Generational Perception Towards the Tobacco Generation End Game Policy in Malaysia

The Generation End Game (GEG) policy plan represents a groundbreaking initiative by the Malaysian government aimed at creating a smoke-free generation. This cross-sectional study aims to explore the factors influencing knowledge, attitude and perception of Malaysian adolescents towards the policy. A quantitative pre- and post-test survey was conducted among 731 adolescents born in 2007 and above across Malaysia, following a brief informational introduction to the GEG policy. This study utilized ANCOVA and binomial logistic regression to assess the association between various sociodemographic factors with knowledge, attitude and perceptions of the GEG. The results reveal that gender, tobacco-related experiences, peer influences, and health-related beliefs significantly impacted perception outcomes (p < 0.05). Female participants were significantly more likely to express supportive perceptions compared to male participants (unadjusted OR = 2.538, 95% CI = 1.598-4.030, p < 0.001). Non-smokers/vapers were more supportive of the GEG than smokers/vapers (unadjusted OR = 3.308, 95% CI = 2.032-5.384, p < 0.001). Participants who identified tobacco use as "definitely harmful" exhibited significantly greater support (unadjusted OR = 2.563, 95% CI = 1.522-4.315, p < 0.001). Individuals who reported no prior tobacco education were significantly less supportive (unadjusted OR = 0.321, 95% CI = 0.114-0.90, p = 0.031). The findings underline the need for targeted educational campaigns to address knowledge gaps and improve public understanding of the policy. Efforts to enhance perceptions of the harmfulness of tobacco use and its broader societal impacts could further bolster support for the GEG policy.