Cigarette smoking, e-cigarette, and heated tobacco product use and associated factors among a nationally representative sample of adult Malaysians: An online survey.

INTRODUCTION

We aimed to estimate the prevalence of cigarette smoking, e-cigarette, and heated tobacco product use behaviors and their associated factors among adult Malaysians.

METHODS

A cross-sectional online survey was conducted in December 2024 among a nationally representative sample of 1000 adult Malaysians (≥18 years). We used a questionnaire adapted from the Global Adult Tobacco Survey. Binary logistic regression analyses were performed to identify factors associated with tobacco and nicotine product use.

RESULTS

The overall prevalence of current smoking was 28.6% (95% CI: 25.8-31.4), with a mean age of smoking initiation of 21.5 years. Awareness of e-cigarettes was high (92.4%), with 14.6% (95% CI: 12.5-17.0) and 13.4% (95% CI: 11.4-15.8) reporting current daily and non-daily use, respectively. Fewer respondents were aware of heated tobacco products (HTPs, 548.5%), with 4.5% (95% CI: 3.4-6.1) and 10.0% (95% CI: 8.2-12.1) reporting current daily and non-daily use, respectively. Current smoking (AOR=44.19; 95% CI: 24.78-78.81 for e-cigarettes; AOR=31.0; 95% CI: 13.58-73.57 for HTPs), male sex, younger age, and exposure to advertisements were significantly associated with e-cigarette and HTP use. A smoke-free home environment was a protective factor against e-cigarette (AOR=0.44; 95% CI: 0.24-0.80) and HTP use (AOR=0.27; 95% CI: 0.13-0.55).

CONCLUSIONS

Continued surveillance of nicotine product use is essential. Tobacco control measures under the new Public Health Act should include specific regulations for e-cigarettes and heated tobacco products, particularly targeting younger populations.