AIMS AND METHODS: The present study aimed to examine the changes in mean daily cigarette consumption among random samples of the Malaysian current smoker population over 20 years using an age-period-cohort (APC) approach. We conducted APC analysis using a multilevel hierarchical age-period-cohort model and data from four nationally representative, repeated cross-sectional surveys (National Health and Morbidity Survey) conducted in 1996, 2006, 2011, and 2015 among individuals aged 18 to 80 years. Analyses were also stratified by gender and ethnicity.
RESULTS: Overall, mean daily cigarette consumption (smoking intensity) among current smokers increased with age until 60, after which a drop was observed. There were increases in daily cigarette consumption across birth cohorts. Age and cohort trends did not vary by gender but by ethnicity. The decreasing cigarette consumption after age 60 among the current smoker population was consistent with those observed among the Chinese and Indians, a trend that was not observed in Malays and other aborigines. In contrast, the increasing cohort trend was consistent with those observed among the Malays and other bumiputras.
CONCLUSIONS: The present study highlighted important ethnic-specific trends for mean daily cigarette consumption among the current smoker population in Malaysia. These findings are essential in guiding the formulation of interventional strategies or implementation of national tobacco control policies and help achieve the Ministry of Health Malaysia's 2025 and 2045 targets for smoking prevalence.
IMPLICATIONS: This is the first APC study on smoking intensity among current smokers in a multiracial, middle-income nation. Very few studies had performed gender- and ethnic-stratified APC analyses. The ethnic-stratified APC analyses provide useful insights into the overall age and cohort trends observed among the current smoker population in Malaysia. Therefore, the present study could add evidence to the existing literature on the APC trends of smoking intensity. The APC trends are also important in guiding the government to develop, implement, and evaluate antismoking strategies.
METHODS: Data from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect.
RESULTS: Generally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups.
CONCLUSIONS: The profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.
RESULTS: The resazurin-based TB assay demonstrated that the L. cuprina larval extract was inhibitory against all tested bacteria, whilst the larval extract of S. peregrina and M. domestica were only inhibitory against the MRSA, with a MIC of 100 mg ml(-1). Subsequent sub-culture of aliquots revealed that the larval extract of L. cuprina was bactericidal against MRSA whilst the larval extracts of S. peregrina and M. domestica were bacteriostatic against MRSA. The GC-MS analysis had quantitatively identified 20 organic compounds (fatty acids or their derivatives, aromatic acid esters, glycosides and phenol) from the larval extract of L. cuprina; and 5 fatty acid derivatives with known antimicrobial activities from S. peregrina and M. domestica.
CONCLUSION: The resazurin-based turbidometric assay is a simple, reliable and feasible screening assay which evidently demonstrated the antibacterial activity of all fly larval extracts, primarily against the MRSA. The larval extract of L. cuprina exerted a broad spectrum antibacterial activity against all tested bacteria. The present study revealed probable development and use of novel and effective natural disinfectant(s) and antibacterial agent(s) from flies and efforts to screen more fly species for antibacterial activity using resazurin-based TB assay should be undertaken for initial screening for subsequent discovery and isolation of potential novel antimicrobial substances, particularly against the multi-drug resistant strains.
DESIGN: Cross-sectional study.
SETTING: Primary and secondary schools in Malaysia.
PARTICIPANTS: 11 246 non-smoking school-going adolescents.
OUTCOME MEASURES: The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia.
RESULTS: Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking.
CONCLUSION: Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.
METHODS: The data were derived from the Malaysian Global Adult Tobacco Survey (GATS-M), collected in 2011-2012, involving 4250 respondents. Data analyses involved 1343 respondents reported to be in the working population.
RESULTS: More than half of the respondents (58.5%) were reportedly working in smoke-free workplaces. Almost a quarter (24.8%) of those who worked in smoke-free workplaces stayed in smoke-free homes, which was more than two times higher than their counterparts who worked at non-smoke-free workplaces (24.8% vs 12.0%, p<0.001). Multivariable analyses further substantiated this finding (AOR=2.01, 95% CI: 1.11-3.61, reference group = worked at non-smoke-free workplaces).
CONCLUSIONS: This study found an association between living in smoke-free homes and working at smoke-free workplaces, which could suggest a positive impact of implementing smoke-free workplaces.