Introduction: Secondhand tobacco smoke is a known carcinogen and has shown positive association with smok-ing status, susceptibility and cessation. Smoke free environment policy seem to reduce this exposure and influence intention to quit and frequency of quit attempts. Despite having a smoke free policy, smokers are still exposed to second hand smoke and this might influence their smoking behaviour and cessation. The objective of this study was to examine the association between environmental tobacco smoke exposures with intention to quit smoking among young adults in college with smoke free policy. Methods: Data were drawn from a cluster based randomised controlled trial in 10 government colleges in Selangor. Baseline characteristics of 160 college smokers were mea-sured using adapted questionnaire. Intention to quit was measured using Transtheoretical Model and environmental influence of tobacco smoke exposure. Results: Majority of the smokers were male (99.4%), single (100%), of Malay ethnicity (94.4%) and Muslim (95.6%). Most of them are in pre-contemplation stage where they do not have any intention to quit (65.6%). On environmental influence, at work or college environmental exposure, majority were exposed between 1 to 2 hours (36.9%) and 3 to 8 hours (40.6%). On exposure at home or hostel, majority were exposed between 1 to 4 hours (44.4%) and 5 to 14 hours (21.9%). In terms of friend’s exposures, majority have most of their friends smoking (68.1%). We found no statistically significant association between environmental influence and intention to quit smoking. Conclusion: Although we found no relationship, future research should examine the pathway between environmental influence and smoking behaviour.
Carbon monoxide measurement is one of the biomedical risk assessments in smoking cessation. With the advancement in medical devices, risk assessment among smoker using carbon monoxide can be an effective intervention for quit smoking. A systematic review was conducted on the effectiveness of using carbon monoxide measurement in smoking cessation intervention. Material and methods: A systematic review and narrative synthesis were done using PRISMA guideline. A broad database search on English literature was conducted including Medline, PubMed, Scopus and Science Direct from 2008 till 2017. Additional studies were also searched through snowballing technique by searching the bibliographies of selected studies. Five studies met the criteria with two studies were done in clinical settings while the other was done at population settings. The studies were conducted in the United States of America, United Kingdom and South Korea. All study were two-arm randomized controlled trials with variation in the outcome measurement mainly intention to quit, quit attempt and smoking abstinence. There was also variation in the duration of follow up ranging from 1 week to 12 months. Results: Only three studies found statistically significant increased in motivation or intention to quit smoking but only at 1 month follow up. All five study found no significant difference in frequency of quit attempt or smoking abstinence. Most of the studies recruited participants based on voluntary participation thus limiting the generalizability of the results. Conclusions: The present review has found limited studies on the effect of carbon monoxide measurement intervention for quit smoking. It may only be beneficial at the motivational level and not translated into behavioural changes. However, the effect too was short term and not sustained in the long term.
Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis