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A cross-sectional survey conducted in 2001 among 4500 adolescent secondary students from 14 schools in
Negeri Sembilan, Malaysia, revealed several important health issues that deserve the attention of primary
care doctors and health policy planners.
Reprints request: Dr Lee Lai Kah, laikah@gmail.com
SMOKING: 1 IN 7
Lee LK, Chen PCY, Wong KC, Jagmohni K. Smoking among secondary school students in Negeri Sembilan,
Malaysia. Asia Pac J Public Health. 2005;17(2):130 [PubMed]
The prevalence of smoking among the students was 14.0%. About a third of the students (37.8%) started
smoking at 13 to 14 years of age. The prevalence of smoking among the male students was higher (26.6%)
compared to the female students (3.1%). Adolescent smoking was associated with (1) socio-demographic
factors (age, ethnicity, rural/urban status); (2) environmental factors (parental smoking, staying with
parents); (3) behavioural factors (playing truant and risk-taking behaviours such as physical fighting, drug
use, alcohol use, sexual activity, lack of seatbelt use, riding with a drunk driver); (4) lifestyle behaviours
(being on diet and lack of exercise); (5) personal factors (feeling sad and suicidal behaviours).
EVER ATTEMPTED SUICIDE: 1 IN 20
Chen PCY, Lee LK, Wong KC, Jagmohni K. Factors relating to adolescents suicidal behavior: a cross-sectional
Malaysian school survey. J Adolesc Health. 2005;37(4):337 [PubMed]
Seven percent of the adolescent students had seriously considered attempting suicide. Among the
adolescents, 4.6% of them had attempted suicide at least once during the 12 months preceding the survey.
The female adolescents were more likely to put their suicidal thought into suicidal action than male
adolescents. Malay and Indian are more likely than Chinese in the aspect of ‘felt sad and hopeless’.
However, Malay adolescents had the lowest rate in attempting suicide. Based on multiple logistic
regression, factors significantly related to the urban adolescents suicide behavior are ‘felt sad or hopeless’,
‘number of days felt unsafe to go to school’, ‘riding with a driver who had been drinking alcohol’, ‘physical
fight’, and ‘number of days absent from school’. On the other hand, factors relating to the rural adolescent
suicide behavior are ‘felt sad or hopeless’, ‘physical fight’, ‘physical fight resulting in injury’, and ‘drive a
vehicle after drinking alcohol’.
EVER HAD SEX: 1 IN 19
Lee LK, Chen PCY, Lee KK, Jagmohni K. Premarital sexual intercourse among adolescents in Malaysia: a
cross-sectional Malaysian school survey. Singapore Med J. 2006;47(6):476-81 [PubMed]
The study showed that 5.4% of the total sample reported to have ever had sexual intercourse. The
proportion among males students who had ever had sex was higher (8.3%) compared with females students
(2.9%). The mean age at first sexual intercourse was 15 years. One percent of students reported that they
had been pregnant or had made someone else pregnant. Adolescent sexual intercourse was significantly
associated with (1) socio-demographic factors (age, gender); (2) environmental factors (staying with
parents); (3) substance use (alcohol use, cigarette smoking, drug use) even after adjustment for
demographic factors. The survey showed that 20.8% of respondents had ever taken alcohol, 14.0% had
smoked cigarettes and 2.5% had tried marijuana, 1.2% had tried ecstasy pills, 2.6% had tried glue sniffing,
0.7% had tried heroin and 0.7% had taken intravenous drugs into the body.
DYSMENORRHOEA: ONE OUT OF THREE BUT ONLY ONE IN TEN CONSULTED DOCTORS
Lee LK, Chen PCY, Lee KK, Jagmohni K. Menstruation among adolescent girls in Malaysia: a cross-sectional
Malaysian school survey. Singapore Med J. 2006;47(10):899-74 [PubMed]
A cross sectional descriptive study was carried out among 2411 secondary school adolescent females in
Negeri Sembilan. Abnormal cycle length (menstrual cycle longer than 35 days or cycle length between 14 to
20 days or irregular pattern) was common and affected 37.2% of them. Majority (74.6%) experienced
premenstrual syndrome and 69.4% had dysmenorrhoea. About 18% reported excessive menstrual loss
(use 2 pads at a time to prevent blood from soaking through or confirmed by doctor to be anaemic due to
heavy menstrual flow). Only 11.1% of schoolgirls seek medical consultation for their menstrual disorders.
Mothers remained the most important source of information (80%). Menstrual disorders were significantly
more common in female adolescents who smoke and have suicidal behaviours (p<0.05). Absenteeism was
more common in those with increasing severity of dysmenorrhoea.
Around 5.4 million people die each year worldwide because of smoking and tobacco
related disease, according to the World Health Organization – including over
438,000 Americans, 650,000 Europeans and 1.2 million people in China.
Tobacco use will kill 1 billion people worldwide in the 21st century if current smoking trends
continue.
6.6 billion people are on this planet and 1.3 billion are smokers, the International Union against
Tuberculosis and Lung Disease (The Union) and the World Lung Foundation (WLF) told the
38th Union World Conference on Lung Health.
66 percent of all smokers live in just 15 countries, according to The Union and the WLF.
1.8 billion young people aged of 10 to 24 smoke cigarettes, according to the World Health
Organization.
* More than 85 percent of these young smokers live in developing countries (WHO).
Nearly one billion men and 250 million women use tobacco every day around the world,
according to a study presented at the 14th World Conference on Tobacco or Health.
Top of Form
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Quit Smoking Book
There are thought to be 800 million smokers in developing countries and only 1.1 billion
smokers worldwide (WHO).
Learn more about how many people smoking kills worldwide.
45+ million Americans smoked in 2006. That's 20.8 percent of Americans, according
to estimates from the federal Centers for Disease Control and Prevention (CDC).
American men smoked at a rate of nearly 24 percent of the population, while 18 percent of
women smoked.
2.4 million cases of cancer in the US from 1999 to 2004 were caused by tobacco use, according
to the CDC.
Read on for more international smoking facts.
Grab 13 Lucky Freebies Now
• More than two thirds of the world's smokers live in just 10 countries (WHO):
1. China
2. India
3. Indonesia
4. Russia
5. US
6. Japan
7. Brazil
8. Bangladesh
9. Germany
10.Turkey
• Tobacco is a "major health problem" in Southeast Asia. "Approximately 50
percent of males smoke and youths, especially girls, continue to take up
smoking," experts from eight of the 10 Association of Southeast Asian
Nations (ASEAN) members said. ASEAN consists of Cambodia, Indonesia,
Laos, Malaysia, the Philippines, Singapore, Thailand and Vietnam.
• The global anti-smoking pact was operational beginning February 27, 2005
for countries that have actually ratified it. It was the first international treaty
against smoking, including an advertising ban, and was signed by more than
190 countries on May 21, 2003.
• In China, there are about 350 million smokers (about 25 percent of the
population). It's also one-third of the world's smokers, according to World
Health Organization statistics.
* 100 million smokers in China are under the age of 18, according to the
Chinese health ministry.
* Did you you that just 10 percent of Chinese Americans smoke in the US
as opposed to the 36 percent smoking rate in China itself?
* About 40 million of China's 130 million children aged 13 to 18
had tried smoking, according to a Health Ministry report.
* 56.8 percent male Chinese doctors smoke, highest in the world,
according to a report by the China Preventive Medicine Association.
• Spain deals low price tobacco brands a blow. 9 months after passing tough
new legislation limiting lighting up in public places, which set off a bitter price
war by tobacco manufacturers, Spain hiked cigarette tobacco taxes to 70
euros (90 dollars) per 1,000 cigarettes.
• "20 million cigarettes are smoked every day in Egypt (that's billions of
cigarettes each year). . . There are no accurate figures for shisha (hookahs)
but it is becoming a modern trend," Egyptian Health Minister Hatem al-Gabal
said.
* "An average of 2.5 percent of household income is spent on tobacco in
Egypt, which is more than on health and leisure," Dr Fatima el-Awa, from the
World Health Organization's (WHO) regional office said.
• Did you know that the regular tobacco waterpipe (hookah) smoker is exposed
to larger amounts of nicotine, carbon monoxide and certain other toxins than
the typical cigarette smoker? (WHO).
• In India, 40 percent of all health problems were due to tobacco, according to
Health Minister, Anbumani Ramadoss.
* Nearly 17 percent of students in India, aged 15 and under, use some
form of tobacco, mainly cigarettes, according to a survey conducted by the
World Health Organization.
* Can you believe some 37 percent of kids below the age of 10 tried
smoking cigarettes? This, however, is down from 49 percent of Indian
children who tried their first cigarette (from WHO study above).
* Teaching tobacco use? More than a third of school personnel, including
teaching staff, are tobacco users (from WHO study above).