Aim To examine the association of socio-economic position (education, income and employment status) with cigarette consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia. Design and setting The data were based on a survey of adult smokers conducted in early 2005 in Thailand and Malaysia as part of the International Tobacco Control-South-East Asia (ITC-SEA) project. Participants A total of 1846 men in Thailand and 1906 men in Malaysia. Measurement Participants were asked questions on daily cigarette consumption, intention to quit and self-efficacy to quit in face-to-face interviews. Findings Analyses were based on multivariate regression models that adjusted for all three socio-economic indicators. In Thailand, higher level of education was associated strongly with not having self-efficacy, associated weakly with having an intention to quit and was not associated with cigarette consumption. Higher income was associated strongly with having self-efficacy, associated weakly with high cigarette consumption and was not associated with having an intention to quit. Being employed was associated strongly with having an intention to quit and was not associated with cigarette consumption or self-efficacy. In Malaysia, higher level of education was not associated with any of the outcomes. Higher income was associated strongly with having self-efficacy, and was not associated with the other outcomes. Being employed was associated moderately with higher cigarette consumption and was not associated with the other outcomes. Conclusion Socio-economic and cultural conditions, as well as tobacco control policies and tobacco industry activities, shape the determinants of smoking behaviour and beliefs. Existing knowledge from high-income countries about disparities in smoking should not be generalized readily to other countries.

At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking. Keywords smoking; tobacco use; youthTobacco use is the leading cause of preventable death among adults worldwide. 1 Currently, 1 in 10 adults die from tobacco use, and the health toll is increasing: by 2030, the number of tobacco-related deaths is predicted to double to approximately 10 million per year. 2,3 Although the prevalence of smoking among most Western countries has been in steady decline for more than a decade, smoking rates continue to rise in many developing countries. 4 Currently, 70% of the world's 1.1 billion smokers are in developing countries, Address correspondence to: David Hammond, PhD, Department of Health Studies and Gerontology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada; dhammond@uwaterloo.ca. HHS Public AccessAuthor manuscript Asia Pac J Public Health. Author manuscript; available in PMC 2015 October 14. Published in final edited form as:Asia Pac J Public Health. 2008 ; 20(3): 193-203. doi:10.1177/1010539508317572. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript with over 50% in Asia alone. 3 As a consequence, the health and economic burden of tobacco use is rapidly shifting from high to low and middle income countries.Asia is an, especially, important region for global tobacco control given its large population and the trajectory of smoking rates in the region. Out of 500 million smokers in Asia, the vast majority is males, and smoking remains relatively rare among females. In most countries, the smoking rate among males approaches or exceeds 50%, whereas less than 5% of females smoke. 4 However, this gender gap is projected to narrow, extrapolating from historical trends in Western countries. The prevalence of smoking among Asian women is expected to increase dramatically in the coming decades, particularly as the presence of multinational tobacco companies continues to grow in the region. 5Two Asian countries, Thailand and Malaysia, illustrate different stages of tobacco control in this critical region. For more than a decade, Thailand has served as a model for tobacco control in Asia. Thailan...

Roll-your-own (RYO) cigarette use has been subject to relatively limited research, particularly in developing countries. This paper seeks to describe RYO use in Thailand and Malaysia and relate RYO use to smokers' knowledge of the harmfulness of tobacco. Data come from face-to-face surveys with 4,004 adult smokers from Malaysia (N = 2,004) and Thailand (N = 2000), collected between January and March 2005. The prevalence of any use of RYO cigarettes varied greatly between Malaysia (17%) and Thailand (58%). In both countries, any RYO use was associated with living in rural areas, older average age, lower level of education, male gender, not being in paid work, slightly lower consumption of cigarettes, higher social acceptability of smoking, and positive attitudes toward tobacco regulation. Among RYO users, exclusive use of RYO cigarettes (compared with mixed use) was associated with older age, female gender (relatively), thinking about the enjoyment of smoking, and not making a special effort to buy cheaper cigarettes if the price goes up. Finally, exclusive RYO smokers were less aware of health warnings (RYO tobacco carries no health warnings), but even so, knowledge of the health effects of tobacco was equivalent.

This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA) conducted face-to-face in Malaysia and Thailand (n=4005) were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban) but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% versus 51%, p<.001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.

These findings demonstrate that comprehensive tobacco advertising legislation when well implemented can lead to dramatic decline in awareness of tobacco promotion, thus supporting strong implementation of Article 13 of the Framework Convention on Tobacco Control.