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This paper intends to narrow the knowledge gap with the illustration of SHS exposure in various public areas (restricted and non-restricted) and social demographic variation of exposure among Malaysians to SHS.
Data for this paper was derived from the Malaysian Global Adult Tobacco Survey (GATS) which was carried out from October 2011 to January 2012.
It consists of nine components, namely social demographics, smoking status, type of tobacco product used, exposure to SHS at home, work and selected public areas, expenditure on cigarettes, knowledge of smoking hazards and SHS, intention to quit, exposure to tobacco product advertisements and information regarding the hazards of tobacco products. Exposure to SHS was determined by items ‘Have you visited these public areas: (1) government offices; (2) health facilities (including a hospital or clinic); (3) public transport terminal; (4) air-conditioned shopping complex; (5) bar or night club; (6) cafe/coffee shop/bistro; and (7) non-air-conditioned restaurant during the last 1 month?
The smoking status of respondents was evaluated by several items: ‘Do you currently smoke? ’ Respondents who answered ‘No’, ‘Don’t know’ or ‘refused to answer’ were excluded from further analysis.
The study utilised a cross-sectional design and three-stage sampling proportionate to size to obtain a representative sample of Malaysians aged 15 years and above.
The first strata consisted of 15 states in Malaysia, while the second stage was the division of urban and rural areas by each state.
Design Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia.
Data was obtained through face-to-face interviews using a validated pre-tested questionnaire.
All information given was treated as confidential and utilised for research purposes only.
Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9).
Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas.
See: Secondhand smoke (SHS) is composed of side stream smoke (the smoke released from the burning end of a cigarette) and exhaled mainstream smoke (the smoke exhaled by the smoker).1 There are more than 200 of these chemicals, confirmed carcinogens and respiratory toxins (eg, benzene, 1,3-butadiene, formaldehyde, mercury and hydrogen cyanide).2 Exposure to SHS could affect the health of an individual.
Epidemiological studies revealed that SHS exposure causes an increased risk of lung cancer by 20% to 30%,3 heart disease by 25% to 30%,4 stroke by up to 82%5 and an increased risk of other non-fatal respiratory illnesses.4 In addition it has been shown to have adverse effects on reproduction and associated with sudden infant death syndrome (SIDS).3 4 Furthermore, SHS has also been associated with recurrent wheezing, respiratory illnesses, decreased lung function and asthma,6 7 as well as chronic respiratory symptoms among adults.8 Annually 600 000 deaths were reported globally due to exposure to the SHS.9 10 Prohibition of smoking in public areas was among the public health policies to reduce exposure to SHS in public areas apart from de-normalising smoking behaviour.
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The face-to-face interview approach by trained research assistants was used to obtain data from selected respondents.