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Induction of ROS‑mediated cell death and activation of the JNK pathway by a sulfonamide derivative

Ahmad R, Vaali-Mohammed MA, Elwatidy M, Al-Obeed O, Al-Khayal K, Eldehna WM, et al.

Int J Mol Med, 2019 Jul 23.
PMID: 31364730 DOI: 10.3892/ijmm.2019.4284

The emergence of colorectal cancer in developed nations can be attributed to dietary habits, smoking, a sedentary lifestyle and obesity. Several treatment regimens are available for primary and metastatic colorectal cancer; however, these treatment options have had limited impact on cure and disease‑free survival, and novel agents need to be developed for treating colorectal cancer. Thus, the objective of this study was to explore the anticancer mechanism of a benzo(1,3)dioxol‑based derivative of sulfonamide. The compound's inhibitory effect on cell proliferation was determined using the MTT assay and the xCelligence RTDP machine. Alternations in the expression of Bcl‑2 and inhibitor of apoptosis protein families were detected by western blotting. Apoptotic marker protein expression, including cytochrome c and cleaved poly(ADP‑ribose)polymerase was measured in the cytosolic extract of cells. Apoptosis and necrosis were detected by flow cytometry and immunofluorescence. Reactive oxygen species (ROS), and activation of caspase‑3 and caspase‑7 were measured using flow cytometry. Activation of the JNK pathway was detected by western blotting. We investigated the molecular mechanism of action of the sulfonamide derivative on colorectal cancer cells and found that the compound possesses a potent anticancer effect, which is primarily exerted by inducing apoptosis and necrosis. Interestingly, this compound exhibited little antiproliferative effect against the normal colonic epithelial cell line FHC. Furthermore, our results showed that the compound could significantly increase ROS production. Apoptosis induction could be attenuated by the free oxygen radical scavenger N‑acetyl cysteine (NAC), indicating that the antiproliferative effect of this compound on colorectal cancer cells is at least partially dependent on the redox balance. In addition, JNK signaling was activated by treatment with this derivative, which led to the induction of apoptosis. On the contrary, a JNK inhibitor could suppress the cell death induced by this compound. Our findings thus suggested a novel anticancer mechanism of a benzo(1,3)dioxol‑based derivative of sulfonamide for colorectal cancer cells and may have therapeutic potential for the treatment of colorectal cancer; however, further investigation is required.

Matched MeSH terms: Smoking
Fulltext Cytogenetic analysis of buccal cells from farmers in Tanjung Karang and Kelantan who were exposed to pesticides

Ahmad Rohi Ghazali, Maziani Abdullah, Asmah Hamid, Asmariah Ahmad, Tava Shelan Nagapan, Ismarulyusda Ishak, et al.

Jurnal Sains Kesihatan Malaysia, 2018;16(101):1-8.
MyJurnal

Pesticides and chemical fertilizers are widely used in agriculture to increase crop productivity among farmers. However, exposure to pesticides will give potential risk to human health. The aim of this study was to analyze the frequency of micronucleus (MN) and binucleus (BNu) formation in buccal cells from farmers who were exposed to pesticides using the MN assay. Buccal swabs were collected from the farmers in Tanjung Karang (n = 32) and Kelantan (n = 43) using wooden tongue depressor. A structured questionnaire was used to obtain demographic data of the farmers. Cytogenetic analysis was carried out by Acridin Orange (AO) staining 0.0025% (w/v). The frequency of MN and BNu as the biomarkers for cytogenetic damage was observed by using a fluorescence microscope. Comparison of frequency of MN and BNu is conducted in two areas namely Tanjung Karang, Selangor and Kelantan because of the agricultural activity and the type of pesticides used are different. Results showed that the frequencies of both MN and BNu among farmers in Tanjung Karang were significantly higher (p < 0.05) compared to farmers in Kelantan. Meanwhile, for the socio-demographic factors (age, smoking status, working period), MN and BNu frequencies among farmers in Tanjung Karang were also significantly higher (p < 0.05) as compared to farmers in Kelantan. While in the aspect of pesticide exposure, the frequencies of MN and BNu showed no significant difference between the frequency of pesticide spraying (p > 0.05) and the practices of PPE (Personal Protective Equipment) (p > 0.05). This may suggests that cytogenetic changes were not influenced by these factors. In addition, correlation study shows positive correlation between the frequency of MN with the pesticide exposure of farmers in Tanjung Karang (p > 0.05, r = 0.015) and Kelantan (p > 0.05, r = 0.0158). Besides, the frequency of BNu also has a positive correlation with the pesticide exposure among farmers in Tanjung Karang (p > 0.05, r = 0.036) and farmers in Kelantan (p > 0.05, r = 0.013). Hence, this present study demonstrated that exposure to pesticides increased the formation of MN and BNu among farmers and the prolonged use of pesticides may induce genotoxicity and DNA damage to human

Matched MeSH terms: Smoking
Fulltext Risk factors for diabetic nephropathy among non insulin dependent patients who attended city hall’s staff clinic in Kuala Lumpur

Ahmad U, Mohd Nor MI, Ali O

Malaysian Journal of Public Health Medicine, 2001;1(1):16-21.
MyJurnal

Diabetes mellitus and its main complication, nephropathy, ajjbcts the economic wellbeing and quality of Iife of the sufferers and the population. A matched case control study was conducted in September 1998 to investigate the factors involved with nephropathy such as diabetic control, smoking, hypertension, familv history of diabetes and diabetic duration. Respondents were classyied based on the presence of microalbuminuria or macroalbuminuria, Seventy-two pairs of case and control were studied Duration of diabetes Q2 = 0.005), presence of lethargy and weakness prior to diabetes diagnosis @7 = 0.019), duration of smoking @7 = 0.014), duration of hypertension @2: 0.000), systolic hypertension Qu= 0e 025), uncontrolled diabetes with poor HbA1c level (v= 0.02Q and lack of diabetes knowledge Q2 = 0.037) were jbctors which related signyicantlv to nephropathy by univariate anahrsis. In multivariate anahrsis, systolic hypertension (p = 0.0015), lack of diabetes knowledge (17 = 0.0197), presence of lethargy symptom Q7 = 0.0027), prolonged diabetic duration @ = 0.0301) and higher body mass indices (p = 0. 0213) were predictors to diabetic nephropathy.

Matched MeSH terms: Smoking
Fulltext Amphetamine type stimulant (ATS) induced psychosis: A rising problems in Malaysia

Ahmad, H.S.

Malaysian Journal of Psychiatry, 2008;17(2):1-4.
MyJurnal

The past decade has seen a marked increase in the popularity of ATS use, particularly methamphetamine, within East Asia,and the Pacific region. In Malaysia, the National Anti Drug Agency has identified 8,870 addicts (from January till August 2008) out of which 1,126 was ATS dependence. During the same period, the police have arrested 46,388 people under the Dangerous Drug Act 1952. They also has seize 283kg of syabu, 545kg of ecstacy powder, 66194 tablets of esctacy pills and 222,376 tablets of yaba pills from Jan till August this year. The occurrence of psychosis arising from the use of ATS was first reported in the late 1930's. With growing ATS use, particularly methamphetamine, ATS-induced psychosis has become a major impact on public health.Symptoms of ATS-induced psychosis: Methamphetamine use produces a variety of effects, ranging from irritability, to physical aggression, hyperawareness, hypervigilance, and psychomotor agitation. Repeated or high-dose use of the stimulant can cause drug-induced psychosis resembling paranoid schizophrenia, characterized by hallucinations, delusions and thought disorders. When used in long term, methamphetamine may lead to development of psychiatric symptoms due to dopamine depletion in the striatum. The most common lifetime psychotic symptoms among methamphetamine psychotic patients - as reported in a cross-country study involving Australia, Japan, the Philippines and Thailand - are persecutory delusion, auditory hallucinations, strange or unusual beliefs and thought reading. Those patients were also reported to suffer from impaired speech, psychomotor retardation, depression and anxiety. An ATS psychosis can be distinguished from primary psychotic disorders by time. In ATS-induced psychosis symptoms usually resolve after the drug is discontinued. If symptoms do not resolve within 2 weeks after cessation of stimulant use, a primary psychiatric disorder should be suspected. When compared with other stimulants, such as cocaine, psychosis is induced more commonly by ATS, possibly due to the longer duration of action produced by amphetamines.For example, while smoking cocaine produces a high that lasts for 20-30 minutes, smoking methamphetamine produces a high that lasts 8-24 hours. Other symptoms of ATS-induced psychosis reported include affective blunting,(6) violent behavior, and self-mutilation and self-injurious behavior.

Matched MeSH terms: Smoking
Fulltext Comparison of tobacco import and tobacco control in five countries: lessons learned for Indonesia

Ahsan A, Wiyono NH, Veruswati M, Adani N, Kusuma D, Amalia N

Global Health, 2020 07 18;16(1):65.
PMID: 32682431 DOI: 10.1186/s12992-020-00595-y

BACKGROUND: With a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018. However, the government still has not ratified the Framework Convention on Tobacco Control. In the meantime, tobacco import increases rapidly in Indonesia. These create a double, public health and economic burden for Indonesia's welfare.
OBJECTIVE: Our study analyzed the trend of tobacco import in five countries: Indonesia, Pakistan, Bangladesh, Zimbabwe, and Mozambique. Also, we analyze the tobacco control policies implemented in these countries and determine some lessons learn for Indonesia.
METHODS: We conducted quantitative analyses on tobacco production, consumption, export, and import during 1990-2016 in the five countries. Data were analyzed using simple ordinary least square regressions, correcting for time series autocorrelation. We also conducted a desk review on the tobacco control policies implemented in the five countries.
RESULTS: While local production decreased by almost 20% during 1990-2016, the proportion of tobacco imports out of domestic production quadrupled from 17 to 65%. Similarly, the ratio of tobacco imports to exports reversed from 0.7 (i.e., exports were higher) to 2.9 (i.e., import were 2.9 times higher than export) in 1990 and 2016, respectively. This condition is quite different from the other four respective countries in the observation where their tobacco export is higher than the import. From the tobacco control point of view, the four other countries have ratified the Framework Convention on Tobacco Control (FCTC).
CONCLUSION: The situation is unlikely for Indonesia to either reduce tobacco consumption or improve the local tobacco farmer's welfare, considering that the number of imports continued to increase. Emulating from the four countries, Indonesia must ratify the FCTC and implement stricter tobacco control policies to decrease tobacco consumption and import.

Matched MeSH terms: Smoking
Fulltext Randomized controlled trial on the effect of Al-Quran recitation vs counseling on smoking intensity among Muslim men who are trying to quit smoking

Aida Maziha Z, Imran A, Azlina I, Harmy MY

Malays Fam Physician, 2018;13(2):19-25.
PMID: 30302179 MyJurnal

Introduction: Nicotine cravings and withdrawal symptoms are associated with higher rates of relapse. It has been shown that combining behavioral therapy and pharmacotherapy leads to a higher long-term abstinence rate in those who quit smoking. Al-Quran recitation has been proven to reduce anxiety among athletes before tournaments and pulse and heart rates among patients awaiting cardiac operations. As most of the patients who wish to stop smoking experience high-anxiety states, we postulate that Al-Quran recitation will also able to reduce craving among smokers attempting to quit smoking.

Methods: Fifty smokers from an outpatient clinic were randomly assigned to control and intervention groups. They were taught different ways of coping with smoking urges, i.e., counseling using the 12'M' method (control group) versus Al-Quran recitation (intervention group). They met for four consecutive weeks of counselling and to fill out a withdrawal scale. Carbon monoxide (CO) levels were tested at baseline and at week 4. At week 12, the number of cigarettes smoked was measured again. The decrease in the number of cigarettes considered to be clinically significant for the calculation of sample size was based on expert opinion.

Results: The reduction in the number of cigarettes smoked was 7 cigarettes in the counselling group and 9 cigarettes in Al-Quran recitation group over 12 weeks duration. There was a statistically significant difference in the number of cigarettes smoked between the groups. There was also a statistically significant difference in the change in cravings between the groups at week 4 (p-value = 0.005). However, the difference in the changes in CO levels between the two groups was not statistically significant.

Conclusion: Al-Quran recitation produced a statistically significant reduction in the number of cigarettes smoked at week 12 and a significant change in cravings at week 4 among smokers attempting to quit. Difference in smoking abstinence rates was not measured in this study.

Matched MeSH terms: Smoking
Loss of weight in a female heavy smoker with diffuse interstitial pulmonary fibrosis

Al-Adsani A, Dahniya MH, Al-Adsani N

Postgrad Med J, 2001 Feb;77(904):127, 137-8.
PMID: 11161092
Matched MeSH terms: Smoking/adverse effects*
Independent determinants of periodontitis in Yemeni adults: A case-control study

Al-Alimi A, Halboub E, Al-Sharabi AK, Taiyeb-Ali T, Jaafar N, Al-Hebshi NN

Int J Dent Hyg, 2018 Nov;16(4):503-511.
PMID: 29963753 DOI: 10.1111/idh.12352

OBJECTIVES: The relative importance of risk factors of periodontitis varies from one population to another. In this study, we sought to identify independent risk factors of periodontitis in a Yemeni population.
METHODS: One hundred and fifty periodontitis cases and 150 healthy controls, all Yemeni adults 30-60 years old, were recruited. Sociodemographic data and history of oral hygiene practices and oral habits were obtained. Plaque index (PI) was measured on index teeth. Periodontal health status was assessed using Community Periodontal Index (CPI) and Clinical Attachment Loss (CAL) according to WHO. Periodontitis was defined as having one or more sextants with a CPI score ≥ 3. Multiple logistic regression modelling was employed to identify distal, intermediate and proximal determinants of periodontitis, while ordinal regression was used to identify those of CAL scores.
RESULTS: In logistic regression, PI score was associated with the highest odds of periodontitis (OR = 82.9) followed by cigarette smoking (OR = 12.8), water pipe smoking (OR = 10.2), male gender (OR = 3.4) and age (OR = 1.19); on the other hand, regular visits to the dentist (OR = 0.05), higher level of education (OR = 0.37) and daily dental flossing (OR = 0.95) were associated with lower odds. Somewhat similar associations were seen for CAL scores (ordinal regression); however, qat chewing was identified as an additional determinant (OR = 4.69).
CONCLUSION: Water pipe smoking is identified as a risk factor of periodontitis in this cohort in addition to globally known risk factors. Adjusted effect of qat chewing is limited to CAL scores, suggestive of association with recession.

Matched MeSH terms: Smoking/adverse effects; Smoking/epidemiology
Fulltext The influence of cigarette smoking on gingival bleeding and serum concentrations of haptoglobin and alpha 1-antitrypsin

Al-Bayaty FH, Baharuddin N, Abdulla MA, Ali HM, Arkilla MB, ALBayaty MF

Biomed Res Int, 2013;2013:684154.
PMID: 24286083 DOI: 10.1155/2013/684154

The objectives of this study were to evaluate the influence of cigarette smoking on gingival bleeding and serum concentrations of cotinine, haptoglobin, and alpha 1-antitrypsin in Malaysian smokers. A total of 197 male smokers and nonsmokers were recruited for this study. Plaque index, bleeding on probing (BOP), and levels of serum cotinine, haptoglobin, and alpha 1-antitrypsin were evaluated. The data were analyzed using SPSS version 20.0, with the significance level set at α ≤ 0.05. Linear regression analyses were performed. The mean cigarette consumption per day was 13.39 ± 5.75 cigarettes; the mean duration was 16.03 ± 8.78 years. Relatively low BOP values (26.05 ± 1.48) and moderate plaque indexes (51.35 ± 11.27) were found. The levels of serum cotinine (106.9 ± 30.71 ng/dL), haptoglobin (76.04 ± 52.48 mg/dL), and alpha 1-antitrypsin (141.90 ± 18.40 mg/dL) were significantly higher in smokers compared to non-smokers. Multiple logistic regression models for all variables and smokers demonstrated observed differences between BOP, the number of cigarettes per day, and duration of smoking, while serum cotinine, haptoglobin and alpha-1 antitrypsin levels showed no significant differences. Duration of smoking (years) and the cotinine level in serum showed a significant correlation with plaque index. The present analysis demonstrated that the duration of smoking in years, but not the number of cigarettes smoked per day, was associated with reduced gingival bleeding in smokers.

Matched MeSH terms: Smoking/adverse effects; Smoking/blood*
Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen

Al-Bayaty FH, Wahid NA, Bulgiba AM

J Periodontal Res, 2008 Feb;43(1):9-13.
PMID: 18230101 DOI: 10.1111/j.1600-0765.2007.00988.x

Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen.

Matched MeSH terms: Smoking/adverse effects*
Fulltext The Role of Psychosocial and Belief Factors in Self-Reported Cigarette Smoking Among University Students in Malaysia

Al-Dubai S, Ganasegeran K, Alshagga M, Hawash A, Wajih W, Kassim S

Health Psychol Res, 2014 Jan 13;2(1):1195.
PMID: 26973928 DOI: 10.4081/hpr.2014.1195

This study aimed to explore factors associated, specifically belief factors, with self-reported tobacco smoking status. A sample of 300 students was recruited from a private university in Malaysia. Data was collected using a pre-tested self-administrated questionnaire that investigated various factors including socio-demographics, socio-economic status, smoking behavior and beliefs on tobacco smoking. The main tobacco use in this study sample was cigarettes and the estimated prevalence of self-reported cigarette smoking was 10.3%. In bivariate analysis, self-reported cigarette smoking was significantly associated with socio-demographic, behavioral factors and faculty of study (P<0.05). In multivariate modeling, being male and a non-medical student, did not exercise, having a smoker father and brother or sister, suffering from financial difficulties and having the belief that smokers had more friends, all had statistically significant associations (P<0.05) with self-reported cigarette smoking. Social and interpersonal factors were associated with self-reported cigarette smoking status. A comprehensive health model focusing on changing the social norms of parent and sibling tobacco smoking and students' beliefs, alongside nurturing skills of dealing with stressful situations, warrant implementation.

Matched MeSH terms: Smoking
Fulltext Epidemiological study on tobacco smoking among university students in Damascus, Syrian Arab Republic

Al-Kubaisy W, Abdullah NN, Al-Nuaimy H, Halawany G, Kurdy S

East Mediterr Health J, 2012 Jul;18(7):723-7.
PMID: 22891520

There is a lack of data on tobacco use in the Syrian Arab Republic. This cross-sectional questionnaire survey estimated the prevalence of smoking among university students in Damascus and identified factors related to smoking. Among the 583 respondents, the overall prevalence of cigarette smoking was 20.8%. The mean age of smokers [25 (SD 2.2) years] was significantly higher than non-smokers [21 (SD 1.8) years]. Smoking prevalence among males (26.1%) was significantly higher than among females (9.5%). However, female students consumed a significantly higher number of cigarettes per day than did males [mean 21 (SD 5) versus 9 (SD 2)]. The smoking prevalence among students in non-health faculties (27.8%) was significantly higher than that of health professional students (14.5%) and was higher among students living away from their families (27.8%) than those living with their families (16.2%). The study raised concerns about smoking in student residences and women's smoking patterns.

Matched MeSH terms: Smoking/epidemiology*
Fulltext Pattern of shisha and cigarette smoking in the general population in Malaysia

Al-Naggar RA, Bobryshev YV, Anil S

Asian Pac J Cancer Prev, 2014;15(24):10841-6.
PMID: 25605187

BACKGROUND: Smoking is a primary risk factor for cancer development. While most research has focused on smoking cigarettes, the increasing popularity of shisha or water pipe smoking has received less attention. This study measured the prevalence and risk factors for shisha and cigarette smoking and related knowledge.

MATERIALS AND METHODS: This cross-sectional analytical study was conducted in Shah Alam, Malaysia. Participants aged ≥ 18 years were selected from restaurants. Data regarding demographic variables, smoking patterns, and knowledge about shisha smoking were collected in local languages. Logistic regression was performed to assess risk factors.

RESULTS: Of 239 participants, 61.9 % were male and 99.2% revealed their smoking status. Some 57.4% were smokers: 50.7% only cigarettes, 5.9% only shisha and 42% both. Mean age of starting cigarette smoking was 17.5 ± 2.4 years and for shisha smoking 18.7 ± 2.0 years. In a univariate model, male gender, age 33-52 years and monthly income > MYR 4,000 increased the risk and unemployment and being a student decreased the risk. In a multivariate model, male gender increased the risk of smoking, while being a student decreased the risk, adjusting for age and income. The perception of shisha being less harmful than cigarettes was present in 14.6% and 7.5% had the opinion that shisha is not harmful at all, while 21.7% said that it is less addictive than cigarettes, 39.7% said that shisha did not contain tar and nicotine, 34.3% said that it did not contain carbon monoxide and 24.3% thought that shisha did not cause health problems.

CONCLUSIONS: Prevalence of shisha and cigarette smoking is high in the general population in Malaysia and knowledge about shisha smoking is relatively low. The findings of our study might have implications for understanding similarities and differences in incidence of shisha and cigarette smoking in other cultural/geographic regions.

Matched MeSH terms: Smoking/epidemiology*; Smoking/psychology
Lifestyle practice among Malaysian university students

Al-Naggar RA, Bobryshev YV, Mohd Noor NA

Asian Pac J Cancer Prev, 2013;14(3):1895-903.
PMID: 23679290

BACKGROUND: It is well established that a healthy lifestyle is of benefit in the prevention of diseases such as cancer and promotion of well-being. Therefore, the objective of this study was to determine lifestyle practice and associated factors among university students in Malaysia.
MATERIALS AND METHODS: A cross sectional study was conducted over six months from November 2011 until May 2012 among the students from the Management and Science University. This study was approved by its ethical committee , the students being explained the objective and invited to participate. A consent form was signed by all study participants. Questionnaire was distributed randomly to the students of the five faculties through their lecturers in different faculty. For univariate analysis t-test and ANOVA test were performed. Multiple linear regression used for multivariate analysis using SPSS 13.0.
RESULTS: A total number of 1100 students participated with a mean age of 22.1±2.21 (SD) years. The majority were 22 years or younger (56.3%), female (54%), Malay (61.5%), single (92.3%), with family monthly income ≥5000 Ringgit Malaysia (41.2%). Regarding lifestyle, about were 31.6% smokers, 75.6% never drank alcohol and 53.7% never exercised. Multivariate analysis showed that age, sex, race, parent marital status, participant marital status, type of faculty, living status, smoking status, exercise, residency, brushing teeth, fiber intake and avoid fatty food significantly influenced the practice of drinking alcohol among university students (p=0.006, p=0.042, p<0.001, p=0.003, p=0.002, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.003, p<0.001; respectively). It similarly showed that sex, race, parent marital status, participant marital status, monthly family income, exercise, residency, brushing teeth and fiber intake significantly influenced the practice of sun protection (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.017, p<0.001, p<0.001, p<0.001; respectively) and that age, sex, parent marital status, participant marital status, type of faculty, living status, exercise, taking non- prescribed medication, brushing the teeth, coffee consumption and fiber intake were significantly influenced the practice of fruits consumption (p=0.008, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.002, p<0.001, P<0.001; respectively).
CONCLUSIONS: This study showed a poor practice of healthy lifestyle among university students. Therefore universities should emphasize a healthy lifestyle in all faculties as a required subject. Socio-demographic characteristics significantly influenced practice and thus should be considered when planning preventive measures among university students. Frequent campaigns and educational seminars are to be encouraged.

Matched MeSH terms: Smoking*
Lung cancer knowledge among secondary school male teachers in Kudat, Sabah, Malaysia

Al-Naggar RA, Kadir SY

Asian Pac J Cancer Prev, 2013;14(1):103-9.
PMID: 23534705

BACKGROUND: The objective of this study is to determine knowledge about lung cancer among secondary school male teachers in Kudat, Sabah, Malaysia.
MATERIALS AND METHODS: A cross-sectional study was conducted among three secondary schools located in Kudat district, Sabah, Malaysia during the period from June until September 2012. The protocol of this study was approved by ethics committee of Management and Science University, Malaysia. The aims were explained and a consent form was signed by each participant. Respondents were chosen randomly from each school with the help of the headmasters. Self-administrated questionnaires, covering socio-demographic characteristics and general knowledge of lung cancer, were distributed. Once all 150 respondents completed the questionnaire, they passed it to their head master for collecting and recording. All the data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. ANOVA and t-test were applied for univariate analysis; and multiple linear regression for multivariate analysis.
RESULTS: A total of 150 male secondary school teachers participated in this study. Their mean age was 35.6 ∓ 6.5 (SD); maximum 50 and minimum 23 years old. More than half of the participants were Malay and married (52%, 79%; respectively). Regarding the knowledge about lung cancer, 57.3% of the participants mentioned that only males are affected by lung cancer. Some 70.7% mentioned that lung cancer can be transmitted from one person to another. More than half (56.7%) reported that lung cancer is not the leading cause of death in Malaysian males. As for risk factors, the majority reported that family history of lung cancer is not involved. However, 91.3% were aware that cigarettes are the main risk factor of lung cancer and more than half (52%) believed that second-hand smoking is one of the risk factor of lung cancer. More than half (51.3%) were not aware that asbestos, ionizing radiation and other cancer causing substances are risk factors for lung cancer. Quitting smoking, avoiding second-hand smoking and avoiding unnecessary x-ray image of the chest (53.3%, 96.0%, 87.3%; respectively) are the main preventive measures mentioned by the participants. For the factors that influence the participants knowledge, univariate and multivariate analysis showed that only race was significant.
CONCLUSIONS: Overall, the knowledge of school male teachers about lung cancer was low. However, few items were scored high: cigarettes are the main risk factor; avoiding second-hand smoking; and avoiding x-rays. Interventions to increase lung cancer awareness are needed to improve early detection behavior. Increase the price of pack of cigarettes to RM 20 and banning smoking in public places such as restaurants are highly recommended as primary preventive measures.

Matched MeSH terms: Smoking/adverse effects
Fulltext Prevalence and of smoking and associated factors among Malaysian University students

Al-Naggar RA, Al-Dubai SA, Al-Naggar TH, Chen R, Al-Jashamy K

Asian Pac J Cancer Prev, 2011;12(3):619-24.
PMID: 21627354

OBJECTIVE: The objectives were to determine the prevalence and associated factors for smoking among university students in Malaysia.
METHODOLOGY: A cross-sectional study was conducted among 199 students in the period from December of academic year 2009 until April of academic year 2010 in Management and Science University (MSU), Shah Alam, Selangor, Malaysia. The questionnaire was distributed randomly to all faculties of MSU by choosing one of every 3 lecture rooms, as well as the library and cafeterias of the campus randomly by choosing one from every 3 tables. Questions concerned socio-demographic variables, knowledge, attitudes and practice toward smoking. Participant's consent was obtained and ethical approval was provided by the ethics committee of the University. Data entry and analysis were performed using descriptive statistics, chi square test, Student t- test and logistic multiple regression with the SPSS version 13.0, statistical significance being concluded at p < 0.05.
RESULTS: About one third of students were smokers (29%). The most important reason of smoking was stress (20%) followed by 'influenced by friends' (16 %). Prevalence of smoking was significantly higher among male and those in advanced semesters (p = >0.001, p = 0.047). Smokers had low level of knowledge (p < 0.05), had wrong beliefs on smoking (p < 0.05), and negative attitude toward tobacco control policies compared to non smokers (p < 0.05). On multiple logistic regression, significant predictors of smoking in the model were gender (p = 0.025), age (p = 0.037), semester of study (p = 0.025) and attitude toward smoking (p < 0.001).
CONCLUSION: This study found that 29% of university students were smokers. Males and students in advanced semesters were more likely to smoke. The results provide baseline data to develop an anti-smoking program to limit smoking in the university by implementing policies against smoking.

Matched MeSH terms: Smoking/epidemiology*
Nutrition and cancer prevention: knowledge, attitudes and practices among young Malaysians

Al-Naggar RA, Chen R

Asian Pac J Cancer Prev, 2011;12(3):691-4.
PMID: 21627365

OBJECTIVE: The objective of this study was to determine the knowledge, attitudes and practices of university students toward nutrition related to cancer prevention.
METHODOLOGY: A total of 396 students from the Management and Science University (MSU) participated during the semester of March 2010. Stratified random sampling was used and consent was obtained before the questionnaire was distributed. ANOVA and the t-test were used for the univariate analysis and multiple linear regression was used for the multivariate analysis.
RESULTS: The participants ages ranged from 18 to 27 years (Mean ± SD = 23.3 ± 1.57), more than half being female (62.4%). The majority were 23 years old or younger, single, Malay and from non-Medical and Health Science faculties and with a family monthly income of less than 10,000 Ringgits Malaysia(79.5%; 99%, 65.9, 52.5%, 63.9%; respectively). Only 18.4% of participants reported a family history of cancer. About 32.1% had a medical check-up in the previous 12 months and 17.4% were smokers. Multivariate analysis showed the faculty type to be significantly associated with knowledge of cancer prevention (p = 0.04). Regular medical check-ups were associated with attitudes and practices of cancer prevention (p = 0.04, p=0.003 respectively), the latter being significantly influenced by sex, family history of cancer and smoking (p = 0.034, p=0.013, p=0.002; respectively).
CONCLUSION: The majority of participants had poor knowledge of nutrition as related to cancer prevention. Attention should be given to regular medical check-ups, awareness of family history and smoking influence.

Matched MeSH terms: Smoking
Fulltext Water pipe (shisha) smoking and associated factors among Malaysian university students

Al-Naggar RA, Saghir FS

Asian Pac J Cancer Prev, 2011;12(11):3041-7.
PMID: 22393987

OBJECTIVE: The objective of this study was to determine the prevalence of waterpipe (shisha) smoking and associated factors among Malaysian university students.
METHODOLOGY: A total of 200 university students from Management and Science University participated in this study. The survey was conducted by simple random sampling by randomly distributing self-administered questionnaires to the library, cafeterias and classes. The protocol of this study was approved by the ethics committee of Management and Science University. Consent forms were obtained from the students before they answered the questionnaire. Statistical analyses were performed using the Statistical Package for Social Science (SPSS) version 13. with the Student's t-test for comparison of the mean practice and backward multiple linear regression for multivariate analysis.
RESULTS: The majority of the subjects were male, single, Malay and from urban areas (61.5%, 94.5%, 66%, 76.5%; respectively). In this study 30% of the study participants were shisha smokers. Regarding knowledge about shisha smoking, the majority (48.5%) mentioned that shisha is less harmful than cigarettes and 55% reported that shisha is less addictive. Univariate analysis showed that age, race, sex and income significantly influenced the practice of smoking shisha among university students (p=0.019, p=0.002, p=0.001, p=0.018; respectively). For multivariate analysis, income and gender demonstrated significant influence (both p=0.001).
CONCLUSION: There was a high prevalence of shisha smoking among Malaysian university students and knowledge about the dangers is low. Income and gender significantly influenced the practice of smoking shisha in our population. Banning of smoking including shisha smoking in public places is strongly recommended.

Matched MeSH terms: Smoking/epidemiology*
Prevalence of cigarette smoking and associated factors among secondary school teachers in Malaysia

Al-Naggar RA, Jawad AA, Bobryshev YV

Asian Pac J Cancer Prev, 2012;13(11):5539-43.
PMID: 23317214

OBJECTIVE: The smoking prevalence in Malaysia is high, especially among men and adolescents. This study aimed to determine the prevalence and associated factors towards cigarette smoking among school teachers in Malaysia.
METHODOLOGY: This study was a school-based cross-sectional study conducted among 495 secondary school teachers. The questionnaire used in this study consisted of 29 questions categorized into two sections: socio-demographic characteristics and smoking behaviour. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) program 13.0. ANOVA; t-tests were used in univariate analysis; multiple linear regression was applied for multivariate analysis.
RESULTS: The majority of the participants were female (81.6%), in the age group ranged between 30-39 years (44%), Malay (90.1%), married (89.7%), degree holders (85.1%), with monthly income ranged between 3000-3999 Ringgit Malaysia (33.5%), from urban areas (94.7%), their specialty is social studies (33.9%) and with no family history of cancer (83.6%). The prevalence of smoking among school teachers in Malaysia was found to be 7.8%. Regarding reasons to start smoking among school teachers: the major reason was found to be relaxation (33.3%), followed by stress-relief (28.2%). Univariate analysis showed that sex, educational status, monthly income and residency were significantly associated with smoking among school teachers (p<0.001, p=0.004, p=0.031, p=0.010; respectively). Multivariate analysis showed that gender and marital status were significantly associated with smoking among school teachers (p<0.001, p=0.033; respectively).
CONCLUSION: The prevalence of smoking among school teachers in Malaysia was found to be relatively low. Sex, marital status, educational status, monthly income and residency were significantly associated with smoking among school teachers.

Matched MeSH terms: Smoking/epidemiology*
Fulltext Shisha smoking and associated factors among medical students in Malaysia

Al-Naggar RA, Bobryshev YV

Asian Pac J Cancer Prev, 2012;13(11):5627-32.
PMID: 23317228

BACKGROUND: The aim of the study was to determine the prevalence of shisha smoking and associated factors among medical students in Malaysia.

MATERIALS AND METHODS: A cross-sectional study was conducted at the Management and Science University from December 2011 until March 2012. The questionnaire consisted of five sections including socio-demographic, social environment, knowledge about shisha, psychosocial factors, and personal shisha smoking behavior. Obtained data were analyzed using Statistical Package for the Social Sciences (SPSS 13). T-test was used to determine the relationships between shisha smoking and socio-demographic characteristic.

RESULTS: A total number of 300 medical students participated in this study. Mean age was 22.5±2.5 years. The majority were female, Malay, single, from urban areas (67%, 54%, 97%, 73%; respectively). The prevalence of shisha smoking among medical students was found to be 20%. The study revealed that many students believed that shisha does not contains nicotine, carbon monoxide, does not lead to lung cancer, dental problems and does not lead to cardiovascular diseases (25%, 20.7%, 22.3%, 29%, 26.7%; respectively). Age and sex were found to be significantly associated with smoking shisha status among medical students (p=0.029, p<0.001; respectively). Furthermore, having parents, siblings and friends smokers of shisha were found to be significantly associated with shisha smoking status (p<0.001, p<0.001, p<0.001; respectively). Furthermore, family problems, problems with friends, financial problems and university life were found to significantly associated with shisha smoking status among medical students (p<0.001, p=0.002, p<0.001, p=0.002; respectively).

CONCLUSIONS: There is a high prevalence of shisha smoking and a poor knowledge about its impact on health among medical students. More attention is needed to focus on medical education in this regard. The policies that are currently employed in order to reduce the cigarettes smoking should be applied to shisha smoking and shisha products.

Matched MeSH terms: Smoking/epidemiology*; Smoking/psychology

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