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Research on Smoke-Free Environment in Malaysia: Evidence for Policy Foong Kin, Ph.D. National Poison Centre Universiti Sains Malaysia Paper presented at the Third Malaysian Conference on Tobacco Control, 8-9 August 2009, held at UKKMMC, Cheras
Outline of Presentation ,[object Object],[object Object],[object Object]
Prevalence of Passive Smoking in Malaysia ,[object Object],[object Object],[object Object],[object Object],Source: 3rd National Health and Morbidity Survey (Household Survey), (MOH 2008)
Recent Research Related to Smoke-free Environment ,[object Object],[object Object]
Measuring Air Quality ,[object Object],[object Object],*US Environmental Protection Agency, Fine Particle (PM 2.5) Designations.
Why PM 2.5 ? ,[object Object],[object Object],[object Object],- The EPA, USA has set standards of 15   g/m3  as the average annual level of PM 2.5  exposure and 65   g/m 3  as the 24-hours exposure in order to protect the public health. TSI SidePak AM510 Personal Aerosol Monitor
Study on Indoor Air Pollution in Different Workplaces ,[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Levels of Air Pollution in 4 Bars in  Kuala Lumpur
Level of air pollution in smoking venues are 11 times greater than that in non-smoking venues; in Penang (4 times); KL (16.5 times)
 
 
PM 2.5  Standards to Protect  Public Health ,[object Object]
US EPA Air Quality Index Air Quality Air Quality Index   PM 2.5  (  g/m 3 )   Health Advisory   Good   0-50   ≤ 15   None.   Moderate   51-100   16-40   Unusually sensitive people should consider reducing prolonged or heavy exertion.   Unhealthy for Sensitive Groups   101-150   41-65   People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion.   Unhealthy   151-200   66-150   People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion. Everyone else should reduce prolonged or heavy exertion. Very Unhealthy 201-300   151-250   People with heart or lung disease, older adults, and children should avoid all physical activity outdoors. Everyone else should avoid prolonged or heavy exertion.   Hazardous   ≥ 301   ≥ 251   People with heart or lung disease, older adults, and children should remain indoors and keep activity levels low. Everyone else should avoid all physical activity outdoors.
Key Findings ,[object Object],[object Object],[object Object]
Study on risks of  respiratory and  sensory symptoms  among non-smoking restaurant  workers exposed to secondhand  smoke  in the workplace
Study Objectives ,[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object]
Measures ,[object Object],[object Object],[object Object]
Reported Smoking Policy By Type of Venue   Type of Restaurant Smoking not allowed in any indoor area   (%) Smoking is allowed in some indoor area (%) Smoking allowed everywhere (%) Total (%) Family restaurant (n=36) 61.1 22.2 16.7 100.0 Fast food restaurant (n=5) 100.0 - 100.0 Fine dining restaurant (n=19) 84.2 10.5 5.3 100.0 Bar/pub (n=6) 100.0 100.0 Cafes (n=6) 100.0 100.0
Reported Exposure to Secondhand Smoke in the  Workplace by Type of Restaurant (% reported Yes) Type of Restaurant n % reported exposure Mean Duration of Exposure to Secondhand Smoke  Per Day (in hours) Family restaurant 102 71.6 0.7 ±1.0 Fast food restaurant 57 35.1 1.0±0.8 Fine dining restaurant 56 51.8 1.7±1.3 Bar/pub 16 100.0 6.5±3.0 Cafes 14 78.6 0.8±0.6
Reported Exposure to Secondhand Smoke ,[object Object],[object Object]
Adjusted Odds Ratios (OR) for Respiratory Symptoms in the Last Month Respiratory Symptoms Not exposed to SHS in Workplace Exposed to SHS in Workplace p-value % OR % OR (95% CI) Wheezing or whistling in the chest 2.1 1 8.7 4.49  (0.99-20.4) 0.051 Shortness of breath 10.4 1 12.1 1.18 (0.52-2.68) 0.69 Cough during day or night 29.2 1 33.6 1.23 (0.70-2.14) 0.47 Phlegm 16.7 1 26.8 1.83  (0.96-3.51) 0.07 Any respiratory symptom 37.5 1 49.3 1.62  (0.96-2.74) 0.07 Rhinitis 4.7 1 3.1 0.654 (0.16-2.59) 0.55
Adjusted Odds Ratios (OR) for Sensory Symptoms  in the Last Month * Statistically significant at p<0.05 Sensory Symptoms Not exposed to SHS in Workplace Exposed to SHS in Workplace p-value % OR % OR (95% CI) Red or irritated eyes 9.4 1 17.4 2.04 (0.91-4.57) 0.08 Running nose, sore nose or sneezing 33.3 1 41.6 1.43 (0.83-2.43) 0.19 Painful or scratchy throat 25.0 1 38.3 1.86 ( 1.05-3.28) 0.03* Any sensory symptom 46.9 1 61.7 1.83  (1.09-3.07) 0.02*
Key Findings  ,[object Object],[object Object],[object Object]
Key Findings ,[object Object],[object Object]
Policy Recommendations ,[object Object],[object Object]
[object Object]

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Current Research On Sfe

  • 1. Research on Smoke-Free Environment in Malaysia: Evidence for Policy Foong Kin, Ph.D. National Poison Centre Universiti Sains Malaysia Paper presented at the Third Malaysian Conference on Tobacco Control, 8-9 August 2009, held at UKKMMC, Cheras
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. Levels of Air Pollution in 4 Bars in Kuala Lumpur
  • 11. Level of air pollution in smoking venues are 11 times greater than that in non-smoking venues; in Penang (4 times); KL (16.5 times)
  • 12.  
  • 13.  
  • 14.
  • 15. US EPA Air Quality Index Air Quality Air Quality Index PM 2.5 (  g/m 3 ) Health Advisory Good 0-50 ≤ 15 None. Moderate 51-100 16-40 Unusually sensitive people should consider reducing prolonged or heavy exertion. Unhealthy for Sensitive Groups 101-150 41-65 People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion. Unhealthy 151-200 66-150 People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion. Everyone else should reduce prolonged or heavy exertion. Very Unhealthy 201-300 151-250 People with heart or lung disease, older adults, and children should avoid all physical activity outdoors. Everyone else should avoid prolonged or heavy exertion. Hazardous ≥ 301 ≥ 251 People with heart or lung disease, older adults, and children should remain indoors and keep activity levels low. Everyone else should avoid all physical activity outdoors.
  • 16.
  • 17. Study on risks of respiratory and sensory symptoms among non-smoking restaurant workers exposed to secondhand smoke in the workplace
  • 18.
  • 19.
  • 20.
  • 21. Reported Smoking Policy By Type of Venue Type of Restaurant Smoking not allowed in any indoor area (%) Smoking is allowed in some indoor area (%) Smoking allowed everywhere (%) Total (%) Family restaurant (n=36) 61.1 22.2 16.7 100.0 Fast food restaurant (n=5) 100.0 - 100.0 Fine dining restaurant (n=19) 84.2 10.5 5.3 100.0 Bar/pub (n=6) 100.0 100.0 Cafes (n=6) 100.0 100.0
  • 22. Reported Exposure to Secondhand Smoke in the Workplace by Type of Restaurant (% reported Yes) Type of Restaurant n % reported exposure Mean Duration of Exposure to Secondhand Smoke Per Day (in hours) Family restaurant 102 71.6 0.7 ±1.0 Fast food restaurant 57 35.1 1.0±0.8 Fine dining restaurant 56 51.8 1.7±1.3 Bar/pub 16 100.0 6.5±3.0 Cafes 14 78.6 0.8±0.6
  • 23.
  • 24. Adjusted Odds Ratios (OR) for Respiratory Symptoms in the Last Month Respiratory Symptoms Not exposed to SHS in Workplace Exposed to SHS in Workplace p-value % OR % OR (95% CI) Wheezing or whistling in the chest 2.1 1 8.7 4.49 (0.99-20.4) 0.051 Shortness of breath 10.4 1 12.1 1.18 (0.52-2.68) 0.69 Cough during day or night 29.2 1 33.6 1.23 (0.70-2.14) 0.47 Phlegm 16.7 1 26.8 1.83 (0.96-3.51) 0.07 Any respiratory symptom 37.5 1 49.3 1.62 (0.96-2.74) 0.07 Rhinitis 4.7 1 3.1 0.654 (0.16-2.59) 0.55
  • 25. Adjusted Odds Ratios (OR) for Sensory Symptoms in the Last Month * Statistically significant at p<0.05 Sensory Symptoms Not exposed to SHS in Workplace Exposed to SHS in Workplace p-value % OR % OR (95% CI) Red or irritated eyes 9.4 1 17.4 2.04 (0.91-4.57) 0.08 Running nose, sore nose or sneezing 33.3 1 41.6 1.43 (0.83-2.43) 0.19 Painful or scratchy throat 25.0 1 38.3 1.86 ( 1.05-3.28) 0.03* Any sensory symptom 46.9 1 61.7 1.83 (1.09-3.07) 0.02*
  • 26.
  • 27.
  • 28.
  • 29.