Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.
Electronic cigarettes (e-cigarettes) are handheld devices that deliver an aerosol by heating a solution made up of propylene glycol and/or glycerol with or without flavoring agents and nicotine. This nationwide cross-sectional survey examined factors associated with e-cigarette usage and reasons for its initiation among 13 162 Malaysian adolescents. Data from TECMA (Tobacco and E-Cigarette Survey among Malaysian Adolescents) were used. Nine percent of adolescents had used e-cigarettes in the past month. Males (adjusted odds ratio [aOR] = 4.08; 95% confidence interval [CI] = 3.36-4.95), 16 to 19 year olds (aOR = 2.64; 95% CI = 2.13-3.26), Malays (aOR = 2.25; 95% CI = 1.79-2.83), Sabah and Sarawak Bumiputeras (aOR = 2.25; 95% CI = 1.61-3.15), and cigarette smokers (aOR = 13.16; 95% CI = 11.14-15.54) were more likely to use e-cigarettes. Three main reasons for e-cigarette initiation among adolescents were its taste and smell, experimentation, and popularity. Sale of e-cigarettes with or without nicotine to people aged younger than 18 years should be banned. Flavored e-cigarettes should also be banned since there is evidence suggesting increased appeal among the younger generation.
We assessed the prevalence of cessation of e-cigarette and its associated factors among adolescents in Malaysia. This study analyzed data from the Tobacco and E-Cigarette Survey among Malaysian Adolescent (TECMA) in 2016, a cross-sectional study with 2-stage stratification cluster sampling. A total of 14 832 school-going adolescents aged 10 to 19 years participated in this survey. A complex sampling design and multiple logistic regression analysis were applied. Nearly half of the adolescents (49.9%; 95% confidence interval [CI] = 44.9-55.0) who had ever used e-cigarette ceased the usage. Based on multivariate analysis, adolescents were more likely to quit e-cigarette because they could not afford the e-cigarette (adjusted odds ratio [aOR] = 2.39, 95% CI = 1.78-3.20), if they are aged 13 year and older (aOR = 1.80, 95% CI = 1.25-2.61), and those who claimed their e-cigarette does not contain nicotine (aOR = 1.35, 95% CI = 1.03-1.78). E-cigarette prevention efforts among adolescents could consider the cessation factors described in this study.
Electronic cigarettes (e-cigarettes) are a new method for the consumption of nicotine. A nationwide survey among 4288 Malaysian adults was conducted in 2016 to measure the prevalence and to describe the population characteristics of e-cigarette users. A complex sampling design was used, and data were collected using a face-to-face questionnaire. The overall prevalence of current, ever, former, and dual users of e-cigarettes in Malaysia were 3.2% (95% confidence interval [CI] = 2.5-4.1), 11.9% (95% CI = 10.5-13.5), 8.6% (95% CI = 7.5-9.8), and 2.3% (95% CI = 1.8-3.1), respectively. The prevalence of all type of e-cigarette use was higher in urban than in rural areas. Current e-cigarette users were likely to be younger, males, and with higher education level. Among current e-cigarette users, 74% (95% CI = 64-82) also smoked conventional cigarettes (dual user). E-cigarette use is prevalent in Malaysia. It is common among younger adults, males, and cigarette smokers.
This article describes the design, outcomes, challenges, and lessons learned from the ASian Collaboration for Excellence in Non-Communicable Disease (ASCEND) program, implemented between 2011 and 2015 in India, Sri Lanka, and Malaysia. The program involved a blended-delivery model, incorporating online and face-to-face training, mentoring, and supervision of trainees' research projects. Evaluation data were collected at baseline, 6, 12, 18, and 24 months. Intended outcomes, lessons, and challenges were summarized using a logic model. During the program period, 48 participants were trained over 2 cohorts in June 2011 and 2012. The trainees published 83 peer-reviewed articles between 2011 and 2015. Additionally, 154 presentations were given by trainees at national and international conferences. Underutilization of the online learning management system was an important challenge. Utilizing a combination of intensive face-to-face and online learning and mentoring of early career researchers in low- and middle-income countries has great potential to enhance the research capacity, performance, and outputs.
The publication of information is essential for expanding the benefits of public health throughout the Asia-Pacific region. All academics are familiar with the adage "Publish or perish," but for public health, this should be rewritten as "Publish or the population perishes." Publication and communication in public health continues to undergo rapid change. There are many challenges that a regional journal faces. The number of printed journals is beginning to decline. Digital publishing and extensive databases and search engines have become the only practical way to access data. But the advent of digital publishing has seen the arrival of profit-making entrepreneurs. Whether a Journal is in the printed form or digital, it remains the key communication in public health and ultimately improve the health of the people. The Asia-Pacific Journal of Public Health (APJPH), which is owned by Asia Pacific Academic Consortium for Public Health (APACPH) and published by Sage ensures that your data gets maximum digital exposure in the region where it can make a difference. Over the years, APJPH has increased its impact factor and gained in prestige. Although impact factor of a journal is important in documenting the recognition of work by academics, it does not necessarily reflect importance to our region. There needs to be a re-evaluation of publication and communication strategies so that all citizens of the Asia-Pacific region benefit.
Malaysia currently has an estimated hepatitis C virus (HCV) prevalence of 1.3% with an infected population of 384,000. Fishermen in Malaysia are at risk of HCV infection due to injection drug use and disproportionately high rates of incarceration. This study used quantitative data from Project WAVES, a large-scale mixed methods project charting environmental drivers of risk-taking behaviors among a respondent-driven sample of 406 fishermen in Malaysia. Over a quarter of participants (27.9%) reported injecting drugs in the past month; 49.8% of the sample tested positive for HCV. Respondents who had previously been arrested displayed increased odds of being HCV-positive (adjusted odds ratio = 4.79, confidence Interval = 2.46-9.35). Participants who reported being in lock-up displayed close to 6-fold odds of being HCV-infected (adjusted odds ratio = 5.49, confidence interval = 2.77-10.90, P < .001). These findings underscore the need for policies and structural interventions targeting the negative effects of aggressive incarceration contributing to the burden of HCV among high-risk communities.
This study aims to determine tuberculosis incidence, all-cause mortality, and its associated factors among health care workers (HCWs) registered in 2012 to 2014 with the Malaysian National Tuberculosis (MyTB) Surveillance Registry. Regression analysis was used to determine factors associated with all-cause mortality. Incidence rates ranged from 135.18 to 156.50/100 000 and were higher for HCWs compared with the general population (risk ratio = 1.70-1.96). The mean age at notification was 34.6 ± 10.55 years; 68.9% were female. Most were paramedics (44.3%) followed by other HCWs (41.9%) and doctors (13.8%). Nearly a quarter (23.8%) had extrapulmonary tuberculosis. There were 23 deaths giving a case fatality rate of 2.4%. Factors associated with death were older age (odds ratio [OR] =1.05; confidence interval [CI] =1.01-1.10), diabetes (OR = 3.83; CI = 1.32-11.08), HIV positivity (OR = 18.16; CI = 4.60-71.68), and not receiving directly observed therapy (DOTS) (OR = 10.97; CI = 3.61-33.38). It is important for HCWs to be aware of these increased risks and for authorities to implement protective measures.
Good nutrition for infants, during the first 1000 days from conception, is one of the most important determinants of a healthy long life. Breastfeeding is the most important component of infant nutrition and reduces morbidity and mortality. With the changes to the climate currently occurring, issues of nutrition and food supply are only going to increase in importance. The Sustainable Development Goals of the United Nations, place nutrition at the forefront of world development and a sustainable planet. The vision of Asia-Pacific Academic Consortium for Public Health (APACPH) is to "achieve the highest possible level of health of all the people of the nations of the Asia-Pacific region." Much of the burden of disease, early deaths, and disability in the Asia Pacific region could be reduced with public health efforts to address the major risk factors, including nutrition-related causes and smoking. The United Nations Decade of Action on Nutrition 2016-2025 has recently been launched with the aim of reducing the global burden of inappropriate nutrition. The goals include increasing rates of exclusive breastfeeding to 6 months, reducing wasting and stunting, and reducing the rates of low birthweight. This is the position endorsed in these guidelines along with the principles of the Baby Friendly Hospital Initiative. These guidelines expand the information on infants that was included in the 2016 APACPH Dietary Guidelines. APACPH covers many different environments, geographical areas, cultures, and socioeconomic groups. These guidelines are generally applicable to all infants in our region, specific local advice may sometimes be needed.