Background The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low.

Objectives The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia.

Methods The data collection method engage in this study was a face-to-face interview for 1651 individuals from all states in Malaysia. Multinomial logistic regression analysis was used to analyse and identify factors related to seatbelt-wearing among rear-seat passengers in Malaysia.

Results The analysis revealed that rear-seat passengers who were older, female, married and more educated and who had a perception of a high level of legislation enforcement, a higher risk-aversion and more driving experience (only for passengers who are also drivers) were more likely to wear a rear seatbelt. There was also a significant positive correlation between driver-seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving.

Significance These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt.