Effectiveness of a Dentist-based Anti-Smoking Intervention Among Malaysian Adolescents: A Randomized Controlled Field Trial.

BACKGROUND

The KOTAK program is a national public health initiative in Malaysian primary and secondary schools aimed at reducing youth smoking through school dental services. This study evaluated its effectiveness in Seremban, Negeri Sembilan, Malaysia.

OBJECTIVES

1) To determine the percentage of schoolchildren who quit smoking through the KOTAK program; 2) To identify factors associated with quitting smoking in the program.

METHODS

A clustered, randomized controlled trial was conducted in schools. Self-reported smokers meeting inclusion criteria were enrolled. Data on demographics, self-reported smoking abstinence, and nicotine addiction levels were collected at baseline, three months, and six months post-intervention. Exhaled carbon monoxide was measured at all time points, and salivary cotinine was collected at three- and six-month follow-ups.

RESULTS

Six months post-intervention, 29.8% of students in intervention schools and 14.6% in control schools reported quitting smoking. The odds of quitting were higher with the KOTAK program (aOR = 2.25, 95% CI = 1.11-4.57). Factors such as age, maternal education, and baseline nicotine addiction level were protective for smoking abstinence.

CONCLUSION

The intervention group showed a higher self-reported smoking cessation rate, indicating the potential efficacy of the KOTAK program.