ArticleTobacco induced diseases2026
Sociodemographic and behavioral factors associated with time to first cigarette upon waking: Findings from the Malaysian national tobacco survey 2023.
Article in Tobacco induced diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionTime to first cigarette (TTFC) upon waking has been recognized as a robust behavioral marker for assessing the severity of nicotine dependence. Given that dependence is a primary driver of sustained tobacco use, which significantly impedes successful cessation efforts, this study aimed to determine the prevalence and associated determinants of TTFC within 30 minutes upon waking, among current smokers in Malaysia.
methodsData were derived from the Global Adults Tobacco Survey Malaysia (GATS-M) 2023, a cross-sectional study employing multi-stage proportionate-to-size sampling to recruit 4269 represent sample of non-institutionalized populations in Malaysia aged ≥15 years. The dependent variable was 'Time to first cigarette' (TTFC) upon waking up (within or more than 30 minutes); while independent determinants investigated including sociodemographic variables (gender, ethnicity, education level and marital status), and behavioral clues: age of smoking initiation, previous quit attempt, future quit intention, perceived difficulty in quitting, and apprehension about adverse health outcome. Data were analyzed using SPSS version 25, descriptively and with multivariable logistic regression to determine the associated factors of TTFC within 30 minutes of waking up.
resultsApproximately 29.2% among the current smokers reported taking the first puff of smoke within 30 minutes upon waking. Multivariable logistic regression substantiated that smoker who initiated smoking before the age of 18 years (AOR=1.60; 95% CI: 1.09-2.76), those without previous quit attempt (AOR=1.59; 95% CI: 1.39-2.01), smokers perceived difficult to quit (AOR=1.48; 95% CI: 1.08-2.54), and those who were not worried about the adverse health outcome of smoking (AOR=2.04; 95% CI: 1.17-3.54) were significantly more susceptible towards TTFC within 30 minutes of waking up.
conclusionsThis finding suggests that highly dependent smokers exhibiting these behavioral characteristics may benefit from targeted behavior-based interventions to address nicotine dependence.
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