Perception of e-cigarette and vape usage among parents, teachers and secondary school children in Kuala Lumpur / Intan Elliayana Mohammed

Objectives: i) To determine the demographics, prevalence & behaviour of cigarette and e-cigarette use among parents, teachers and secondary schoolchildren in Kuala Lumpur. ii) To assess parents’, teachers’ and school children’s perception towards e-cigarette and awareness on anti-tobacco (including e-cigarette/ vape use) policies. iii) To assess the reasons contributing to e-cigarette smoking behaviour initiation. iv) To assess parents and teachers influence on children towards e-cigarette use and their perceptions Methods: Using stratified random sampling, six public secondary schools were chosen (223 parents, 299 teachers, 240 school children) based on prevalence of smoker among school children from the KOTAK (Kesihatan Oral Tanpa Asap Rokok) 2019 data. An online survey was conducted and the link was distributed to Form 1 and 2 school children via parents-teachers and teachers official WhatsApp group. A self‐ administered questionnaire containing 32 questions adapted from TECMA 2016 (Tobacco and E-Cigarette Survey among Malaysian Adolescents) was used while descriptive statistics, chi-square test and logistic regression were used to analyse the data. Results: Among parents, e-cigarette user status (ever smoke) (AOR=0.75 95% CI: 0.08,0.33) and awareness of increased usage of e-cigarette among school children in Malaysia (AOR=3.41 95% CI: 1.49,7.77) while among teachers, ever tried smoking cigarette (AOR=0.43 95% CI: 0.22,0.86) were found to be a significant factor for perception of cigarette. E-cigarette user status (ever smoke) (AOR=0.08, 95% CI: 0.01,0.61) and awareness of tobacco-free policy at school (AOR=1.96 95% CI: 1.13,3.40) were found to be significant associated factors for the perception of ecigarette among school children. Conclusions: Parents and teachers play an important role in influencing school children’s smoking by cultivating them regarding the ecigarettes’ detrimental effects to empower them to recognize and be updated on the latest e-cigarette devices. There is a great need for school and parents to collaborate in order to prevent children from initiating e-cigarette use itself and to prevent e-cigarettes from serving as a gateway to future conventional cigarette smoking.