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Introduction Smoking has been a major contributor to morbidity and mortality worldwide including in Malaysia. Every year, more than 8 million people die from tobacco use worldwide1 . In Malaysia, smoking related-diseases have been identified as the major contributor to disability-adjusted life years and lost of years of life among the Malaysian population. The government of Malaysia through the Ministry of Health and other ministries have introduced numerous anti-smoking measures to prevent and control smoking behaviour in the country. Continuous monitoring of smoking status is essential in evaluating the effectiveness of anti-smoking policies. Objectives This paper aimed to study the trend in prevalence and sociodemographic factors of smoking in Malaysia. Methodology The study utilised data from three national household surveys in Malaysia namely the Global Adult Tobacco Survey (GATS) 2011, the National Health and Morbidity Survey (NHMS) 2015 and the National Health and Morbidity Survey (NHMS) 2019. The surveys adopted a multistage stratified sampling design that could represent population in Malaysia. All the three surveys had the same target population (population aged 15 years and above) and smoking questionnaires. Smoking status was measured based on GATS protocol and definitions5 . Complex sample design analysis was used to estimate the prevalence and complex multivariable logistic regression was used to identify sociodemographic factors of smoking for all the three surveys. Results A total of 4250, 21,410 and 11,111 respondents aged 15 years and above participated in GATS 2011, NHMS 2015 and NHMS 2019 respectively with the response rate of 85% to 87%. The prevalence of smoking was 23.1% (95% CI; 21.2, 25.2) in 2011, 22.8% (95% CI; 21.9, 23.8) in 2015 and 21.3% (95% CI; 19.9, 22.8) in 2019. The prevalence was consistently higher in males (40.5% - 43.9%), adults aged 25-44 years (25.4% - 29.0%), Malay (22.6% - 24.7%), other ethnics (30.0% - 35.0%), and among the self-employed (33.7% - 44.6%) (Table 1). ...

Tobacco control strategies have contributed to substantial declines in smoking in the United States. However, smoking still remains the single largest preventable cause of disease and premature deaths in the country. Despite the continuing challenges of implementing tobacco control strategies and the pervasive influence of the tobacco industry to undermine such strategies, there are now unprecedented opportunities to prevent smoking initiation, facilitate cessation, and protect nonsmokers from secondhand smoke. In this paper, we briefly review the most recent literature discussing key strategies that have proven effective in tobacco control including regulations on sales and marketing of tobacco products, taxation, and smoke-free legislation. We focused on these three tobacco control strategies because of their potential to positively influence the environment of both minors and adults regardless of their smoking status. Although research has identified significant individual and social predictors of tobacco use, environmental influences are also important risk factors for tobacco use.

Personality variables of Discipline, Social Competence, Sophistication, and Religiosity were studied in relation to eating, drinking, and smoking behaviors. Discipline was conceptualized as the intrapsychic predisposition to engage in indulgent behavior, and the remaining personality variables were seen as potentially moderating its form of expression. Data were contributed by 766 female volunteers aged 20 to 30 years, sorted to yield two quasi-representative samples of 265 subjects each. A subsample of 64 subjects repeated the questionnaire after three months, and all measures had acceptable properties. Analyses involving Discipline supported its general relevance to a broad range of behaviors, and Social Competence, Sophistication, and Religiosity were selectively relevant as anticipated. Overall, the personality variables had stronger links with drinking status, smoking status, and drinking level than with eating behavior or smoking level.

Purpose: The current project sought to examine whether delivery of lung cancer risk projections (calculated using the Liverpool Lung Project [LLP] risk model) predicted follow-up smoking status. Design: Two single-blinded randomized controlled trials. Setting: Stop Smoking Services in Liverpool (United Kingdom). Participants: Baseline current smokers (N = 297) and baseline recent former smokers (N = 216) were recruited. Intervention: Participants allocated to intervention groups were provided with personalized lung cancer risk projections, calculated using the LLP risk model. Measures: Baseline and follow-up questionnaires explored sociodemographics, smoking behavior, and lung cancer risk perceptions. Analysis: Bivariate analyses identified significant differences between randomization groups, and logistic regression models were developed to investigate the intervention effect on the outcome variables. Results: Lung cancer risk projections were not found to predict follow-up smoking status in the trial of baseline current smokers; however, they did predict follow-up smoking status in the trial of baseline recent former smokers (odds ratio: 1.91; 95% confidence interval: 1.03-3.55). Conclusion: The current study suggests that lung cancer risk projections may help maintain abstinence among individuals who have quit smoking, but the results did not provide evidence to suggest that lung cancer risk projections motivate current smokers to quit.

Government agencies rely on surveys in which individuals self-report their smoking activities, which raises questions about biases in responses. To validate self-reported smoking numbers, medical researchers often rely on urinary concentrations of cotinine, the main metabolite of nicotine. But virtually all existing studies investigate whether self-reported nonsmokers misreport their smoking status. Such investigations leave unanswered whether individuals who admit smoking nonetheless smoke more than they claim. This article produces two findings of interest, both pertaining to self-reported smoking among Blacks. First, among self-reported nonsmokers, a Black person is approximately 47% more likely to smoke compared with a non-Black person. Second, among individuals who admit to smoking, the average Black smoker underreports his smoking activity by a larger amount than 70% of all self-reported smokers. Slower metabolism of cotinine among Blacks explains some, but not all, of those numbers.

Background: Cigarette smoking is a known risk factor for chronic diseases. It is predicted that by the 2020s there will be about 10 million tobacco related deaths annually worldwide. Improved understanding of factors that contribute to smoking initiation and cessation may help to set strategies that lead to smoking behaviour change. Objective: To assess the prevalence of smoking, and factors associated with smoking initiation among military personnel. Method: A cross-sectional study was conducted and data was obtained from 398 men and women aged 18-52 years in two Defence military academies, located in Holeta and Awash Arba, 30 km and 250 km away from Addis Ababa, respectively. Information on smoking habits, socio-demographic and psycho-social factors were collected through self-administered questionnaire, from January to February 2011. The study population was selected by systematic sampling technique after stratification was made. Data was entered using Epi Info 3.51 version and analyzed using SPSS version 15. Bivariate analysis was used to examine association between dependent and independent variables. Result: Of 398 respondents 86 (21.6%) were current regular smokers, and 165(41.5%) reported having alcohol drinking habit. Majority of smokers were men, unmarried, low education and income status. Smoking initiation was associated with low educational status, OR (2.70, 95% CI, 1.14-6.39), and low income status, OR (3.29, 95% CI, 1.39-7.84). Conclusion: Current smoking status was found to be associated with low educational and low income status. Recommendation: Addressing socioeconomic and educational differences, by upgrading income status and promoting access to education and awareness raising on smoking harm will be required to reduce prevalence of smoking among military personnel.

Background: Cigarette smoking is a known risk factor for chronic diseases. It is predicted that by the 2020s there will be about 10 million tobacco related deaths annually worldwide. Improved understanding of factors that contribute to smoking initiation and cessation may help to set strategies that lead to smoking behaviour change. Objective: To assess the prevalence of smoking, and factors associated with smoking initiation among military personnel. Method: A cross-sectional study was conducted and data was obtained from 398 men and women aged 18-52 years in two Defence military academies, located in Holeta and Awash Arba, 30 km and 250 km away from Addis Ababa, respectively. Information on smoking habits, socio-demographic and psycho-social factors were collected through self-administered questionnaire, from January to February 2011. The study population was selected by systematic sampling technique after stratification was made. Data was entered using Epi Info 3.51 version and analyzed using SPSS version 15. Bivariate analysis was used to examine association between dependent and independent variables. Result: Of 398 respondents 86 (21.6%) were current regular smokers, and 165(41.5%) reported having alcohol drinking habit. Majority of smokers were men, unmarried, low education and income status. Smoking initiation was associated with low educational status, OR (2.70, 95% CI, 1.14-6.39), and low income status, OR (3.29, 95% CI, 1.39-7.84). Conclusion: Current smoking status was found to be associated with low educational and low income status. Recommendation: Addressing socioeconomic and educational differences, by upgrading income status and promoting access to education and awareness raising on smoking harm will be required to reduce prevalence of smoking among military personnel.

The study aimed to investigate the relationship between smoking, Sugar-Sweetened Beverage (SSB) consumption and tooth brushing among adolescents in China. A valid sample of 6084 middle school students from the Zhejiang province was included. Participants were questioned about smoking status, SSB consumption, tooth brushing, and oral health-related quality of life (OHRQoL). Among the participants, smoking prevalence was 1.9% and nearly half of the students consumed SSBs. The demographic factors associated with smoking were gender, place of residence, and parental level of education. There are co-variations between smoking status, SSB consumption, and tooth brushing. Logistic regression showed that smoking adolescents were more likely to brush their teeth less than once per day (OR = 1.74, p < 0.05), consume soft drinks once or more per day (OR = 2.18, p < 0.01) and have a higher score on the Child Oral Health Impact Profile (OR = 1.05, p < 0.05) after adjusting for demographic factors. The findings provide compelling evidence for governments and related stakeholders to intervene in the lifestyle of adolescents. Future studies are needed to understand the interaction effects of such behaviors, and should help to inform appropriate interventions.

Abstract.  A key concern in policy debates over youth smoking is whether preventing children from smoking will stop them from smoking as adults or merely defer initiation into smoking. This paper estimates determinants of smoking status in late adolescence viewing smoking at age 14 as an endogenous 'treatment' on subsequent smoking. This approach disentangles causation from unobserved heterogeneity and allows addictiveness to vary across individuals. Exploiting large tax changes across time and across regions in Canada in the early 1990s, the estimated model suggests that smoking is highly addictive for the average youth but less so for youths who actually do initiate early or who are likely to be induced to initiate early at the margin. Thus, policies that deter initiation will reduce eventual smoking rates, but not by as large a magnitude as conventional econometric models might suggest. JEL classification: I1, C3

This study aims to investigate the association between contract type (temporary vs permanent employment) and unhealthy behaviour (alcohol dependence and cigarette smoking) in a sample of Turkish health care workers ( N = 480). The authors hypothesize that temporary compared with permanent workers are more likely to depend on alcohol and to smoke cigarettes owing to increased work-related stress. Conditional logistic regressions were used to estimate the odds ratios of alcohol dependence and smoking status according to contract type. Controlling for gender, occupational position, education, family status, age, tenure and income, temporary workers compared with permanent workers were 5.6 times more likely to be alcohol dependent. However, no significant differences were established for smoking status. The study underlines the association between temporary employment and alcohol dependence, and, in particular, the possibility of reversed causation and possibilities for generalizing results to other populations and to other countries, as an important route for future research.

<b><i>Background:</i></b> Smoking cessation during pregnancy and preventing relapse postpartum is a pivotal public health priority. <b><i>Objectives:</i></b> This study examined the risk and protective indicators of women who (a) smoke before pregnancy, (b) smoke during the entire pregnancy, (c) successfully quit smoking during pregnancy, and (d) relapse postpartum. <b><i>Method:</i></b> This paper reports secondary analyses of the Dutch population-based Monitor on Substance Use and Pregnancy (2016). A representative sample of mothers of young children (<i>n</i> = 1,858) completed questionnaires at youth health care centers. Bivariate and multivariate logistic regression analyses were conducted. <b><i>Results:</i></b> Main results showed that women's smoking around pregnancy was strongly associated with the partner's smoking status before pregnancy, partner's change in smoking during pregnancy, and partner's change in smoking postpartum. Women's educational level and cannabis use before pregnancy were also related with women's smoking before and during pregnancy. Women's intensity of alcohol use before pregnancy was ambiguously related with women's smoking before and during pregnancy. <b><i>Conclusions:</i></b> One of the key findings of this study suggests that it is essential that partners quit smoking before pregnancy and do not smoke during pregnancy. If partners continue smoking during pregnancy, they should quit smoking postpartum. Health care professionals can play an important role in addressing partners' smoking and giving them evidence-based cessation support before, during, and after pregnancy.

Abstract
We estimate and explore mechanisms of the impact of the Earned Income Tax Credit (EITC) expansions on the smoking behavior of women. Differential increases in federal EITC benefits by family size in the mid-1990s allow for a comparison of smoking status changes between mothers with one and more than one child. We exploit these changes in a difference-in-differences framework using data from the 1993-2001 waves of the Behavioral Risk Factor Surveillance System (BRFSS) and show that the increase in EITC benefits yielded a significant decline in the likelihood of being a current smoker among unmarried mothers with less than a college degree. Although women with a high school degree or less and women with some college education received similar benefit increases on average and exhibited similar labor supply responses, the reduction in the likelihood of smoking was concentrated among those with some college.

Purpose:The aims of this analysis were to explore how self-reported barriers to quitting vary by socioeconomic status (SES) among young-adult smokers and to assess their relationship to quitting.Design:This analysis uses 2 waves of telephone-survey data from the Minnesota Adolescent Community Cohort study.Setting:Midwestern United States.Participants:Participants (n = 419) were smokers aged 17 to 24 years.Measures:Socioeconomic status was estimated using the highest level of education completed by the participants' parents. Demographics, smoking behavior, and perceived barriers to quitting were collected via survey questions.Analysis:Differences in barriers by SES were assessed using prevalence ratios (PRs). Relative risks were calculated to assess the association between barriers and quitting status 1 year later, testing for effect modification by SES.Results:Compared to the high SES group (n = 314), the low SES group (n = 105) was more likely to report several barriers to quitting; however, only the risk of gaining weight was significantly more common (PR: 1.38 [1.05-1.83]). There were no significant associations between barriers and quitting status 1 year later, but the number of cigarettes per day was consistently related to the likelihood of quitting 1 year later, regardless of SES.Conclusion:Despite the limited generalizability to racially diverse populations and different geographic locations, the results suggest perceived barriers may not differ by SES or predict quitting among young adults; however, nicotine dependence may play an important role.