Cigarette, e-cigarette and dual use among Malaysian adolescents: A secondary analysis of the 2017 and 2022 adolescent health surveys
Abstract
Introduction: Tobacco usage continues to pose a considerable public health challenge in Malaysia, with a predominant number of smokers initiating use during adolescence. The rapid increase of alternative nicotine products, especially e-cigarettes, has changed tobacco consumption trends among adolescents. This study examined changes in the prevalence of cigarette, e-cigarette, and dual use among Malaysian adolescents between 2017 and 2022.
Methods: This was a secondary analysis of cross-sectional data from the National Health and Morbidity Survey (NHMS) 2017 and 2022 Adolescent Health Survey (AHS), which employed a consistent multistage, stratified, cluster sampling design. Data were collected via self-administered questionnaires. Primary outcomes were past 30-day cigarette-only use, e-cigarette-only use, and dual use of both products. Weighted prevalence estimates and multivariable logistic regression analyses were applied to identify associated factors.
Results: The survey achieved response rates of 89.0% in both 2017 and 2022. Between 2017 and 2022, cigarette-only use declined from 4.9% to 0.9% (p<0.001), while e-cigarette-only use increased from 6.3% to 8.4% (p=0.002). Dual use decreased slightly from 5.6% to 4.5% (p=0.045). Multivariable logistic regression revealed that males, upper secondary students, and those with parental tobacco use had higher odds of tobacco use across all categories. Ethnic differences were also observed.
Conclusions: The nicotine landscape among…
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Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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