Support and Practice of Smoke-Free Eating Places in Sarawak, Malaysia: A Structural Path Analysis

Background: Smoke-free eating places are effective in reducing exposure to secondhand smoke (SHS). Eateries should comply with implementing smoke-free eating-places under the Control of Tobacco Products Regulations ۲۰۱۸ in all open-air eating-places to reduce tobacco consumption to achieve the plan of having Malaysia free of tobacco by ۲۰۴۵. Objectives: To determine the impact of perceived knowledge on tobacco control law and SHS and attitude to support and practice smoke-free eating-places. Methods: A total of ۶۲۰ respondents participated in this cross-sectional study. The eating-places were selected randomly from ۵ administrative divisions of Sarawak. Data on perceived tobacco control law, knowledge of the effects of SHS on health and environment, attitude and support towards smoke-free eating-places, and current smoke-free eating-places were collected by face-to-face interview using a structured questionnaire. A partial least squares model was developed to examine the impact of knowledge, attitude, and support towards the smoke-free eating-places with the current practice of smoke-free eating-places. WarpPLS version ۷.۰ was used to examine the structural path and to test the hypothesis. Results: The structural path analysis revealed that perceived knowledge of tobacco control lawhad no impact on practicing smokefree eating-places (P > ۰.۰۵). However, the knowledge of the health and environmental effects of SHS had direct and indirect effects on attitude and support for smoke-free eating-places (P < ۰.۰۰۱). In addition, attitude towards smoke-free eating-places had a significant mediating effect on practicing smoke-free eating-places (P < ۰.۰۰۱). Besides that, supporting smoke-free eating-places had a significant direct impact on the practice of smoke-free eating-places (P < ۰.۰۰۱). Conclusions: Legislation and implementation of smoke-free eating-places along with the antismoking program and education efforts could support the cessation of tobacco use in all public places, including all eateries.

Keywords:

Smoke-Free , Eating-Places , Support , Practice , Sarawak , Malaysia