electronic cigarette users, conventional cigarette smokers and dual users

Introduction: We conducted a nationally representative study to identify characteristics of current (e-cigarette users, conventional cigarette smokers, and dual users), former and never smokers linked to perceptions of harm and benefit associated with e-cigarette use. Methods: A crosssectional questionnaire survey of 1,987 adults (≥18 years) males was conducted via face-to-face interviews. Survey questions included sociodemographic and smoking-related variables, and questions relating to perceptions of harm and benefit associated with e-cigarette use. Logistic regression was used to identify sociodemographic characteristic linked to the perception of harm and benefit associated with e-cigarettes between types of EC users and smokers, with never smokers as the reference group. Results: Overall, older respondents aged ≥65 years (OR=1.736, CI 0.821-2.260), civil servants (OR=1.721, CI 1.085-2.729), non-governmental organisations (OR=1.570, CI 1.066-2.311) and the selfemployed (OR=1.469, CI 1.016-2.123) were more likely to perceive e-cigarettes as harmful. Conventional cigarette smokers (OR=0.759, CI 0.6090.946) as well as dual users (OR=0.537, CI 0.323-0.893) were less likely to perceive e-cigarettes as harmful. EC users (OR=8.353, CI 3.401-20.517), conventional cigarette smokers (OR=1.948, CI 1.497-2.537), dual users (OR=9.657, CI 5.300-17.596) and former smokers (OR=1.545, CI 1.1332.108), those younger (18-24 years, OR=2.252, CI 1.234-4.109; 25-44 years, OR=1.750, CI 1.055-2.903), were more likely to perceive e-cigarettes as beneficial. However, those with secondary education (OR=0.528, CI 0.379-0.736) and university or college degrees (OR=0.528, CI 0.379-0.736) were less likely to perceive e-cigarettes as beneficial. Discussion: Our findings constitute an important snapshot into the differences between types of EC users or smokers, as well as identifies characteristics associated with perceptions of EC harm and benefit in a nationally representative sample