Publications by authors named "Miaw Yn Jane Ling"

7 Publications

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Polysubstance use among adolescents in Malaysia: Findings from the National Health and Morbidity Survey 2017.

PLoS One 2021 21;16(1):e0245593. Epub 2021 Jan 21.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia.

Background: Polysubstance use is defined as the use of more than one non-prescribed licit or illicit substance either concurrently or simultaneously. This study aimed to determine the prevalence of single substance users and polysubstance users and 'their associated factors among adolescents in Malaysia.

Methods: This study was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2017, a cross-sectional survey conducted among Malaysian school-going adolescents aged 13 to 17. The NHMS utilised a two-stage stratified cluster sampling. Multivariate Multinomial Logistic Regression analysis was applied.

Results: The overall prevalence of single substance use and polysubstance use among adolescents were 17.2% and 5.1% respectively. The multinomial model showed a higher likelihood of being single or polysubstance user among male (single user OR = 3.0, poly user OR = 4.6), others Bumiputeras vs Malay (single user OR = 1.7, poly user OR = 5.3), those who live with a single parent (single user OR = 1.2, poly user OR = 1.4), involved in truancy (single user OR = 1.7, poly user OR = 3.6) and being bullied (single user OR = 1.3, poly user OR = 3.4), those who had lack of peer support (single user OR = 1.3, poly user OR = 1.4), poor parental bonding (single user OR = 1.4, poly user OR = 1.8), depression (single user OR = 1.4, poly user OR = 3.2) and those who had no close friend (single user OR = 1.3, poly user OR = 2.7).

Conclusion: Our study highlighted multiple significant associated factors of single and polysubstance use among adolescents in Malaysia. This result can assist in the development of specific intervention and prevention programs targeting high-risk groups.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245593PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819602PMC
January 2021

Self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia.

Geriatr Gerontol Int 2020 Dec;20 Suppl 2:79-84

Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia.

Aim: The objective of this study is to determine the prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia and their associated factors.

Methods: The study used data from the National Health and Morbidity Survey in 2018. It was a cross-sectional study with two-staged stratified cluster sampling design. In total, 3977 adults aged ≥60 years were selected for this study. Respondents were interviewed face to face using a structured questionnaire. Self-reported diabetes, hypertension or hypercholesterolemia was defined as having ever been told they have these diseases by a medical doctor or paramedic. Data were analyzed using SPSS version 25. The multiple logistic regression model was used to examine the factors associated with the prevalence of self-reporting.

Results: The prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia were 27.7%, 51.1% and 41.8% respectively. Presence of other comorbidities and being obese showed higher odds for all three diseases. Indians, unemployed, inactive had higher odds for diabetes. Other Bumiputras, unemployed, non-smoker, obese and inactive had higher odds for hypertension. Non-smoker had higher odds for hypercholesterolemia.

Conclusions: Health promotion, vigilance, attention and services targeting on the associated factors should be strengthened for older persons in Malaysia to ensure healthy aging. Geriatr Gerontol Int 2020; 20: 79-84.
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http://dx.doi.org/10.1111/ggi.13968DOI Listing
December 2020

Prevalence of obesity and its associated risk factors among the elderly in Malaysia: Findings from The National Health and Morbidity Survey (NHMS) 2015.

PLoS One 2020 11;15(9):e0238566. Epub 2020 Sep 11.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia.

Background: Obesity is a crucial public health problem and is rising globally. This study was conducted to determine the prevalence of obesity and its associated factors among the elderly in Malaysia.

Methods: Data were obtained from the National Health and Morbidity Survey (NHMS) 2015. This was a cross sectional population-based study using a two stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected using pre-tested self-administered questionnaire in the form of sociodemographic profile, non-communicable diseases (NCD) comorbidities (status on hypertension, diabetes and hypercholesterolemia) and NCD risk factors (current smoker and physical activity). Obesity has been defined using the World Health Organization (WHO) Body Mass Index (BMI) guideline, 1998. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for obesity were identified using Multiple Logistic Regression analysis.

Results: A total of 3794 respondents were included in this study. The prevalence of obesity among Malaysian elderly was 30.2%. The prevalence of obesity among the elderly was significantly higher in females, respondents from urban areas and Indians. Approximately one third of the elderly with non-communicable diseases such as hypertension (33.1%) and diabetes (38.8%), respectively, were obese. Among elderly who were obese, majority of them (89.8%) had at least one NCD. The prevalence of obesity was 16.8% among current smokers (aOR 0.59). Multiple logistic regression analysis revealed that elderly females (aOR [adjusted odds ratio] 1.52), having secondary education (aOR 1.96) with household income of RM 3000 and above (aOR 1.57) as well as being hypertensive (aOR 1.61) and diabetic (aOR 1.50) were more likely to be obese. In contrast, the Chinese elderly respondents (aOR 0.62) and current smokers (aOR 0.59) were less likely to be obese. There were no significant associations of obesity with hypercholesterolemia or with physical activity.

Conclusions: A substantial proportion of Malaysian elderly were obese, and factors associated with obesity among them were being female, having secondary education with a household income of RM 3000 and above and being hypertensive or diabetic. Enhanced health promotion and education should be targeted at younger people in order to prevent obesity in the later years.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238566PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486079PMC
October 2020

A systematic review protocol on small/kiddie cigarette packaging size and its impact on smoking.

Syst Rev 2020 01 13;9(1):13. Epub 2020 Jan 13.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia.

Background: Small/kiddie cigarette packs consist of less than 20 cigarette sticks. Kiddie packs were recently proposed to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. By reintroducing kiddie packs, cigarettes will inevitably be more affordable and this would appeal to lower-income consumers especially teens. In this systematic review, we aimed to identify the impact of kiddie packs on smoking, specifically on smoking initiation, the urge/tendency to buy cigarettes and attempts to reduce cigarette consumption.

Methods: This systematic review will be based on the review of original articles on the impact of kiddie packs on smoking. There is no restriction on the publication dates. The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science and Scopus will be searched to retrieve potential original articles. Additional records identified through other sources: Google Scholar, as well as Journal of Substance Use and Tobacco Control, are also to be searched. These will include original articles in any language which included all study designs (randomised controlled trials, quasi experimental and experimental studies, observational cross-sectional and cohort studies) comparing kiddie packs with regular cigarette packs. The primary outcomes of interest will be initiation of smoking and urge/tendency to buy cigarettes in the general population and attempts to reduce cigarette consumption among current smokers. Secondary outcomes will be the prevalence of smoking using kiddie packs among the current smokers.

Discussion: This systematic review will provide evidence to support the impact of kiddie packs on smoking in terms of smoking initiation, smoking prevalence, urge/tendency to purchase cigarettes and attempts to reduce cigarette consumption. The findings from this review could be helpful to policymakers in regulating kiddie packs to control the consumption of tobacco.

Systematic Review Registration: PROSPERO CRD42018102325.
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http://dx.doi.org/10.1186/s13643-019-1263-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958659PMC
January 2020

Cigarette Smoking Among Secondary School-Going Male Adolescents in Malaysia: Findings From the National Health and Morbidity Survey 2017.

Asia Pac J Public Health 2019 11 19;31(8_suppl):80S-87S. Epub 2019 Sep 19.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.

Smoking is a learned behavior during adolescence, and it is found predominantly among male adolescents in Malaysia. Our study aimed to investigate the prevalence and predictive factors of current cigarette smoking among school-going male adolescents in Malaysia. Data were derived from the National Health and Morbidity Survey: Adolescent Health Survey 2017, a cross-sectional study that utilized a 2-stage stratified cluster sampling to select a nationally representative sample of school-going adolescents in Malaysia (n = 27 497). Multiple logistic regression analysis was performed to identify factors associated with current cigarette smoking among male adolescents in Malaysia. Male adolescents aged 16 to 17 years (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.41-1.70), current illicit drug users (AOR = 8.14; 95% CI = 6.37-10.41), current alcohol users (AOR = 1.92; 95% CI = 1.65-2.23), those from rural schools (AOR = 1.60; 95% CI = 1.46-1.76), those whose parents were widowed/divorced/separated (AOR = 1.37; 95% CI = 1.21-1.55), and those whose parents/guardians were tobacco product users (AOR = 3.47; 95% CI = 2.33-5.16) were more likely to be current cigarette smokers. Tobacco control strategies should be aimed at both adolescents at risk and at promoting parental smoking cessation.
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http://dx.doi.org/10.1177/1010539519874948DOI Listing
November 2019

Risk Factors for Illicit Drug Use Among Malaysian Male Adolescents.

Asia Pac J Public Health 2019 11 26;31(8_suppl):48S-56S. Epub 2019 Jul 26.

Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia.

This study was carried out to determine the prevalence of illicit drug use and its associated factors among male adolescents in Malaysia. Data of 13 135 adolescents were extracted from the National Health and Morbidity Survey 2017, a cross-sectional survey among school-going adolescents in Malaysia aged between 13 and 17 years, using a 2-stage stratified cluster sampling. A complex sample design analysis and multiple logistic regression analysis were applied. The overall prevalence of lifetime illicit drug use among male adolescents was 6.6%. The multivariable model showed that illicit drug use among male adolescents were associated with younger age, rural school area, marital status of parent, current smoker, ever having sex, truancy, involved in physical fight, and lack of peer support. The findings from this study can assist community and relevant authorities in their efforts to combat illicit drug usage among adolescents using intervention programs that diminishes risk factors and enhances the protective factors.
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http://dx.doi.org/10.1177/1010539519865053DOI Listing
November 2019

Smoking among school-going adolescents in selected secondary schools in Peninsular Malaysia- findings from the Malaysian Adolescent Health Risk Behaviour (MyaHRB) study.

Tob Induc Dis 2017 31;15. Epub 2017 Jan 31.

Allied Health College, Jalan Hospital, 47000 Sg. Buloh, Malaysia.

Background: A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia.

Methods: A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire.

Results: This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%,  < 0.001). Majority of smokers initiated smoking during their early adolescent years (60%) and almost half of the respondents bought cigarettes themselves from the store. Multivariable analysis revealed that the following factors increased the likelihood of being a current smoker: being male (aOR 21. 51, 95% CI:13.1-35), perceived poor academic achievement (aOR 3.42, 95% CI:1.50-7.37) had one or both parents who smoked (aOR 1.80, 95% CI:1.32-2.45; aOR 6.50, 95 CI%:1.65-25.65), and always feeling lonely (aOR 2.23, 95% CI:1.21-4.43). In contrast, respondents with a higher religiosity score and protection score were less likely to smoke (aOR 0.51, 95% CI:0.15-0.92; aOR 0.71, 95% CI 0.55-0.92).

Conclusion: This study demonstrated that the prevalence of smoking among Malaysian adolescents of school-going age was high, despite implementation of several anti-smoking measures in Malaysia. More robust measures integrating the factors identified in this study are strongly recommended to curb the smoking epidemic among adolescents in Malaysia.
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http://dx.doi.org/10.1186/s12971-016-0108-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282817PMC
January 2017