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Fulltext Quit rates at 6 months in a pharmacist-led smoking cessation service in Malaysia

Fai SC, Yen GK, Malik N

Can Pharm J (Ott), 2016 Sep;149(5):303-312.
PMID: 27708676

BACKGROUND: Smoking cessation clinics have been established in Malaysia since 2004, but wide variations in success rates have been observed. This study aimed to evaluate the proposed pharmacist-led Integrated Quit Smoking Service (IQSS) in Sabah, Malaysia, and identify factors associated with successful smoking cessation.
METHODS: Data from 176 participants were collected from one of the quit-smoking centres in Sabah, Malaysia. Pharmacists, doctors and nurses were involved throughout the study. Any health care provider can refer patients for smoking cessation, and free pharmacotherapy and counselling was provided during the cessation period for up to 3 months. Information on demographic characteristics, smoking behaviours, follow-up and pharmacotherapy were collected. The main outcome measure was the abstinence from smoking, which was verified through carbon monoxide in expired air during the 6-month follow-up.
RESULTS: A 42.6% success rate was achieved in IQSS. Smoking behaviour such as lower cigarette intake and lower Fagerström score were identified as factors associated with success. On top of that, a longer duration of follow-up and more frequent visits were significantly associated with success in quitting smoking.
CONCLUSION: Collaboration among health care practitioners should be the main focus, and we need a combination of proven effective modalities in order to create an ideal smoking cessation module.
Study site: Klinik Kesihatan Luyang, Kota Kinabalu, Sabah, Malaysia

Matched MeSH terms: Smoking Cessation*
Fulltext Predictors of sexual risk behaviour among adolescents from welfare institutions in Malaysia: a cross sectional study

Farid ND, Rus SC, Dahlui M, Al-Sadat N, Aziz NA

BMC Public Health, 2014;14 Suppl 3(Suppl 3):S9.
PMID: 25437631 DOI: 10.1186/1471-2458-14-S3-S9

BACKGROUND: In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia.
METHODS: Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour.
RESULTS: The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour.
CONCLUSION: There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.

Matched MeSH terms: Smoking/epidemiology
Fulltext Prevalence of smoking and Its associated factors among university staff

Fasoro, A.A., Rampal, L., Sherina, M.S., Salmiah, M.S.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):45-51.
MyJurnal

Globally, one person dies every six seconds as a result of tobacco use. This makes tobacco use the cause of every one out of 10 deaths in adults and the single largest and leading cause of preventable death in the world. The objective of this study was to determine the prevalence of smoking among staff of Universiti Putra Malaysia. For the purpose of this study an analytical cross sectional study design was used and a standardized, pre-tested, while a validated well-structured questionnaire was used for data collection. The prevalence of smoking was found to be 10.0% (26.5% among males and 0.5% among females). In addition, significant associations were found between smoking and gender, religion, marital status, highest educational level, occupation, and family income (p < 0.05). In particular, gender and educational level were significant predictors of smoking. In conclusion, the prevalence of smoking among university staff was shown to be considerably lower than that stated for the national level. However, the University could aim at achieving zero prevalence in the years to come.

Matched MeSH terms: Smoking
Fulltext Exposure to second-hand Smoke among adolescent in secondary school students in Sana’a, Yemen

Fateh Addin Nejm Addin Al-Emad, Zaleha Md. Isa

Int J Public Health Res, 2017;7(1):783-790.
MyJurnal

BACKGROUND: The aim of the study was to assess the knowledge and attitude of secondary school students in Sana'a Yemen related to exposure to second-hand smoking.
METHODS: A cross-sectional study was conducted in Sana'a city. The total sample size was 336 students in which 63 were males and 273 were females. These students were stratified random sampling . Data were collected by using Questionnaire comprising of 3 parts: Part 1- consists of socio-demographic data. Part 2- consists of the knowledge regarding smoking and second-hand smoking and Part 3-consists of adolescents' attitude in relation to second-hand smoking.
RESULTS: Out of 336 students, majority were between 14-18 years old (75.9%), males (81.2%) , (55.7%)of them was fathers' occupation private employee and low educated mother was (86.3%).The students who do not have smoking habit were (94.3%),and those who do not have friends with the habit of smoking was (57.4%). (57.10) having some one else at home who smokes beside them .The reaction of non printed mass media for SHS warning was (83.3%) . The exposed to smoke out door was (60.1%) . In this study, the majority of students had inadequate knowledge about the second-hand smoke was (52.7%). A higher percentage of students who had unfavorable attitudes toward secondhand smoke was(86.6%).
CONCLUSION: We concluded that The level of knowledge and attitude about the second-hand smoke is relatively low among the secondary school student in Sana'a Yemen .The finding of this study emphasized the need of effective awareness programs to increase level of consciousness and knowledge regarding SHS. Keywords: Second-hand Smoking, Secondary School, Adolescent, Sana'a .

Matched MeSH terms: Smoking
Fulltext Stronger pack warnings predict quitting more than weaker ones: finding from the ITC Malaysia and Thailand surveys

Fathelrahman AI, Li L, Borland R, Yong HH, Omar M, Awang R, et al.

Tob Induc Dis, 2013 Sep 18;11(1):20.
PMID: 24330614 DOI: 10.1186/1617-9625-11-20

BACKGROUND: We examined the impact of cigarette pack warning labels on interest in quitting and subsequent quit attempts among adult smokers in Malaysia and Thailand.
METHODS: Two overlapping cohorts of adults who reported smoking factory- made cigarettes from Malaysia and Thailand were interviewed face-to-face (3189 were surveyed at baseline and 1781 re-contacted at Wave 2; 2361 current smokers were surveyed at Wave 2 and 1586 re-contacted at Wave 3). In Thailand at baseline, large text only warnings were assessed, while at Wave 2 new large graphic warnings were assessed. In Malaysia, during both waves small text only warnings were in effect. Reactions were used to predict interest in quitting, and to predict making quit attempts over the following inter-wave interval.
RESULTS: Multivariate predictors of "interest in quitting" were comparable across countries, but predictors of quit attempts varied. In both countries, cognitive reactions to warnings (adjusted ORs; 1.57 & 1.69 for Malaysia at wave 1 and wave 2 respectively and 1.29 & 1.19 for Thailand at wave 1 and wave 2 respectively), forgoing a cigarette (except Wave 2 in Malaysia) (adjusted ORs; 1.77 for Malaysia at wave 1 and 1.54 & 2.32 for Thailand at wave 1 and wave 2 respectively), and baseline knowledge (except wave 2 in both countries) (adjusted ORs; 1.71 & 1.51 for Malaysia and Thailand respectively) were positively associated with interest in quitting at that wave. In Thailand only, "cognitive reactions to warnings" (adjusted ORs; 1.12 & 1.23 at wave 1 and wave 2 respectively), "forgoing a cigarette" (adjusted OR = 1.55 at wave 2 only) and "an interest in quitting" (adjusted ORs; 1.61 & 2.85 at wave 1 and wave 2 respectively) were positively associated with quit attempts over the following inter-wave interval. Salience was negatively associated with subsequent quit attempts in both Malaysia and Thailand, but at Wave 2 only (adjusted ORs; 0.89 & 0.88 for Malaysia and Thailand respectively).
CONCLUSION: Warnings appear to have common mechanisms for influencing quitting regardless of warning strength. The larger and more informative Thai warnings were associated with higher levels of reactions predictive of quitting and stronger associations with subsequent quitting, demonstrating their greater potency.

Matched MeSH terms: Smoking; Smoking Cessation
Fulltext Impact of the new Malaysian cigarette pack warnings on smokers' awareness of health risks and interest in quitting smoking

Fathelrahman AI, Omar M, Awang R, Cummings KM, Borland R, Bin Mohd Samin AS

Int J Environ Res Public Health, 2010 11;7(11):4089-99.
PMID: 21139879 DOI: 10.3390/ijerph7114089

The objective of this research was to compare the response of adult smokers in Malaysia to newly proposed pictorial cigarette warnings against the current text-only warnings. The study population included 140 adult male smokers who were enrolled in a randomized trial to view either the new pictorial warnings (intervention) or the old text-only warnings (control). Participants completed pre-exposure and post-exposure questionnaires that assessed their awareness of the health risks of smoking, response to the package warnings, and interest in quitting smoking. Exposure to the pictorial warnings resulted in increased awareness of the risks of smoking, stronger behavioral response to the warnings and increased interest in quitting smoking. The new warnings in Malaysia will increase smokers' knowledge of the adverse health effects of smoking and have a positive effect on interest in quitting.

Matched MeSH terms: Smoking/psychology*; Smoking Cessation*
Fulltext Smokers' responses toward cigarette pack warning labels in predicting quit intention, stage of change, and self-efficacy

Fathelrahman AI, Omar M, Awang R, Borland R, Fong GT, Hammond D, et al.

Nicotine Tob Res, 2009 Mar;11(3):248-53.
PMID: 19246625 DOI: 10.1093/ntr/ntn029

This paper is concerned with the effects of cigarette pack warning labels on quitting intentions. We examined whether different responses among smokers toward cigarette pack warning labels could predict quit intentions and self-efficacy in quitting. Variables studied were "noticing warning labels during last month," "reading or looking closely at warning labels," "avoiding looking at labels during last month," "thinking about health risks of smoking because of the warning labels, "more likely to quit because of the warning labels," and "stopping from having a cigarette when about to smoke one because of the labels."

Matched MeSH terms: Smoking/adverse effects*; Smoking Cessation*
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: Smoking
Fulltext Prediction and explanation on adolescent aggression: a study protocol

Fatimah Ahmad Fauzi, Nor Afiah Mohd Zulkefli, Anisah Baharom

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):106-114.
MyJurnal

Introduction: Adolescent aggression is an important public health concern with escalating prevalence of juvenile cases and violence among these age groups including robbery, homicide, and gang fights. The objectives of this study protocol are to determine the biopsychosocial predictors and explore the contextual factors of adolescent ag- gression among secondary school students in Hulu Langat. Methods: Explanatory mixed method study design will be used, consist of quantitative cross-sectional study followed by basic qualitative study. Proportionate population sampling among Form 4 secondary school students from selected public secondary schools in Hulu Langat will be executed. Questionnaires will be distributed to 481 students on aggression as the dependent variable, and several independent variables: demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skipping), psychological (attitude and normative beliefs, personality trait, emotional intelligence), and so- cial factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, substance abuse). Subsequently, participants with moderate to high aggression scores will be further explored on the contextual factors of adolescent aggression by in-depth interview. Multiple linear regression will be executed using SPSS to determine significant predictors whereas thematic analysis will be applied for qualitative data analysis on the context of adolescent aggression. Both findings will be further integrated and discussed to give comprehensive description on the phenomena. Conclusion: Better knowledge and understanding on adolescent aggression may generate new framework to drive more effective preventive strategies and unravel adolescent aggressive related Pub- lic Health problems.

Matched MeSH terms: Smoking
Manual work and lung cancer risk in high-risk populations

Fauziah Nordin, Lewis, SJ., O’Donnell, PNS., Crosbie, PAJ., Richard Booton, Agius, RM., et al.

Journal of Occupational Safety and Health, 2014;11(1):5-14.
MyJurnal

Manual work is associated with increased lung cancer risk possibly because of increased exposure to occupational and other carcinogens, reduced use of health care services and/or a less healthy lifestyle. The aim of this study was to examine whether the association between manual work and lung cancer risk has changed over time. Three separate retrospective studies were carried out over a 10-year period (1996-1997, 1998-2000 and 2003-2005) in patients attending a bronchoscopy clinic to investigate lung cancer risk in an area of Manchester characterised by high deprivation and unemployment. Cases (n=321) were patients newly diagnosed with a tumour of the lung, trachea or bronchus and controls (n=542) were patients free of tumours at the time of, and prior to, examination. Patients were interviewed using the same structured questionnaire for associations between risk factors and lung cancer examined. The study population in all three studies was similar with little difference in smoking history. In each study smoking was associated with lung cancer risk. Lung cancer risk was higher in manual workers (compared to managers and other professionals) in the first (OR 2.50, 95% CI 1.20 – 5.05) and second study (OR 2.73, 95% CI 0.97 – 7.70) but not the third (OR 0.97, 95% CI 0.58 – 1.61). However, the summary odds ratio (meta-OR) for lung cancer in manual worker was 1.81 (95% 1.75 – 1.87) after controlling for sex, age and smoking. This study suggested that even after taking into account known occupational and environmental causes of cancer, there was a residual cancer risk associated with manual work, high risk working populations of lung cancer. However this appears to have attenuated recently for as yet unknown reasons.

Matched MeSH terms: Smoking
Fulltext Protecting women and girls from tobacco and alcohol promotion

Feeny E, Dain K, Varghese C, Atiim GA, Rekve D, Gouda HN

BMJ, 2021 Jul 19;374:n1516.
PMID: 34281828 DOI: 10.1136/bmj.n1516

Gender transformative measures could curb the industries’ expansion into low and middle income countries, contain the burden of chronic disease, and promote gender equity, argue Emma Feeny and colleagues

Matched MeSH terms: Smoking/adverse effects
Fulltext Endemic goiter in the Lemanak and Ai river villages of Sarawak

Foo LC, Zainab T, Letchuman GR, Nafikudin M, Azriman R, Doraisingam P, et al.

Southeast Asian J. Trop. Med. Public Health, 1994 Sep;25(3):575-8.
PMID: 7777929

In a survey of 974 villagers (408 males, 566 females; ages = 11-82 years) of the Ai (n = 496; 212 males, 284 females) and Lemanak (n = 478; 196 males, 282 females) rivers in the district of Lubuk Antu in Sarawak's Sri Aman Division during July 1993, goiter was found in 31.8% of the subjects. The goiter prevalence was higher in the more interior Ai river area than in the Lemanak river area (36.9% vs 26.5%). In females aged 15 years and above, the goiter prevalence was 75.4% and 49.1%, respectively, in the Ai and Lemanak river areas. The difference in goiter prevalence between the two areas was related to the degree of iodine deficiency in the two areas. The median urinary iodine excretion in the Ai river villagers was 22.1 micrograms/l compared to 72.9 micrograms/l in the Lemanak river villagers (p < 0.0001). Goitrous subjects tended to have lower urinary iodine concentration than non-goitrous subjects. In the males, smoking of tobacco was associated with a two-fold increase in goiter frequency. Despite on-going distribution of iodized salt by the medical and health services in the State, only 23% of the 135 salt samples obtained from the households in the areas contained detectable iodine.

Matched MeSH terms: Smoking
Platelets of habitual smokers have reduced susceptibility to aggregating agent

Foo LC, Roshidah I, Aimy MB

Thromb. Haemost., 1991 Mar 4;65(3):317-9.
PMID: 2048056 DOI: 10.1055/s-0038-1648142

Platelet aggregation to collagen, and productions of 6-keto-prostaglandin-F1-alpha and thromboxane B2 during aggregation were measured after an overnight fast, involving both food and cigarettes, in 19 clinically healthy habitual smokers (10 or more cigarettes/day) and 23 non-smokers receiving the same diet. The subjects (all males; ages = 21-30 years) were residents of a school hostel. Mean platelet aggregation was significantly lower in smokers than non-smokers (23.2 ohms vs 31.5 ohms, p less than 0.005). Non-smokers had significantly higher mean concentration of 6-keto-prostaglandin-F1-alpha than smokers (109.8 pmol/l vs 92.3 pmol/l, p less than 0.05). The level of thromboxane B2 did not differ significantly between the two groups. These observations suggest that the role of smoking as a risk factor for ischaemic heart disease is unlikely to be related to a direct enhancement of aggregation. On the contrary, the observations seem to suggest that habitual smoking may directly reduce platelet aggregability.

Matched MeSH terms: Smoking/blood*
Fulltext Smoking in Girls and Young Women in Malaysia

Foong K, Tan YL

Citation: Foong K, Tan YL. Smoking in Girls and Young Women in Malaysia. Bangkok: Southeast Asia Tobacco Control Alliance (SEATCA); 2008

Matched MeSH terms: Smoking
Fulltext Exposure to Famine at a Young Age and Unhealthy Lifestyle Behavior Later in Life

Fransen HP, Peeters PH, Beulens JW, Boer JM, de Wit GA, Onland-Moret NC, et al.

PLoS One, 2016;11(5):e0156609.
PMID: 27244088 DOI: 10.1371/journal.pone.0156609

BACKGROUND: A healthy diet is important for normal growth and development. Exposure to undernutrition during important developmental periods such as childhood and adolescence can have effects later in life. Inhabitants of the west of the Netherlands were exposed to severe undernutrition during the famine in the last winter of the second World War (1944-1945).
OBJECTIVE: We investigated if exposure of women to the Dutch famine during childhood and adolescence was associated with an unhealthy lifestyle later in life.
DESIGN: We studied 7,525 women from the Prospect-EPIC cohort, recruited in 1993-97 and aged 0-18 years during the Dutch famine. An individual famine score was calculated based on self-reported information about experience of hunger and weight loss. We investigated the association between famine exposure in early life and four lifestyle factors in adulthood: smoking, alcohol consumption, physical activity level and a Mediterranean-style diet.
RESULTS: Of the 7,525 included women, 46% were unexposed, 38% moderately exposed and 16% severely exposed to the Dutch famine. Moderately and severely exposed women were more often former or current smokers compared to women that did not suffer from the famine: adjusted prevalence ratio 1.10 (95% CI: 1.05; 1.14) and 1.18 (1.12; 1.25), respectively. They also smoked more pack years than unexposed women. Severely exposed women were more often physically inactive than unexposed women, adjusted prevalence ratio 1.32 (1.06; 1.64). Results did not differ between exposure age categories (0-9 and 10-17 years). We found no associations of famine exposure with alcohol consumption and no dose-dependent relations with diet.
CONCLUSIONS: Exposure to famine early in female life may be associated with higher prevalence of smoking and physical inactivity later in life, but not with unhealthy diet and alcohol consumption.

Matched MeSH terms: Smoking/epidemiology*
Fulltext Association between lifestyle factors and quality-adjusted life years in the EPIC-NL cohort

Fransen HP, May AM, Beulens JW, Struijk EA, de Wit GA, Boer JM, et al.

PLoS One, 2014;9(11):e111480.
PMID: 25369457 DOI: 10.1371/journal.pone.0111480

The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend <0.0001). A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).

Matched MeSH terms: Smoking/epidemiology
Fulltext Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015

GBD 2015 Tobacco Collaborators

Lancet, 2017 May 13;389(10082):1885-1906.
PMID: 28390697 DOI: 10.1016/S0140-6736(17)30819-X

BACKGROUND: The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed.
METHODS: We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI).
FINDINGS: Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2-25·7) for men and 5·4% (5·1-5·7) for women, representing 28·4% (25·8-31·1) and 34·4% (29·4-38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95% UI 5·7-7·0 million]) were attributable to smoking worldwide, of which 52·2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking-attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015.
INTERPRETATION: The pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are poised to heighten smoking's global toll, unless progress in preventing initiation and promoting cessation can be substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and adequately implemented and enforced policies, which might in turn require global and national levels of political commitment beyond what has been achieved during the past 25 years.
FUNDING: Bill & Melinda Gates Foundation and Bloomberg Philanthropies.
Malaysian Collaborators: Southern University College, Skudai, Malaysia (Y J Kim PhD); University of Science Malaysia, Kubang Kerian, Malaysia (K I Musa MD); International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD)

Matched MeSH terms: Smoking/epidemiology*
Fulltext The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019

GBD 2019 Cancer Risk Factors Collaborators

Lancet, 2022 Aug 20;400(10352):563-591.
PMID: 35988567 DOI: 10.1016/S0140-6736(22)01438-6

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally.
METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented.
FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01-4·94) deaths and 105 million (95·0-116) DALYs for both sexes combined, representing 44·4% (41·3-48·4) of all cancer deaths and 42·0% (39·1-45·6) of all DALYs. There were 2·88 million (2·60-3·18) risk-attributable cancer deaths in males (50·6% [47·8-54·1] of all male cancer deaths) and 1·58 million (1·36-1·84) risk-attributable cancer deaths in females (36·3% [32·5-41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6-28·4) and DALYs by 16·8% (8·8-25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9-42·8] and 33·3% [25·8-42·0]).
INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden.
FUNDING: Bill & Melinda Gates Foundation.

Matched MeSH terms: Smoking/adverse effects; Smoking/epidemiology
Fulltext Tobacco usage among rural Bajaus in Sabah, Malaysia

Gan CY

Southeast Asian J. Trop. Med. Public Health, 1998 Sep;29(3):643-8.
PMID: 10437972

As part of a larger study to bring attention to smoking and smokeless tobacco use among the indigenous people of Sabah State in Malaysia, the Bajaus were interviewed in a cross-sectional survey. 74.4% of the men smoked compared to 3.3% of the women and 77% of women used smokeless tobacco compared to 4.3% of men. Local handrolled cigarettes called kirais were popular and smokeless tobacco was used as an ingredient in the ritual of betel-quid chewing. Tobacco was also used because it was thought to have medicinal effects. The prevalence of smokeless tobacco use was significantly lower among the better educated women but for smoking, education had no relation with prevalence. Both habits could be easily maintained as they were cheap practices which were socially and culturally accepted. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.

Matched MeSH terms: Smoking/adverse effects; Smoking/epidemiology*; Smoking/psychology
Projecting the future smoking prevalence in Norway

Gartner CE, Lund KE, Barendregt JJ, Mohamed Nor N, Hassan H, Vedøy TF, et al.

Eur J Public Health, 2017 Feb 1;27(1):139-144.
PMID: 28177432 DOI: 10.1093/eurpub/ckw180

Norway has achieved a noteworthy reduction in smoking prevalence over the past forty years. In 2015, 13% of Norwegians aged 13-74 smoked daily and a further 9% smoked occasionally. One of the objectives of the Norwegian 2013-16 national strategy for tobacco control is to achieve a reduction in the daily smoking prevalence to < 10% by 2016. This paper aims to estimate how long it will take for Norway to achieve the 10% smoking prevalence.

Matched MeSH terms: Smoking

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