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      Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA)

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          Abstract

          INTRODUCTION

          Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers.

          METHODS

          Our sample consisted of 1348 youth aged 10–17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth).

          RESULTS

          Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38–99.8) frequent smokers (AOR=4.41, 95% CI: 2.05–9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41–10.02) and upper secondary (AOR=4.74, 95% CI: 1.72–13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant.

          CONCLUSIONS

          The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.

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          Most cited references22

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          Psychosocial factors related to adolescent smoking: a critical review of the literature

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            Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.

            To determine the relation between extent of restrictions on smoking at home, at school, and in public places and smoking uptake and smoking prevalence among school students. Cross sectional survey with merged records of extent of restrictions on smoking in public places. United States. 17 287 high school students. Five point scale of smoking uptake; 30 day smoking prevalence. More restrictive arrangements on smoking at home were associated with a greater likelihood of being in an earlier stage of smoking uptake (P<0.05) and a lower 30 day prevalence (odds ratio 0.79 (95% confidence interval 0.67 to 0.91), P<0.001). These findings applied even when parents were smokers. More pervasive restrictions on smoking in public places were associated with a higher probability of being in a earlier stage of smoking uptake (P<0.05) and lower 30 day prevalence (0.91 (0.83 to 0.99), P=0.03). School smoking bans were related to a greater likelihood of being in an earlier stage of smoking uptake (0.89 (0.85 to 0.99), P<0.05) and lower prevalence (0. 86 (0.77 to 0.94), P<0.001) only when the ban was strongly enforced, as measured by instances when teenagers perceived that most or all students obeyed the rule. These findings suggest that restrictions on smoking at home, more extensive bans on smoking in public places, and enforced bans on smoking at school may reduce teenage smoking.
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              'If I don't smoke, I'm not a real man'--Indonesian teenage boys' views about smoking.

              With a lack of tobacco control and regulation at the national level, Indonesia has been targeted by many national and transnational tobacco companies. The prevalence of youth smokers in Indonesia in 2005 was 38% among boys and 5.3% among girls. The aim of this study was to describe and analyse beliefs, norms and values about smoking among teenage boys in a rural setting in Java, Indonesia. Six focus group discussions with boys aged 13-17 years were conducted using a thematic discussion guide. Four themes were derived from the descriptive content analysis: (i) smoking as a culturally internalized habit, (ii) striving to become a man, (iii) the way we smoke is not dangerous and (iv) the struggle against dependency. Cultural resistance against women smoking in Indonesia remains strong. The use of tobacco in the construction of masculinity underlines the importance of gender-specific intervention. National tobacco control policy should emphasize a smoking-free society as the norm, especially among boys and men, and regulations regarding the banning of smoking should be enforced at all levels and areas of community. A comprehensive community intervention programme on smoking prevention and cessation should be a major focus of tobacco control policies in Indonesia.
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                Author and article information

                Journal
                Tob Induc Dis
                Tob Induc Dis
                TID
                Tobacco Induced Diseases
                European Publishing on behalf of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID)
                2070-7266
                1617-9625
                05 November 2018
                2018
                : 16
                : 51
                Affiliations
                [1 ]Institute for Medical Research, Kuala Lumpur, Malaysia
                [2 ]Jabatan Kesihatan Negeri Perlis, Perlis, Malaysia
                [3 ]Institute of Public Health, Kuala Lumpur, Malaysia
                [4 ]Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
                Author notes
                CORRESPONDENCE TO Kuang Hock Lim. Institute for Medical Research, Jalan Pahang 50588, Kuala Lumpur, Malaysia. E-mail: keelimkota@ 123456yahoo.com
                Article
                51
                10.18332/tid/96297
                6659477
                31516448
                ed0a5918-ee93-42db-ae03-3e55b75a6c86
                © 2018 Lim K. H

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License.

                History
                : 13 June 2018
                : 17 September 2018
                : 26 September 2018
                Categories
                Research Paper

                Respiratory medicine
                source of cigarettes,malaysian youth,frequent smokers,tecma
                Respiratory medicine
                source of cigarettes, malaysian youth, frequent smokers, tecma

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