Effectiveness of a Dentist-based Anti-Smoking Intervention Among Malaysian Adolescents: A Randomized Controlled Field Trial.

Background:  The KOTAK program is a national public health initiative in Malaysian primary and secondary schools aimed at reducing youth smoking through school dental services. This study evaluated its effectiveness in Seremban, Negeri Sembilan, Malaysia.

Objectives: 1) To determine the percentage of schoolchildren who quit smoking through the KOTAK program; 2) To identify factors associated with quitting smoking in the program.

Methods: A clustered, randomized controlled trial was conducted in schools. Self-reported smokers meeting inclusion criteria were enrolled. Data on demographics, self-reported smoking abstinence, and nicotine addiction levels were collected at baseline, three months, and six months post-intervention. Exhaled carbon monoxide was measured at all time points, and salivary cotinine was collected at three- and six-month follow-ups.

Results: Six months post-intervention, 29.8% of students in intervention schools and 14.6% in control schools reported quitting smoking. The odds of quitting were higher with the KOTAK program (aOR = 2.25, 95% CI = 1.11-4.57). Factors such as age, maternal education, and baseline nicotine addiction level were protective for smoking abstinence.

Conclusion: The intervention group showed a higher self-reported smoking cessation rate, indicating the potential efficacy of the KOTAK program.