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Many roads lead to Rome--is that true of the teaching and learning of pharmacology? Lessons from three medical schools in Malaysia

Sim SM, Achike FI, Geh SL

Med J Malaysia, 2005 Aug;60 Suppl D:41-7.
PMID: 16315623

In Malaysia many new medical schools (both public and private) have been set up in the last 12 years. As a result of global changes and local adjustments made in medical training, cross-breeds of different medical curricula have produced a wide spectrum of teaching-learning methods in these medical schools. In this paper, we have selected three medical schools--two public (Universiti Malaya and Universiti Putra Malaysia) and one private (International Medical University) to illustrate different approaches in the teaching-learning of pharmacology that exist in Malaysia. How do these different teaching-learning approaches affect the students' interest and ability to "master" pharmacology and in turn to develop a good prescribing practice?

Matched MeSH terms: Schools, Medical
Measurement Invariance of the Internet Addiction Test Among Hong Kong, Japanese, and Malaysian Adolescents

Lai CM, Mak KK, Cheng C, Watanabe H, Nomachi S, Bahar N, et al.

Cyberpsychol Behav Soc Netw, 2015 Oct;18(10):609-17.
PMID: 26468915 DOI: 10.1089/cyber.2015.0069

There has been increased research examining the psychometric properties on the Internet Addiction Test (IAT) in different populations. This population-based study examined the psychometric properties and measurement invariance of the IAT in adolescents from three Asian countries. In the Asian Adolescent Risk Behavior Survey (AARBS), 2,535 secondary school students (55.9% girls) aged 12-18 years from Hong Kong (n=844), Japan (n=744), and Malaysia (n=947) completed a survey in 2012-2013 school year. A nested hierarchy of hypotheses concerning the IAT cross-country invariance was tested using multigroup confirmatory factor analyses. Replicating past findings in Hong Kong adolescents, the construct of the IAT is best represented by a second-order three-factor structure in Malaysian and Japanese adolescents. Configural, metric, scalar, and partial strict factorial invariance was established across the three samples. No cross-country differences on Internet addiction were detected at the latent mean level. This study provided empirical support for the IAT as a reliable and factorially stable instrument, and valid to be used across Asian adolescent populations.

Matched MeSH terms: Schools
Endotoxin, ergosterol, muramic acid and fungal DNA in dust from schools in Johor Bahru, Malaysia--Associations with rhinitis and sick building syndrome (SBS) in junior high school students

Norbäck D, Hashim JH, Markowicz P, Cai GH, Hashim Z, Ali F, et al.

Sci Total Environ, 2016 Mar 1;545-546:95-103.
PMID: 26745297 DOI: 10.1016/j.scitotenv.2015.12.072

This paper studied associations between ocular symptoms, rhinitis, throat and dermal symptoms, headache and fatigue in students by ethnicity and in relation to exposure to chemical microbial markers and fungal DNA in vacuumed dust in schools in Malaysia. A total of 462 students from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated (96% response rate). Dust was vacuumed from 32 classrooms and analysed for levels of five types of endotoxin as 3-hydroxy fatty acids (C10, C12, C14, C16 and C18 3-OH), muramic acid, ergosterol and five sequences of fungal DNA. Multiple logistic regression was applied. Totally 11.9% reported weekly ocular symptoms, 18.8% rhinitis, 15.6% throat and 11.1% dermal symptoms, 20.6% headache and 22.1% tiredness. Totally 21.1% reported pollen or furry pet allergy (atopy) and 22.0% parental asthma or allergy. Chinese students had less headache than Malay and Indian had less rhinitis and less tiredness than Malay. Parental asthma/allergy was a risk factor for ocular (odds ratio=3.79) and rhinitis symptoms (OR=3.48). Atopy was a risk factor for throat symptoms (OR=2.66), headache (OR=2.13) and tiredness (OR=2.02). There were positive associations between amount of fine dust in the dust samples and ocular symptoms (p<0.001) and rhinitis (p=0.006). There were positive associations between C14 3-OH and rhinitis (p<0.001) and between C18 3-OH and dermal symptoms (p=0.007). There were negative (protective) associations between levels of total endotoxin (LPS) (p=0.004) and levels of ergosterol (p=0.03) and rhinitis and between C12 3-OH and throat symptoms (p=0.004). In conclusion, the amount of fine dust in the classroom was associated with rhinitis and other SBS symptoms and improved cleaning of the schools is important. Endotoxin in the school dust seems to be mainly protective for rhinitis and throat symptoms but different types of endotoxin could have different effects. The ethnic differences in symptoms among the students deserve further attention.

Matched MeSH terms: Schools
Fulltext Prevalence of stress among medical students: a comparative study between public and private medical schools in Bangladesh

Eva EO, Islam MZ, Mosaddek AS, Rahman MF, Rozario RJ, Iftekhar AF, et al.

BMC Res Notes, 2015;8:327.
PMID: 26223786 DOI: 10.1186/s13104-015-1295-5

Throughout the world all health professionals face stress because of time-pressures, workload, multiple roles and emotional issues. Stress does not only exist among the health professionals but also in medical students. Bangladesh has currently 77 medical colleges 54 of which are private. This study was designed to collect baseline data of stress-level among Bangladeshi students, which we believe will form the basis for further in depth studies.

Matched MeSH terms: Schools, Medical
Fulltext Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study

Elkalmi RM, Khan MU, Ahmad A, Srikanth AB, Abdurhaman NS, Jamshed SQ, et al.

J Res Pharm Pract, 2015 Apr-Jun;4(2):94-8.
PMID: 25984548 DOI: 10.4103/2279-042X.155760

OBJECTIVE:This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia.
METHODS: A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students' demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20.
FINDINGS: The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception.
CONCLUSION: Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results.
KEYWORDS: Awareness; contraceptive; knowledge; perception; students

Matched MeSH terms: Schools, Pharmacy
Pathways to Youth Empowerment and Community Connectedness: A Study of Youth-Adult Partnership in Malaysian After-School, Co-Curricular Programs

Zeldin S, Krauss SE, Kim T, Collura J, Abdullah H

J Youth Adolesc, 2016 08;45(8):1638-51.
PMID: 26092232 DOI: 10.1007/s10964-015-0320-2

After-school programs are prevalent across the world, but there is a paucity of research that examines quality within the "black box" of programs at the point of service. Grounded in current theory, this research examined hypothesized pathways between the experience of youth-adult partnership (youth voice in decision-making; supportive adult relationships), the mediators of program safety and engagement, and the developmental outcomes of youth empowerment (leadership competence, policy control) and community connectedness (community connections, school attachment). Surveys were administered to 207 ethnically diverse (47.3 % female; 63.3 % Malay) youth, age 15-16, attending after-school co-curricular programs in Kuala Lumpur, Malaysia. Results showed that youth voice in program decision-making predicted both indicators of youth empowerment. Neither youth voice nor supportive adult relationships was directly associated with community connectedness, however. Program engagement mediated the associations between youth-adult partnership and empowerment. In contrast, program safety mediated the associations between youth-adult partnership and community connectedness. The findings indicate that the two core components of youth-adult partnership-youth voice and supportive adult relationships-may operate through different, yet complementary, pathways of program quality to predict developmental outcomes. Implications for future research are highlighted. For reasons of youth development and youth rights, the immediate challenge is to create opportunities for youth to speak on issues of program concern and to elevate those adults who are able and willing to help youth exercise their voice.

Matched MeSH terms: Schools
Thyroid volumes in a national sample of iodine-sufficient swiss school children: comparison with the World Health Organization/International Council for the control of iodine deficiency disorders normative thyroid volume criteria

Hess SY, Zimmermann MB

Eur. J. Endocrinol., 2000 Jun;142(6):599-603.
PMID: 10822222

The determination of goiter prevalence in children by thyroid ultrasound is an important tool for assessing iodine deficiency disorders. The current World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) normative values, based on thyroid volume in iodine-sufficient European children, have recently been questioned, as thyroid volumes in iodine-sufficient children from the USA and Malaysia are smaller than the WHO/ICCIDD reference data. Our objective was to describe ultrasonographic thyroid volumes in a representative national sample of iodine-sufficient Swiss school children, and to compare these with the current reference data for thyroid volume.

Matched MeSH terms: Schools
Causes of childhood blindness in Malaysia: results from a national study of blind school students

Reddy SC, Tan BC

Int Ophthalmol, 2001;24(1):53-9.
PMID: 11998890

A national study was conducted in children attending six schools for the blind in Malaysia to identify the anatomical site and underlying causes of blindness (BL) and severe visual impairment (SVI), with a view to determine the potentially preventable and treatable causes so that appropriate control measures can be implemented in the future. The standardized clinical examination of eyes was performed and the findings were recorded on the WHO Prevention of Blindness Programme eye examination record form for children with blindness and low vision. A total of 358 children aged between 7 and 17 years were examined, of whom 332 (92.7%) were blind or severely visually impaired. The results relate to these 332 children. Lens was the major anatomical site (22.3%) of visual loss followed by retina (20.8%), whole globe (17.2%), cornea (15.1%), optic nerve (8.7%) and uvea (5.1%). Glaucoma was responsible for BL/SVI in 7.2% and others in 3.6% of cases. Hereditary diseases were responsible for visual loss in 29.5%, intrauterine factors in 4.5%, perinatal factors in 9% and childhood factors in 7.8% of cases. However, the aetiology was unknown in 49.1% of cases which included congenital anomalies of the globe. Childhood cataract and corneal scarring are major treatable causes of BL/SVI that can benefit from future intervention strategies. Perinatal screening for intrauterine factors and hereditary eye diseases, and appropriate interventional therapy will help in reducing the prevalence of childhood blindness.

Matched MeSH terms: Schools
Ocular abnormalities in children from a Malaysian school for the deaf

Elango S, Reddy TN, Shriwas SR

Ann Trop Paediatr, 1994;14(2):149-52.
PMID: 7521631

The prevalence of ocular abnormalities was studied in 165 children from a Malaysian school for the deaf. Ninety-five children (57.6%) had one or more ocular abnormalities. Rubella retinopathy was the commonest form of ocular abnormality (35.2%). Refractive errors were found in 23 children (13.9%). Refractive errors in the rubella group were significantly more common than in the non-rubella group of deaf children (p < 0.001) (chi 2 test). Thirteen children had congenital anomalies causing significantly impaired vision. Ophthalmological examination of deaf children helps in the detection of cases with rubella eye signs and thus helps to identify the cause of deafness. Since deaf children are at greater risk of visual and ocular abnormalities, periodical ophthalmological examination should be carried out in these children.

Matched MeSH terms: Schools
Fulltext Rheumatic heart disease in Malaysia

Jamal F, Mohd Salleh H, Tan SP

World Health Forum, 1994;15(1):56-7.
PMID: 8141979
Matched MeSH terms: Schools
Fulltext A pilot school health survey to study the incidence of common disorders in primary school children and the role of teachers in the school health service

Ayyamani UD

Med J Malaysia, 1986 Mar;41(1):4-11.
PMID: 3796347

Selected students were subjected to a general health appraisal including vision and hearing tests by teachers, nurses and finally a medical officer. The findings of all three examiners were then compared taking the results of the medical officer as the indicator of accuracy. The findings of the survey indicated that the problems of school children were similar to those reported by other workers and by MCH Division of the Ministry of Health namely dental caries, head lice, malnutrition, skin infections and visual disability. Other problems like skeletal deformity and abnormalities of heart, lung, speech and behaviour were extremely uncommon and formed only 1.5% of the total. Teachers and nurses performed extremely well in relation to the doctor with 93% and 95.8% concurrence respectively in detecting these abnormalities. Teachers were also requested to give a feedback on their view of and role in the SHS as well as problems faced in following the school health card. The majority perceived the SHS as a joint effort between the Ministry of Health and Education and agreed that they had a role to play in the SHS. Many teachers also indicated a willingness to carry out the various tasks in the SHS. The main problem in filling the school health card seemed to be in getting relevant details from parents though over 50% of teachers complained that there were too many details to fill. The role of teachers in the SHS is discussed in the light of the findings of the study and recommendations are made.

Matched MeSH terms: Schools
Fulltext Psychiatric consultation in a secondary school in Kuala Lumpur

Loke KH, Woon TH

Med J Malaysia, 1983 Mar;38(1):51-6.
PMID: 6633337

Psychiatric consultation in schools is not a new concept in the Western Countries but it is so in Malaysia owing to the lack ofa sufficient number of trained psychiatrists available locally. The aim of consultation is to help the school authorities to understand and to solve emotional and behaviourial problems of school children. The authors have begun a study project, on a voluntary basis, on the psychiatric problems of the school children of a secondary school in Kuala Lumpur. This was possible with the cooperation between the Department of Education, Kuala Lumpur, the Department of Social Welfare, Federal Territory and the Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur. The authors used two methods to gather data, namely through individual evaluation of the referred students (a total of 23 students having been interviewed) and through the holding of group therapy sessions with the consultee as the cotherapist. The authors found that minor behaviourial problems such as inattentiveness, talking, eating and sleeping in the classrooms constituted the majority of the reasons for referral. This was followed by problems concerned with poor academic performance, including the quality of class work. Major problems such as theft, extortion and gangsterism and personal emotional problems such as interpersonal relationship problems, boyfriend/girfriend problems and sexual problems were also encountered. Female pupils appeared to be more forthcoming in discussing their problems. The project has resulted in the school gradually adopting the guidance rather than the purely disclplinary concept in understanding the pupils' problems and their maladjustment behaviour in many cases. Joint efforts by psychiatrists, psychologists, professional social workers and school health personnel should be invested in this important area of school education.

Matched MeSH terms: Schools
Population education country programmes

UNESCO. Population Education Programme Service

Popul Educ Asia Pac Newsl Forum, 1980 Dec.
PMID: 12264112
Matched MeSH terms: Schools
Fulltext The prevalence of childhood malnutrition: its measurement, what it means and its uses

Chong YH

Med J Malaysia, 1980 Jun;34(4):329-35.
PMID: 7219258
Matched MeSH terms: Schools
Parental and peer supports are associated with an active lifestyle of adolescents: evidence from a population-based survey

Khan A, Uddin R

Public Health, 2020 Nov;188:1-3.
PMID: 33032239 DOI: 10.1016/j.puhe.2020.08.024

OBJECTIVES: Parental and peer support can foster adolescents' activity behaviours; however, little is known about how such support are linked with adolescents' active lifestyle in non-Western settings. The study aimed to explore associations of parental and peer support with an active lifestyle of adolescents in Malaysia.
STUDY DESIGN: This is a cross-sectional study.
METHODS: We used data from the 2012 Malaysian Global School-based Student Health Survey, which covered adolescents aged 11-17 years (51% girls). Adolescents were asked about their physical activity, sitting time, and levels of parental and peer support. Participants with ≥60 min of moderate to vigorous physical activity per day and ≤2 h of sitting time per day were categorised as having an 'active lifestyle'. Binary logistic regression was used to examine the relationships by gender and age group (11-14 and 15-17 years).
RESULTS: Of the participating adolescents (n = 12,081), 15.3% reported to have an active lifestyle (boys: 22.0%; girls: 8.8%). About 31% reported to have higher levels of parental support, whereas 47% reported higher levels of peer support. Higher parental and peer support were significantly associated with an active lifestyle of boys across both age groups. Girls with higher parental support had higher odds of reporting an active lifestyle in both age groups, whereas higher peer support was significantly associated with an active lifestyle among girls aged 11-14 years.
CONCLUSIONS: This study uniquely extends the current evidence by examining the associations of parental and peer support with physical activity and sitting time combined. More research is needed to understand how different types of social support can influence adolescents' active lifestyle.

Matched MeSH terms: Schools
Fulltext Association of children’s BMI and physical activity: a cross sectional study

Lily Shuzeen Kimin, Wenda Riona Lamiri, Alvin Oliver Payus, Constance Liew Sat Lin, Mohd Firdaus Mohd Hayati, Rhanye Mac Guad, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):61-61.
MyJurnal

Introduction:The increasing prevalence of childhood obesity among primary school children is a growing public health concern worldwide. Previous study in West Malaysia showed a prevalence of obesity with an estimated of 6.6% among 7-year-olds children and rising to 13.8% among 10-year-olds children. However, no study has ever been conducted in East Malaysia on childhood obesity. This study was aimed to determine the prevalence of child-hood obesity and to investigate the association of physical activity levels with obesity and its intervention among primary school children in Kota Kinabalu. Methods: A cross-sectional study involving 484 students (aged 7-12 years old) was conducted in five primary schools at Kota Kinabalu, Sabah. The schools were selected based on cluster sampling method and simple random sampling method. Primary school children with a known medical condition such as bronchial asthma, type-1 diabetes mellitus or those with a prolonged use of oral steroids was excluded from the study. Self developed questionnaires were used to record sociodemographic details and anthropometric mea-sures both parents and children, and physical activity was measured using a Children Physical Activity Questionnaire (C-PAQ). The intervention involved 3 components; I) motivational interviewing, ii) brief and focused advice, iii) ac-tivity session. Follow up was done 3 months after the intervention was conducted. Results: The prevalence of child-hood obesity among primary school children is 13.2%. There is a negative correlation between children’s BMI and amount of physical activity (-0.347) and positive correlation between children’s BMI and amount of non-physical activity (0.339). Little changes in the BMI of the children after intervention, t(127)= 2.866, p=0.005. Conclusion: This study provides evidence that childhood obesity is not a prevalent health problem in Kota Kinabalu and has proved that physical activity levels have significant associations with children’s body mass indices.

Matched MeSH terms: Schools
Fulltext Aggression in adolescents: the biopsychosocial predictors

Fatimah Ahmad Fauzi, Nor Afiah Mohd Zulkefli, Anisah Baharom

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):15-15.
MyJurnal

Introduction: Adolescent aggression has become a serious public health problem with the escalating juvenile cases and violence among secondary school students by inflicting harm to others. The objective of this study was to deter-mine the biopsychosocial predictors of adolescent aggression among Form Four students in Hulu Langat. Methods: Cross-sectional study was conducted by proportionate population sampling method among Form Four students from all public secondary schools in Hulu Langat. Pre-tested questionnaires distributed to measure students’ ag-gression, demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skip-ping), psychological (attitude towards aggression, normative beliefs to aggression, personality trait, and emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, and substance abuse). Data was analysed using multivariate analysis to determine the significant predictors. Results: 480 students from four randomly selected schools participated in the study with response rate of 96.5%. The median aggression score was low, which was 23.00 (IQR=12.00). From simple linear regression, 15 factors had significant relationship with adolescent aggression. The predictors of adolescent aggression were lower family income, Malay ethnicity, nutritional deficiency, attitude towards aggression, and peer deviant affiliation (F [8, 244] =15.980, p-value

Matched MeSH terms: Schools
Fulltext Food Security and Hygiene Practice among Adolescent Girls in Maiduguri Metropolitan Council, Borno State, Nigeria

Charles Shapu R, Ismail S, Ahmad N, Lim PY, Abubakar Njodi I

Foods, 2020 Sep 10;9(9).
PMID: 32927593 DOI: 10.3390/foods9091265

Inadequate food security contributes to poor health outcome for all, including adolescent girls. The study aims at determining the level of food security and hygiene among adolescent girls. A school-based cross-sectional study was carried out among adolescent girls aged 10 to 19 years old from six schools in Maiduguri Metropolitan Council, Borno State. The instrument for data collection was a questionnaire using KoBoCollect Toolbox between June and July 2019. Multivariable logistic regression was used to identify the predictors of food security and hygiene among respondents. A majority of the respondents (73.5%) were in a very low food security level. Three factors were significantly associated with food security level, these included schools (p = 0.007), age of mother (p = 0.004), and occupation of mother (p < 0.001). School (p = 0.003), age (father p = 0.017; mother; p = 0.012), hygiene (p = 0.005), and occupation of mother (p = 0.002) were predictors of food security. About (46.6%) of respondents had poor hygiene practice, school (p = 0.016) was significantly associated with hygiene practice. School (p = 0.019; and p = 0.005) and food security (p = 0.009) were predictors of hygiene practice. This study reveals a high prevalence of low food security among adolescent girls.

Matched MeSH terms: Schools
Fulltext Predictors of preventive practices towards Zika virus infection among patients attending health clinics in Seremban

Mohd Safrin Mohamad Bashaabidin, Sri Ganesh Mutiah

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):94-94.
MyJurnal

Introduction: Zika virus is mainly transmitted to human through bite of an infected Aedes species mosquito. It was reported that the transmission also occurs by blood transfusion, sexual intercourse and from mother to foetus. The World Health Organization (WHO) had declared Zika infection outbreak as Public Health Emergency of Internation-al Concern (PHEIC) in February 2016. Since December 2016, total of eight Zika cases had been reported to Ministry of Health, Malaysia (MOH). Since there is no available vaccine and specific treatment for the Zika virus infection, the preventive practices against Zika virus infection is the only defense and method to curb the infection. The ob-jective of this study is to determine predictors of preventive practices towards Zika virus infection among patients attending health clinics in Seremban. Methods: A cross-sectional study was done in selected public health clinics in Seremban, involving 874 respondents recruited by simple random sampling method. Primary data was collected using self-administered questionnaires in English and Bahasa Malaysia. Descriptive and analytical statistics were performed using SPSS version 22.0. Results: Majority of the respondents were female (57.2%), below 40 years old (62.5%), Malay (83.1%), Muslim (83.8%), married (86.2%) and had secondary school education (51.8%), working (64.9%) with monthly household income of

Matched MeSH terms: Schools
Fulltext Exposure to secondhand smoke among school-going adolescents in Malaysia: Findings from the tobacco and e-cigarettes survey among Malaysian adolescents (TECMA)

Ling MYJ, Lim KH, Hasani WSR, Rifin HM, Majid NLA, Lourdes TGR, et al.

Tob Induc Dis, 2020;18:96.
PMID: 33262682 DOI: 10.18332/tid/128622

INTRODUCTION: Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia.
METHODS: We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI).
RESULTS: SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51).
CONCLUSIONS: Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.

Matched MeSH terms: Schools

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