Prevalence and factors associated with smoking among form four students in Petaling District, Selangor, Malaysia

A cross-sectional study was conducted among form four students of secondary schools in the District of Petaling, Selangor, Malaysia from February 2008 to June 2008 with the aim of quantifying the prevalence of smoking and identifying the psychosocial factors related to smoking among adolescents in this district. A two-stage stratified sampling strategy was used to obtain a sample of 1300 students based on an estimated prevalence of 10%. The response rate was 80.5% (1045 out of 1298 students). Results showed that prevalence of smoking was higher among male students (22.3%) compared to females (5.5%) and the median age at smoking initiation was lower among males compared to female smokers (14 years old vs 15 years old). Modifiable risk factors associated with smoking were "percentage of friends who smoke" (OR 2.94, 95% CI [1.71- 5.06]) and "having a brother who smokes" (OR 1.97, 95% CI [1.20-3.31]). There was also a correlation between smoking prevalence and the number of risk factors present. Intensification of health education and anti-smoking programmes and modification of external factors in early adolescence are recommended to prevent smoking initiation.