In Malaysia, tobacco smoking continues to be one of the leading public health concerns; hence, the tobacco control community aims to see a generation free of tobacco use by 2040. Drafted and presented to the parliament, the Malaysian Control of Smoking Products for Public Health Bill 2022 highlighted the Generational Endgame (GEG) policy, which forbids the use and sale of tobacco products and smoking substances to individuals born on or after 1 January 2007. Stakeholders, including government and non-governmental organisations, policymakers, healthcare professionals, tobacco industry representatives and retailers, have expressed differing opinions indicating non-support of the policy. The Attorney General Chamber deemed the policy as ‘unconstitutional’ for discriminating against those within the implementation age range, which prompted its omission from the revised Control of Smoking Products for Public Health 2023 Bill. This paper discusses the obstacles and possible implications of the GEG policy implementation in Malaysia and details its implementation in other countries. This paper also proposes several recommendations for future directions in tackling the obstacles mentioned more effectively.

Electronic cigarettes (ECs) users’ profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users’ profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia’s west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.

Psychological distress is increasing among university students, especially sexual minority individuals in Malaysia, who face stigma and challenges within a sociocultural and dual legal system. This study examined the relationship between sexual minority status and both negative (psychological strain, distress, suicidality) and positive (self-esteem, purpose in life, social support, religiosity) mental health indicators among Malaysian undergraduates. A cross-sectional, multi-institutional survey was conducted utilizing an existing dataset, yielding a final analytical sample of 2244 participants (1870 heterosexual and 374 sexual minority students). Data were analyzed using Welch’s ANOVA and multiple logistic regression, controlling for demographic variables. Heterosexual students reported significantly lower depressive symptoms, anxiety, stress, and suicidality compared to gay, bisexual, and participants with other sexual orientation. In the fully adjusted model, sexual minority identity remained significantly associated with higher deprivation strain (aOR: 1.043), depression (aOR: 1.025), and suicidality (aOR: 1.117). Conversely, identifying as a sexual minority was linked to lower religious commitment (aOR: 0.961) and lower perceived family support (aOR: 0.943). Self-esteem and purpose in life lost statistical significance in the fully adjusted model. Sexual minority undergraduates in Malaysia face heightened psychological distress and suicidality, underscoring the need for comprehensive campus mental health interventions.

(1) Background: University students face increasing mental health challenges, with sociodemographic disparities shaping well-being outcomes and highlighting the need for machine learning approaches to identify distinct psychological profiles. (2) Methods: This cross-sectional study surveyed 4911 Chinese university students (aged 18–25) using the EPOCH Questionnaire, which measures Engagement, Perseverance, Optimism, Connectedness, and Happiness. Data were collected via WenjuanXing (WJX), with recruitment promoted through official channels. Well-being profiles were identified through exploratory K-means clustering, with internal validity and the optimal cluster number assessed using the silhouette coefficient. (3) Results: Cluster analysis identified two distinct groups: Cluster 0 (41.09%) with higher well-being scores and Cluster 1 (58.91%) with lower scores. Differences across all five EPOCH dimensions exceeded 1.0, most notably in Optimism (Δ = 1.31) and Happiness (Δ = 1.37). A subgroup of concern within Cluster 1 (n = 92), primarily male sophomores from rural, low-income, multi-child families receiving financial aid, showed particularly low scores in Connectedness (Δ = −0.57) and Happiness (Δ = −0.43). In contrast, a high well-being subgroup in Cluster 0 (n = 108), mainly urban female freshmen from high-income, only-child families, exhibited elevated scores, especially in Connectedness (Δ = 0.69) and Happiness (Δ = 0.65). (4) Conclusions: This exploratory clustering study identified distinct well-being profiles among Chinese university students, with demographic and socioeconomic vulnerabilities associated with diminished psychological well-being, particularly in Connectedness, Happiness, and Optimism. These findings highlight the need for targeted interventions that integrate psychosocial support with financial assistance to reduce inequalities and promote flourishing.

The increasing prevalence of electronic cigarette (e-cigarette) use among Malaysian youths highlights the inadequacy of current health education initiatives in addressing cessation challenges. This study aims to evaluate the content and face validity of educational infographics to support e-cigarette cessation among youth e-cigarette users in Malaysia. This study employed a cross-sectional study design and involved experts and youth e-cigarette users. Upon the development, 17 experts specialising in smoking or e-cigarette cessation, with a mean age of 39.10 years and a mean years of experience of 12.24 years, were recruited for content validation. Meanwhile, for the face validation, 10 Malaysian youth e-cigarette users, with a mean age of 24.00, were purposively selected to assess the clarity of the infographics and provide feedback. Content validity indices (CVI) and face validity indices (FVI) were calculated for each topic, with thresholds of > 0.74 and 0.83 indicating acceptable content. The infographics demonstrated strong content and face validity, with average CVI of 0.98 (range: 0.94, 1.00; 95% CI: 0.95, 1.00) and average FVI of 0.96 (range: 0.70, 1.00; 95% CI: 0.87, 1.00), respectively. The infographics can be utilised to promote e-cigarette cessation after the trial and implementation phase, to assess their real-world effectiveness.

Introduction: E-cigarette (EC) use is increasing among young adults in Malaysia. However, evidence on how EC-related behaviours and perceived physical activity barriers are associated with physical activity participation remains limited. This study examined the associations between EC-related behaviours and perceived physical activity barriers with physical activity status among Malaysian university students who use EC. Methods: A cross-sectional online survey was conducted between December 2023 and July 2024 across six Malaysian universities. Of 660 respondents, 564 met the age and International Physical Activity Questionnaire (IPAQ) criteria and were included in the analysis. Physical activity was classified as active and inactive. Exposures included EC use frequency, dual use, nicotine content, nicotine dependence, EC knowledge, motivations and perceptions for EC use, EC-related side effects, and perceived physical activity barrier items across personal, social and physical domains. Associations were analysed using chi-square tests and binary logistic regression, with odds ratios (ORs) and 95% confidence intervals. Results: Overall, 64.9% were classified as active. At the crude level, EC use frequency, nicotine content, and dual-use status were associated with physical activity. However, these variables were not retained in the multivariable model due to multicollinearity. Nicotine dependence emerged as one of the strongest behavioural correlates of physical inactivity, with higher dependence associated with greater odds of physical inactivity. Perceived barriers to physical activity, particularly personal and social barriers, demonstrated the strongest and most consistent associations, with substantially higher odds of inactivity across barrier levels. EC knowledge and perception variables were not independently associated after adjustment, although item-level patterns were observed. Reported EC related symptoms were mainly gastrointestinal, respiratory, and neurological but were not analysed in relation to physical activity. Conclusion: Physical activity among Malaysian university students who use EC is more consistently associated with nicotine dependence and perceived barriers, than with sociodemographic or knowledge variables. These findings suggest that interventions may benefit from addressing behavioural dependence and contextual constraints. Given the cross-sectional design, these results should be interpreted as hypothesis-generating. Implications: Physical activity among university students who use EC appears more closely associated with nicotine dependence and perceived barriers than with knowledge or sociodemographic factors. While some EC use patterns showed crude associations, nicotine dependence emerged as one of the strongest behavioural correlates of physical inactivity. Lower perceived barriers, particularly personal and social, were consistently linked to higher activity participation. These findings suggest that intervention strategies may benefit from addressing behavioural dependence alongside reducing personal and social barriers to physical activity, particularly factors related to motivation, self-confidence, and competing demands. Integrating accessible, context-specific physical activity opportunities within EC cessation or harm-reduction programmes may enhance engagement and promote healthier lifestyle behaviours among young adults.