Article type
Abstract
Background: Smoking is one of a major public health problem globally. Most smokers start smoking in their youth when growth has not been yet completed and they are more susceptible to the harmful components of tobacco. It is estimated that 20,000 deaths in Malaysia are attributed to smoking annually. There have been several new evidences-based developments in the smoking cessation services such as introduction of new cessation pharmaceutical aids, combination use of pharmaceutical aids, new scientific evidence of behavioural therapies and now the emergence of electronic nicotine and non-nicotine devices such as Vape.
Objective: To provide evidence-based recommendations in the identification of the risk on initiation of smoking among children and to optimise cessation rate.
Methods: A panel of respiratory physician and Cochrane trainers with expertise smoking cessation were invited and convened to develop a national policy smoking free generation. We first identify the risk for initiation of smoking among children. We followed Cochrane Method to search databases including PubMed and CENTRAL (Cochrane Central Register of Controlled Trials) from inception to December 2023, for studies that examined on the factors of smoking initiation among children. Experts in the field were also contacted to identify relevant studies. The findings were discussed and recommendations were given based on best achievable majority opinion.
Results: A total of 249 studies were included in this review. Many factors on smoking initiation among children were identified, including peer influence, influences from family members, influences from other people, exposure to smoking advertisements, influences from social media, mental health, accessibility to cigarette, financial-related factors, curiosity, and other factors. Peer influence (pooled OR 1.07, 95% 1.01 to 1.15, p=0.03) and influences from family members (pooled OR 1.18, 95% CI 1.03 to 1.35, p=0.02) were shown to have significant risks on children to initiate smoking.
Conclusions: Access to tobacco products, smoking by peers and siblings are among the factors for early initiation. The findings indicate a need for specific interventions before smoking initiation. A well-designed national smoking prevention and cessation programs must be put in place after identifying the causes of young people smoking initiation.
Objective: To provide evidence-based recommendations in the identification of the risk on initiation of smoking among children and to optimise cessation rate.
Methods: A panel of respiratory physician and Cochrane trainers with expertise smoking cessation were invited and convened to develop a national policy smoking free generation. We first identify the risk for initiation of smoking among children. We followed Cochrane Method to search databases including PubMed and CENTRAL (Cochrane Central Register of Controlled Trials) from inception to December 2023, for studies that examined on the factors of smoking initiation among children. Experts in the field were also contacted to identify relevant studies. The findings were discussed and recommendations were given based on best achievable majority opinion.
Results: A total of 249 studies were included in this review. Many factors on smoking initiation among children were identified, including peer influence, influences from family members, influences from other people, exposure to smoking advertisements, influences from social media, mental health, accessibility to cigarette, financial-related factors, curiosity, and other factors. Peer influence (pooled OR 1.07, 95% 1.01 to 1.15, p=0.03) and influences from family members (pooled OR 1.18, 95% CI 1.03 to 1.35, p=0.02) were shown to have significant risks on children to initiate smoking.
Conclusions: Access to tobacco products, smoking by peers and siblings are among the factors for early initiation. The findings indicate a need for specific interventions before smoking initiation. A well-designed national smoking prevention and cessation programs must be put in place after identifying the causes of young people smoking initiation.