Incidence of Adverse Transition in Smoking Stages among Adolescents of Kinta, Perak

Background: Few local studies have explored the process of adverse transition of smoking stages amongadolescents. The present investigation aimed to identify adverse transitions prospectively from the early stagestill the escalation of the stages after one year. Materials and
Methods: Data were collected in two waves froma cohort of 2,552 adolescents aged 12-13 years old studying in 15 secondary schools based in Kinta, Perak. Amultistage sampling method was used to select the schools and a self-administered structured questionnairewas applied to help categorize the participants into five different smoking stages. Nonsmokers were dividedinto never smokers and susceptible never smokers. Ever-smokers were categorized as experimenters, currentsmokers or ex-smokers.
Results: Among the participants 46.8% were Malay, 33.5% Chinese and 17.1% Indians.At baseline, we had 85.3% non-smokers and 14.6% ever smokers. Incidence of adverse transition among all ourparticipants was 24.1%, with a higher value among male participants (16.8%). A higher proportion of susceptiblenever smokers and experimenters progressed to current smoking stage compared to never smokers.
Conclusions:This study highlights the changes and patterns of adverse transition among adolescents. Male adolescents, thosewho are susceptible to smoking and those who had already tried experimenting with cigarettes have a higherchance of escalating to a higher smoking stage.