Stakeholders' perspectives on the Malaysian school-based smoking cessation program

Smoking among adolescents remains a public health concern globally, including in Malaysia. Effective execution of the dentist-led school-based smoking cessation program relies on the engagement and insights of important stakeholders. This qualitative study aims to evaluate the Malaysian school-based smoking cessation program delivered by the school dental team, named the KOTAK program. Using a semi-structured interview guide and focus group discussion, the strengths, weaknesses, and recommendations to improve the program were explored among nine homogenous groups of dentists (3 groups), teachers (2 groups), and adolescents (4 groups). The data were analyzed using thematic analysis, resulting in three main domains and seven themes. The three main domains were the KOTAK program's strengths, weaknesses, and recommendations for improving the program. The themes touched on the issues of the school's conducive setting, the dentist's unique role, and the program's perceived effectiveness. Operational and collaboration-related themes emerged under the main domains of the program's weaknesses and improvement recommendations. The dentists, teachers, and adolescents positively perceived the KOTAK program to influence adolescents' smoking habits. In addition, shared opinions of the program's shortcomings were concerned with the lack of training and clear guidelines before the program's execution. Further improvement in the operational and collaboration-related aspects is recommended to improve the program outcomes. Future research should explore the socio-cultural factors that can aid in constructing a tailored intervention program.