Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

• Main Authors: Zulkifli, Aziemah, Zainol Abidin, Najihah, Zainal Abidin, Emilia, Hashim, Zailina, Abdul Rahman, Anita, Rasdi, Irniza, Syed Ismail, Sharifah Norkhadijah, Semple, Sean
• Format: Article
• Language: English
• Published: Asian Pacific Organization for Cancer Prevetion 2014
• Online Access: http://psasir.upm.edu.my/id/eprint/37967/1/Implementation%20of%20smoke-free%20legislation%20in%20Malaysia.pdf; http://psasir.upm.edu.my/id/eprint/37967/; http://www.apocpcontrol.org/page/apjcp_issues_view.php?sid=Entrez:PubMed&id=pmid:24998546&key=2014.15.12.4815

Background: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. Materials and Methods: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. Results: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Conclusions: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.