<p>Characteristics of paternal smoking behaviours.</p>

Individuals burdened with socioeconomic disadvantages, including food insecurity, are often exposed to circumstances that may increase the likelihood of smoking, which may in turn affect the respiratory health of others in the household, particularly children. Yet, the role of these factors in perpetuating tobacco use within households remains underexplored. Therefore, this study attempts to determine the association between household food security and socioeconomic status with paternal smoking in Malaysia. This study utilised data from the South East Asian Nutrition Surveys (SEANUTS II) Malaysia, which involved 2,687 children aged 0.5–12.9 years, recruited through multistage cluster sampling. Although the study recruited children as participants, the present analysis draws on paternal and household information, including food security, socioeconomic status, and paternal smoking, as reported through parent/guardian-reported questionnaires. Multivariate binary logistic regression was used to determine factors associated with paternal smoking habits. Overall, forty-three percent of fathers were reported as smokers. Younger fathers (aged <30.0 years) had twice the odds of smoking [aOR: 2.032 (95%CI 1.301–3.173)] compared to their older counterparts (aged >49.9 years). Fathers from low socioeconomic status households, particularly, those with extremely low household income [aOR: 2.606 (95%CI 1.711–3.968)] and without formal education/completed primary education [aOR: 2.604 (95%CI 1.710–3.966)], had double the odds of smoking than their counterparts. Self-employed/other occupation fathers [aOR: 1.343 (95%CI 1.056–1.709)] and families from food-insecure households [aOR: 1.251 (95%CI 1.053–1.487)] were found to have higher odds of smoking. In conclusion, household food insecurity and socioeconomic status, including age, occupation, household income, and education level were significantly associated with paternal smoking status. Authorities should customise interventions to mitigate socioeconomic barriers and create equitable access to quit-smoking resources. This is important for lowering smoking prevalence and safeguarding children’s health.面临社会经济劣势（包括粮食不安全（food insecurity））的个体，常处于可能提升吸烟概率的环境中，而这又会进而影响家庭内其他成员——尤其是儿童——的呼吸系统健康。然而，此类因素在维持家庭内烟草使用方面的作用仍未得到充分探索。为此，本研究旨在明确马来西亚家庭粮食安全状况与社会经济地位和父亲吸烟行为之间的关联。本研究使用了东南亚营养调查（South East Asian Nutrition Surveys, SEANUTS II）马来西亚数据集，该数据集纳入了通过多阶段整群抽样（multistage cluster sampling）招募的2687名年龄介于0.5至12.9岁的儿童。尽管本研究以儿童作为招募对象，但本次分析采用了由家长/监护人通过问卷报告的父亲相关信息与家庭信息，包括粮食安全状况、社会经济地位以及父亲吸烟行为。本研究采用多变量二元logistic回归（multivariate binary logistic regression）分析，以确定与父亲吸烟习惯相关的影响因素。总体而言，报告显示43%的父亲为吸烟者。与年龄大于49.9岁的父亲相比，年龄小于30.0岁的年轻父亲吸烟的调整后优势比（adjusted odds ratio, aOR）为2.032（95%置信区间（confidence interval, CI）1.301–3.173），吸烟概率为前者的两倍。来自社会经济地位低下家庭的父亲，尤其是家庭收入极低的父亲[aOR: 2.606（95%CI 1.711–3.968）]以及未接受过正规教育/仅完成小学教育的父亲[aOR: 2.604（95%CI 1.710–3.966）]，其吸烟概率是对应群体的两倍。从事自营职业/其他职业的父亲[aOR: 1.343（95%CI 1.056–1.709）]以及来自粮食不安全家庭的群体[aOR: 1.251（95%CI 1.053–1.487）]的吸烟概率显著更高。综上，家庭粮食不安全与社会经济地位相关因素（包括年龄、职业、家庭收入与受教育程度）均与父亲的吸烟状态存在显著关联。相关部门应制定个性化干预措施，以缓解社会经济障碍并为戒烟资源创造公平获取渠道，这对于降低吸烟率并保障儿童健康至关重要。