World Health Organization Collaborating Centre for Smoking Cessation and Treatment of Tobacco Dependence
Best Practices of Smoking Cessation in the Western Pacific Region
Questionnaire
1. Country / Region
Malaysia
Programme background
2. Name of Programme / Service
Kesihatan Oral Tanpa Amalan Merokok (KOTAK) also known as Oral Health Without Smoking Habit; an early smoking detection and intervention programme designed for all primary and secondary school children throughout the country.
3. Objective(s) of the programme / service (e.g. triggering quit attempt, promoting new activity, provision of cessation services)
General Objective
To reduce the prevalence of smoking among schoolchildren through prevention and intervention activities
Specific Objectives
- To assess the current smoking status among schoolchildren.
- To identify smoking habits among school children.
- To raise awareness among all schoolchildren to avoid smoking habits.
- To provide smoking cessation interventions via a behavioural approach for schoolchildren who currently engaged in smoking behaviour
4. Duration / time period of the programme / service
The KOTAK programme has been implemented in all primary and secondary schools nationwide since the year 2016. It is conducted annually under the School Dental Services programme which runs throughout the school year.
5. Target population
The target population comprises all schoolchildren, ranging from Standard One in primary school (7 years old) to Form Five in secondary school (17-18 years old) in Malaysia.
Programme details
6. Please briefly describe the activity(-ies) carried out under the programme / service (e.g. provision of smoking cessation services, campaign to promote/enhance cessation services provision).
| a) | Screening is carried out (by asking if he/she does smoke/vape, has ever smoked/vaped, or is exposed to cigarette smoke/vape at home) to ascertain if student is a: |
| i. Current smoker, ii. Ex-smoker iii. Passive smoker, or iv. Non-smoker |
|
| b) | Apart from the screening, the dentist will also examine the student’s mouth for clinical signs of smoking |
| c) | Ex-smoker, passive smoker, and non-smoker then all receive brief chair-side advice as forms of reminder and encouragement |
| d) | Current smokers will undergo the intervention which targets behaviour modification, which consists of 4 sessions with a facilitator. The intervention can be done for a single student or for a small group |
| e) | Topics covered during the intervention are • Benefits of quitting smoking • Types of tobacco products and its constituents, • Dangers of smoking and its associated diseases • Passive smokers and the associated risks • Preparation to quit smoking, including setting a quit date • Overcoming the desire to smoke again • Encourage and support to quit smoking |
7. What were the factors that contributed to the programme / service establishment?
Through a smart partnership between the Ministry of Health and the Ministry of Education, schools serve as an effective and efficient platform for the dissemination of health promotion activities, with a specific focus on smoking prevention at an early age. Additionally, annual school dental services offer opportunities for oral health clinical practitioners to identify schoolchildren engaged in smoking, enabling them to provide targeted smoking cessation interventions accordingly.
Those who do not smoke were given continuous health education to ensure they remain smoke-free
8. Did the programme / service involve other organisation(s) (e.g. non-governmental organisation, professional association, academia)? What were their roles?
| a) | Oral Health Programme of the Ministry of Health, Malaysia • Training of oral healthcare personnel, oral health promotion, monitoring and evaluation of the programme |
| b) | Disease Control Division of the Ministry of Health Malaysia |
| c) | School Education Division of the Ministry of Education Malaysia • Provide space of dental examinations and intervention sessions to be carried out |
9. Please briefly describe the resource implications for this programme / service:
| a) | How was/were necessary funding and/or manpower secured? |
|---|---|
| The KOTAK programme is implemented and integrated within the framework of School Dental Services, incurring no additional financial implications | |
| b) | Please briefly describe any use of information technology to implement or facilitate the programme / service |
| NIL | |
| c) | Any other special resource required to implement the programme / service? |
| NIL |
10. COVID-19
| a) | Please briefly describe any difficulties encountered during the programme / service implementation amid COVID-19. |
|---|---|
| The implementation was affected by the restrictions imposed on school activities during the COVID-19 pandemic. | |
| b) | How did you overcome them? |
| Preventive measures were implemented by incorporating the topic of Smoking Cessation into the Online Oral Health Education module |
Programme evaluation
11. Was there any evaluation of the programme / service (e.g. quantitative survey, qualitative interview, etc.) conducted?
Monitoring and assessment are conducted to determine the effectiveness of the implemented program. Among the things monitored and evaluated are
- Percentage of new clinical staff trained for screening and smoking cessation interventions in schools
- Percentage of school children screened for smoking habit
- Smoking status of schoolchildren
- Percentage of schoolchildren identified as smokers and undergoing at least 3 intervention sessions
- Percentage of smokers with a quit date after the intervention
- Percentage of schoolchildren who have successfully quit smoking
12. What was the impact of the programme / services (e.g. number of smokers who quit)?
13. How would the evaluation results be used (e.g. improving policy / programmes)?
Data spanning from 2016 to 2019 were collected and analysed. Following a comprehensive assessment, the program underwent thorough evaluation, leading to revisions. These efforts resulted in the publication of the second edition of guidelines in the year 2020.