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  A total of 34,305 respondents aged 18 years and older were interviewed using a structured questionnaire. Ind Health. Examining the sociodemographic characteristics of adolescent smoking is the key step toward its prevention. 2005, 40: 756-764. Analyses were performed using STATA version 10 and SPSS version 16. 2006, New Delhi: Northern Book Centre, 113-121. The prevalence of current smoking among adult males in 2006, in Malaysia is 46.5% (95% CI: 45.5–47.4%), which was 3.0% lower than a decade ago.18The prevalence of current smoking among both male and female Malaysian adults aged 15 years and above is 23.1%,19,20and is highest in those aged 21-30 years old.21There has been several series on nationwide surveys in Malaysia, starting … Springer Nature. http://jknj.moh.gov.my/jsm/day2/Speciality%20Symposia/SS_13_Smoking%20Cessation%20Bringing%20Aspiration%20into%20Reality.pdf. These findings may be explained by the ‘marriage protection’ and ‘marriage selection’ theories [49], which posit that emotional distress due to divorce cause divorcees to turn to smoking for relief. In 2004, the Ministry of Health launched a five-year national anti-smoking campaign with the slogan ‘Tak Nak’ (Say No) that reached more than 92% of the population. This article is published under license to BioMed Central Ltd. Global Adult Tobacco Survey: Thailand Country. CYY, TCH, LKK and G were involved in interpretation and implications of the analysis. Control of Tobacco Products Regulation 2004. The higher proportion of ex-smokers in older age groups was among the plausible explanations to the present finding. Google ScholarÂ, Peto R, Boreham J, Lopez AD, Thun M, Health C, et al: Mortality from smoking in developed countries 1950–2000: indirect estimates from national vital statistics. 85% of teenagers end up as cigarette addicts. A majority of the smokers were between 21–40 years of age. The regulation will be fully enforced effective 1 … Tob Control. At present very little data of this kind exist. Regulations prohibiting the sale of tobacco products to minors are in place, but lack of enforcement has resulted in an increase in cigarette purchases by under-aged adolescents in spite of the law [58]. We would also like to thank those who were involved in the study and assisted in data collection and management for their support and cooperation. Among the Malaysians, 71% were Malays. Tobacco smoking is a growing pandemic and in Malaysia, with the current smoking epidemic; the prevalence of smoking in Malaysia is high and tobacco related morbidity and mortality in … Before each interview started, the interviewer read out the consent form in order to obtain written consent. Below are the links to the authors’ original submitted files for images. (Accessed on 26 December 2012), enforcement among minor smokers in Maharani Town, Muar, Johor 2010, ITC Mauritius National Report-Result of the Wave 3 Survey. 10.1056/NEJMc1102459. The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5–47.4%), which was 3% lower than a decade ago. Terms and Conditions, While it is unclear if this can be attributed to a switch to vaping, the same report shows five per cent of Malaysians use vaping products. The prevalence of smoking declined with age; with 59.3% (95% CI 57.4–61.2) among 21–30 year olds, 56.8% (95% CI 55.0–58.6) among 31–40 year olds, 48.5% (95% CI 46.7–50.3) among 41–50 year olds, and 35.0% (95% CI 32.9–37.1) among those aged 61 and above. As developing countries comprise 73% of the world’s smoker population, these countries will be more adversely affected by the health, economic and social impacts of smoking-related diseases [3–5]. (Accessed on 26 Dec 2012), ITC Project: Findings from Wave 1 to 4 Surveys (2005–2009). It excludes smokeless tobacco use. 2004, 13 (2): 63-70. A total of 7,113 out of 15,639 respondents interviewed were current smokers (46.4%, 95%, CI 45.5–47.4). The majority had received secondary education. Divorced (1.67, 95% CI 1.22–2.28) and residing in rural areas (1.12, 95% CI 1.03–1.22) were also associated with a higher likelihood of smoking. 10.1016/j.healthplace.2006.11.001. Cite this article. Correspondence to 2003, http://www.google.com.my/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CDIQFjAA&url=http%3A%2F%2Fwww.moh.gov.my%2Fattachments%2F3996&ei=-zTtUOruLInVkwWklIC4DA&usg=AFQjCNE__D1pUqD9Z8CmrcU53TX7DvqEWQ&sig2=6jWFxsk8yAIhtHlqcCHjmA. A majority began to smoke before the age of 25 (90.1%), 19.7% (95% CI 18.8–20.6) between 13–15 year-old and 33.8% (95% CI 32.7–34.9) between 16–18 year-old. The need and urgency of this issue takes on new meaning with the high prevalence of adolescent smoking in Malaysia, where 1 in 10 adolescents in the 13 to 17-year-old age group are smokers [ 4 ]. 10.1136/tc.2007.022319. Ferketich AK, Gallus S, Iacobelli N, Zuccaro P, Colombo P, La Vecchia C: Smoking in Italy 2007, with a focus on the young. The overall response rate was 96.7%. Data on monthly household income was obtained using an open-ended question asking for the exact income which was later categorized into three categories: (a) less than RM 2000, (b) RM 2000–2999, and (c) RM 3000 and above. A total of 2,150 EBs (1425 urban and 726 rural) and 17,251 LQs were randomly selected. This finding is consistent with what has been reported from previous studies in Europe and Asia [39, 54–56] where it has been postulated that lower-level occupational groups face more physical and psychosocial stressors compared to the managerial and professional classes and therefore, are more likely to engage in high risk health behaviors such as smoking. According to the Control of Tobacco Products (Amendment) Regulations 2018, which were issued in December 2018, smoking is banned in any “eating place,” which is defined as Tobacco Counters Health Vol 4. CAS  Key socio-demographic status variables included age, gender, marital status, highest education level attained, occupation, residential locality and household income level. (Accessed on 8 August 2012), Fact sheet, California Department of Public Health: California Tobacco Control Update. Report http://www.searo.who.int/LinkFiles/Regional_Tobacco_Surveillance_System_GATS_Thailand_2009.pdf. 10.1136/tc.8.2.196. Eur J Public Health. Huisman M, Kunst AE, Mackenbach JP: Inequalities in the prevalence of smoking in the European union: comparing education and income. Male respondents in rural areas were more likely to be smokers compared to males living in urban areas (Adjusted Odds Ratio (aOR) 1.12, 95%, CI 1.03–1.22). The present study also found that 56.0% of current male smokers smoked less than 11 cigarettes per day and another 38.8% smoked between 11–20 cigarettes per day. Addict Behav. Khang and Cho (2006), [53] found that the likelihood of smoking was higher among those from lower education and income bracket. (A).324: Food Act 1983. 2001, 11: 206-210. Smoking can cause harm throughout the body, including the heart, brain, and lungs. Smoking was more common among respondents with low socioeconomic status and among those with primary school education. 1992, 339: 1268-1278. Health Policy. 95% CI 32.0–38.0) (Table 1). Cho HJ, Khang YH, Jun HJ, Kawachi I: Marital status and smoking in Korea: the influence of gender and age. Table 2 shows the distribution of the age of smoking onset and number of cigarettes smoked per day among current smokers. Google ScholarÂ. Public Health. These variations may be due to differences in the tobacco control programs and legislation implemented in these countries [28]. 10.1016/j.healthpol.2009.08.013. These include introduction of tobacco control regulations in 1993, prohibition of advertisement on tobacco products and event sponsorship from tobacco companies, and control on the sales of tobacco products to minors. Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986–2006. Epidemiology of smoking among Malaysian adult males: prevalence and associated factors. Data was collected using a structured questionnaire administered by trained public health personnel. Woobaidullah ASM (2011) Kajian sosio-ekonomi penanam tembakau di Malaysia. 10.1016/0140-6736(92)91600-D. CAS  All authors contributed to developing the manuscript, and read and approved the final version. Moreover, married people tend to have more economic advantages, and receive more social and psychological support which can make quitting smoking more likely. PubMed  The observed decrease, though statistically significant, is very modest compared to other countries that have reduced smoking prevalence by 9% to 25% over 10–20 years after implementing anti-tobacco measures [21, 22]. As Article 14 of the Framework Convention of Tobacco Control is implemented worldwide, it will be helpful to those designing stop smoking services to plan for the kinds of clients they can expect and this depends on how far findings in one country can generalise to other countries. California Privacy Statement, In addition, in this paper we discuss the effectiveness of current tobacco control measures in light of these findings. Teenage smoking is a severe problem in Malaysia and according to the World Tobacco Marketfile, the number of youth smokers are increasing (See Table 1.2). These respondents were thereafter excluded from the sampling frame. However, in Malaysia retailers are still allowed to display tobacco products, and 32% of Malaysian respondents noticed signs and picture of items with cigarette logos at outlets where tobacco products are sold. A similar pattern was reported by the Global Adult Tobacco Survey (GATS), which found that in Malaysia the proportion of current smokers was higher among the 25–44 years old age group (54.9%), decreased to 43.8% for 45–64 year olds, and decreased further to 25.3% for respondents 65 years and above [20]. Helasoja V, Prattala R, Klumbiene J, Petkeviciene J, Kasmel A, Lipand A, Uutela A, Puska P: Smoking and passive smoking in Estonia, Lithuania and Finland. Public Health. Memon A, Moody PM, Sugathan TN, El-Gerges N, Al-Bustan M, Al-Shatti A, Al-Jazzaf H: Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics and attitudes. %%EOF U.S. Department of Health and Human Services: Preventing tobacco use among young people: A report of the Surgeon General. 2000, 78: 1306-1315. volume 13, Article number: 8 (2013) Family with low socioeconomic status is an example of socio-demographic factor. * * Department of Psychology, Universiti Kebangsaan Malaysia, 43600 Bangi, … in 2000 [51, 52] reported higher income level as a protective factor for smoking while Aekplakorn et al. 2010, http://www.wpro.who.int/internet/resources.ashx/TFI/2010GATSCountryReport_FinalVietnam.pdf. Increasing the tax on tobacco products is an avenue for the Malaysian government to effectively decrease the affordability of cigarettes and potentially curb smoking-related diseases in Malaysia. This heralds a worrying trend in Malaysia since at present more than a quarter of its population is aged 15 and below [35]. (2006) [18] and the Malaysia NCD Surveillance-1 in 2006 [19], which found smoking rates of 47.2% and 46.5%, respectively. In addition, smoking status is based on self-reporting and is not validated by objective measurements like biochemical markers of smoking. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al: Priority actions for the non communicable disease crisis. Several possible explanations for this finding are, urban residents are more often exposed to anti-smoking campaigns and measures, and the co-existence of other known risk factors for smoking, namely lower income and education levels, among those living in rural areas. 2006, 62: 1427-1442. 2011, 377 (9775): 14381447-, Article  Approximately 3% of youth between the ages of 13 and 17 were … endstream endobj startxref Moreover, the interview technique employed was standardized and made use of a personalized approach to ensure a high response rate (96.7%) and greater willingness to report on socio-economic status and education level, both key factors for examining the relationship between social class and smoking in the adult male population in Malaysia. Possible explanations for this include having more time to encounter smoking-related health problems, increased health consciousness with age, more time to be exposed to anti-smoking efforts, and a sense of vulnerability that is less pronounced in the younger age groups. This is a cross-sectional school survey conducted on 4500 adolescent students based on a structured questionnaire. There were fewer smokers among those with higher education attainment (31.4%, 95% CI 29.0–33.8), monthly household income of at least RM3000 (39.2%, 95% CI 37.2–41.2), and among working professionals (32.3%, 95% CI 29.6–35.1). 10.1016/j.ypmed.2004.09.022. The total sample size was based on a previous finding of a 10% prevalence rate, margin of error of 1.2 and design effect of 2. The study sample was selected using a two-stage, proportional population size stratified sampling design and the Labour Force Survey (LFS) 2004 sampling frame from the Department of Statistics, Malaysia. ORIGINAL ARTICLE Smoking Among University Students: A Comparative Study Between Malaysian Students in Malaysia and Australia B Hashami, MHPEd* o Abdul Halim, EdD** K Yusoff, MRCP*** * Department of Community Health, Universiti Kebangsaan Malaysia, Jalan Raia Muda Abdul Aziz, 50300 Kuala Lumpur. Cigarettes were also the most consumed tobacco product in the Philippines (97.8%) [27] However, cigarettes were less popular in Thailand (64.9%) and India (43.1%) where hand-rolled tobaccos were also commonly used [23, 26]. 2008, Kuala Lumpur: Institute of Publish Health. Prevalence of smoking is the percentage of men and women ages 15 and over who currently smoke any tobacco product on a daily or non-daily basis. Smoking-related diseases such as cancer and cardiovascular disease are the main cause of premature death globally [1]. Other studies by Huisman et al. However in Malaysia, the CTPR’04 have limited areas where smoking is prohibited. Enumeration Blocks (EBs) are artificially created and geographically contiguous areas consisting of 80–120 households and constitute the primary sampling units for the study. In China, a three-year decrease in the mean age of smoking onset has been reported [30] and taken together with Malaysia, this may represent the success of the multinational tobacco companies which continue to focus their advertisement on the youngsters. For types of occupation, respondents were categorised into 10 major groups according to the Department of Statistics standard method of classification, namely, senior officer, professional, technical, clerical, service, skilled agriculture and fisheries, craftsman, plant and machine operator, elementary occupation, and unemployed. Tobacco output has increased from 1.82 million kilograms in 1970 to a peak of 9.4 million kilograms in 1982, worth $38 million. While Malaysia spends around 3 billion ringgit each year treating smoking-related diseases, smoking rates have remained constant for a decade, at around 25 per cent of the population. Noncommunicable Disease Section, Disease Control Division: Ministry of health Malaysia, myNCDS-1 Malaysia NCD Surveillance-1 2005/2006. in 2005 and Gilmore et al. Google ScholarÂ, Disease Control Division, Ministry of Health: Clinical Practice Guidelines. The finding that older Malaysian males smoke less than middle-aged and younger males is also a cause for concern for the two younger cohorts, as population trends show that there will likely be a rise in their numbers in the future, and therefore a greater burden on the country from smoking unless these trends are reversed. Treatment of Tobacco smoking and dependence 2002. Fifty percent of smokers die of a smoking-related disease, and the life expectancy of one in four smokers is reduced by as much as 15-20 years . Nevertheless, the smoking prevalence in Malaysia was still high when compared to developed countries such as Singapore (16%) 22 and Australia (12.8%) 23. 10.1136/tc.2005.015347. Further investigations are certainly needed to elucidate the reasons for the decreased mean age of smoking onset in Malaysia while developed countries are show the opposite trend [32]. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD: Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years and older: Third national healthand nutrition examination survey, 1988–1994. A study on the burden of disease in 2003 estimated that one-fifth of disability adjusted life years (DALYs) and one-third of years of life lost (YLL) for Malaysians were due to smoking-related diseases [7]. Idris BI, Giskes K, Borrell C, Benach J, Costa G, Federico B, et al: Higher smoking prevalence in urban compared to non urban areas: time trend on six European countries. Schools should have trained personnel who are able to provide smoking cessation counseling to students. 10.1016/j.addbeh.2007.10.010. However the sales of hand-rolled cigarettes also need to be regulated considering that a significantly high proportion of smokers also use them. This finding is consistent with findings from the NHMS II [16] and with findings from a population-based study in China, Thailand and Korea [36, 38, 39], yet runs contrary to reports from the western countries [40, 41]. To reduce the consumption of tobacco product among Malaysians, the Malaysian government has instituted many anti-smoking measures. However, the prevalence of smoking was higher than India (24.3%) [25], but lower than China (66.9%) [26] and the Philippines (53.8%) [27]. Aekplakorn W, Hogan MC, Tiptaradol S, Wibulpolprasert S, Punyaratabandhu P, Lim SS: Tobacco and hazardous or harmful alcohol use in Thailand: Joint prevalence and associations with socioeconomic factors. PubMed  Gilmore ABC, McKee M, Telishevska M, Rose R: Epidemiology of smoking in Ukraine. The campaign apparently succeeded in educating the public on the dangers of smoking [11]. in 2008 [38]. 10.1016/S0033-3506(03)00084-2. Smoking in Malaysia was first dealt with in legislation requiring a general warning message on all Malaysian cigarette packaging in 1976. 2010, 7 (3): 262-267. Health education (particularly on smoking) should be incorporated as a subject in primary and secondary schools curricula and should include encouraging healthy leisure time activities to deter smoking, raising awareness of health impact of smoking, enhancing children’s emotional intelligence and social skills to resist smoking. Only 5.6% of smokers smoked more than 20 cigarettes per day with 55.7% of male smokers smoking less than 11 cigarettes per day (Table 2). 2005, Malaysia: Institute for Public Health, National Institute of Health, Available from URL: http://www.globalforumhealth.org/filesupld/forum9/CD%20Forum%209/papers/Yusoff%20F.pdf. Bull World Health Organ. Am J Epidemiol. In Thailand, the respondents were overwhelmingly of Thai ethnicity (98%). Living quarters (LQs) represent secondary sampling units. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21–30 years (59.3%). 0 10.1016/j.ypmed.2006.02.010. 47 0 obj <> endobj https://doi.org/10.1186/1471-2458-13-8, DOI: https://doi.org/10.1186/1471-2458-13-8. �^"^��{ "Hp��@�$8y�����$����L� #Չ��[� ��5 In conclusion, this study reports and comments on the ongoing high prevalence of current male smokers in Malaysia. 7 The high prevalence of current smokers is associated with males, Malays, the rural population, government servant and those with low educational background. (Ban on Smoking in Malaysian Eateries Takes Effect, STRAITS TIMES (Jan. 2, 2019).) National Health and Morbidity Survey Volume 17. 1996, 5: 215-219. 2008, 33: 503-514. JAMA. However, indirect advertising of cigarette brands in display cabinets may still be found at the check-out counters of sundry shops, food outlets and supermarkets [13]. (Accessed on 29 Dec 2011, Canadian Tobacco Use Monitoring Survey (CTUMS). in 2008 [47], and Aekplakorn et al. http://www.chamscircle.com/news.asp?zoneid=2&articleid=17. Health Place. (Accessed on 5 February 2011), –2010, Global Adult Tobacco Survey: China Country report. And although all states in Malaysia will enforce the smoking ban at all eateries tomorrow, it was reported that Sarawak won’t be enforcing this just yet. Imposing higher taxes on tobacco products may be an effective strategy to boost smoking cessation. Education attainment was categorized into four levels: no formal education, primary education (1–6 years), secondary education (7–12 years), and tertiary education (more than 12 years and enrolled in university). Previous studies have shown that smoking is often used as a coping mechanism to deal with stress [57]. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia. The average number of cigarettes smoked by the study respondents was 12.3 cigarettes per day, slightly less than 13.3 cigarettes per day in 1996 (p < 0.01) [16]. As a first step to successfully attain tobacco control goals, the government should pass the draft Tobacco Control Act immediately. © 2020 BioMed Central Ltd unless otherwise stated. This is consistent with findings reported by Nystedt in 2006 [46], Cho et al. Italian J Public Health. Edited by: Varma AK. et al. The current global estimate of 1.3 billion smokers is expected to increase to 1.6 billion by 2025, and the number of deaths due to smoking-related diseases is expected to reach 8.3 million by 2030, up from 4.8 million in 2006 [2]. NHMS III was a nationwide, cross-sectional, population-based survey. CAS  Intensified efforts directed at encouraging smokers to quit smoking are therefore encouraged by these trends and findings. The questionnaire was bilingual (Bahasa Malaysia and English) with additional translations of selected items and terminologies in Hokkien, Cantonese and Tamil, the dialects of the other two major ethnic groups in Malaysia. About 20% teenagers smoke. Yes, it’s a long list of places - they come under … Goh TC, Tee GH, Salleh S, Lidayati MR, Miezal M, Hairal Z, et al: The effectiveness of Tobacco Product Regulation. About 62,000 families (120,000 people) of Malaysia's 14 million population are involved in tobacco farming, and 360 independent curers employ about 25,000 workers. CAS  Reading the warning labels closely often or very often increased from 54.4 to 68.3% and giving up a cigarette at least once due to the reading the label increased from 24.1% to 45.4% [11]. The number of households selected was based on 4.4 expected respondents per LQ. (Accessed on 15 August 2012), Norsiah Ali, Smoking Cessation: Bringing aspiration into reality. PubMed Central  2006, Kuala Lumpur: NCD Risk Factors in Malaysia, Global Adult Tobacco Survey (GATS) Malaysia. So rare, in fact, that doctors were required to report cases of lung cancer to the federal government to help identify the local environmental cause of the condition among an affected population, much like reporting cases of mesothelioma today. 2008, 94: 793-797. Article  National Health and Morbidity Survey Volume 17. Hock Kuang Lim. 2008, 66: 609-619. WHO Report on the Global Tobacco Epidemic. Research Network for Tobacco Control. By using this website, you agree to our (Accessed on 29 Dec 2011). 10.1016/j.puhe.2007.12.013. Google ScholarÂ. (Accessed on 6 February 2012), Global Adult Tobacco Survey Collaborative Group. Assunta M, Chapman S: The tobacco industry’s accounts of refining indirect tobacco advertising in Malaysia. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21–30 years (59.3%). 2004, http://www.jknj.moh.gov.my/…/FP_1_. Smoking was higher among the Malays (55.9%, 95% CI 54.8–57.1) and people of other indigenous ethnic groups (53.8%, 95% CI 51.2–56.3) than the Chinese (36.0%, 95% CI 34.1–37.9) and Indians (35.0%. In the second National Health and Morbidity Survey (NHMS II) in 1996, a representative sample of the Malaysian population was surveyed, and of the 32,991 participants 24.8% reported being active smokers. Google ScholarÂ. PubMed  In our analysis, ex-smokers, ever smokers and never smokers were combined and constituted the non-smokers category. smoking and smoking among girls and young women Malaysia should prioritise implementation of tobacco control measures in line with recommendations of the WHO Framework Convention on Tobacco Control (FCTC). 2010, 94: 101-110. The sample selection method has been described in more detail in the NHMS III official report [17]. Joossens L, Raw M: The tobacco control scale: a new scale to measure country activity. Five million smokers in Malaysia, survey shows By Hashini Kavishtri Kannan - June 3, 2016 @ 4:36am (FILE) An estimated five million Malaysians, or 22.8 per cent of the population, are smokers, according to the National Health and Morbidity Survey (NHMS). PubMed Central  (Accessed on 6 February 2012), Global Adult Tobacco Survey Collaborative Group. Bull World Health Organ. This could result in underestimating the actual prevalence of smoking amongst Malaysian males, but self-reported data on cigarette smoking and smokeless tobacco use has been found to be valid in other surveys [60]. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Lee JM: Effect of a large increase in cigarette tax on cigarette consumption: an empirical analysis of cross-sectional survey data. 2008, 122: 1061-1067. statement and Park EJ, Koh HK, Kwon JW, Suh MK, Kim H, Cho SI: Secular trends in adult male smoking from 1992 to 2006 in south Korea: Age-specific changes with evolving tobacco-control policies. This study has several limitations; principal among them is its cross-sectional design which limits study findings to the reporting of associations between current smoking status and exposure. World Bank: Curbing the epidemic: governments and the economics of tobacco control. Part of Hence, amendments were made to the tobacco control regulations 1993 to ban all advertisements of tobacco brands on the non-tobacco product. In contrast, prevalence of smoking was lower among high-income earners and professionals in the service or production sectors [16]. Article 8 of FCTC dictates the signatory countries consider total smoking prohibition in all enclosed areas and public places. Prev Med. 2006, 42: 415-422. Tob Control. Malaysia has become the latest ASEAN member state to establish more smoke-free zones; rolling out a divisive smoking ban on 1 January which prohibits smoking in all restaurants, open-air eateries, coffee shops and hawker centres. The strengths of this study include its large sample size and representativeness of the Malaysian population. 46.4 %, CI 45.5–47.4 ) study Reports article about smoking in malaysia comments on the product! Regulated considering that a significantly high proportion of ex-smokers in older age was! 16 ] events and smoking behaviour and attitudes among adult persons residing in urban areas of China and professional. Smokers compared to Indians to account for the complex study design and surveyed January. 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While Aekplakorn et al these findings Malaysia for His permission to Publish this paper can be Accessed:. Dropped by only 2.8 % between 1996 and 2006 the consumption of tobacco brands on the high... Biochemical markers of smoking among Malaysian adult males in this study Reports and comments on the dangers of was. Were no significant differences in the European union: comparing education and income the. Per day among current smokers ( 59.3 % ) and 17,251 LQs were randomly selected National Center for Health 49.2. A non-tobacco product use by socio-demographic, environmental and personal factors is increasing million kilograms in 1982, $. Tobacco products may be an effective strategy to boost smoking cessation counseling to students areas where smoking is the step... 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