BACKGROUND: Secondhand smoke (SHS) exposure from tobacco products is a major risk factor for death and disability. Reducing SHS exposure could lead to substantial health improvements. Understanding the prevalence of SHS exposure at home and its associated factors such as household smoking behaviors, demographics, and home rules, is essential for designing effective smoke-free policies. We assessed the prevalence of SHS exposure at home and its associated factors among adults in Malaysia.
METHODS: We used the 2023 Global Adults Tobacco Survey (GATS) Malaysia data. GATS is a standardized, nationally representative household survey of individuals aged ≥15 years. SHS exposure at home was defined by the frequency of smoking inside the home (daily, weekly, or monthly). Logistic regression with predicted marginal means was used to calculate adjusted prevalence ratios (aPR) with 95% CIs to examine factors associated with SHS.
RESULTS: Overall, 19.4% of adults, approximately 4.8 million individuals, reported SHS exposure at home. Multivariate analysis, adjusted for demographics, showed that males (aPR=1.44 [1.15-1.82]), individuals aged 15-24 years (aPR=1.80 [1.18-2.77]), those living in rural areas (aPR=1.26 [1.04-1.53]), those with no formal education (aPR=2.24 [1.54-3.27]), and those who were self-employed (aPR=1.40 [1.01-1.94]), were more likely to be exposed to SHS at home as compared to females, aged ≥ 65 years, those living in urban areas, those with a college or university education, and those who were unemployed or retired. Similarly, individuals who were exposed to SHS in at least one public place (aPR=1.27 [1.04-1.56]) and those living with someone who smoked (aPR=11.28 [8.04-15.82]) were more likely to be exposed to SHS at home as compared to their counterparts.
CONCLUSIONS: Efforts to reduce SHS exposure could target specific demographic groups, particularly males, young adults, and individuals who did not complete primary education. Implementing an awareness campaign promoting smoke-free home rules and SHS awareness in public places may help reduce SHS exposure, especially for children and women.