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

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 2018 in all open-air eating-places to reduce tobacco consumption to achieve the plan of having Malaysia free of tobacco by 2045.

To determine the impact of perceived knowledge on tobacco control law and SHS and attitude to support and practice smoke-free eating-places.

A total of 620 respondents participated in this cross-sectional study. The eating-places were selected randomly from 5 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 7.0 was used to examine the structural path and to test the hypothesis.

The structural path analysis revealed that perceived knowledge of tobacco control law had no impact on practicing smoke-free eating-places (P > 0.05). 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 < 0.001). In addition, attitude towards smoke-free eating-places had a significant mediating effect on practicing smoke-free eating-places (P < 0.001). Besides that, supporting smoke-free eating-places had a significant direct impact on the practice of smoke-free eating-places (P < 0.001).

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.