Secondhand Smoking Among Children in Rural Households: A Community Based Cross-Sectional Study in Bangladesh

Second Hand Smoke Exposure among Children in Indian Homes: Findings from the Global Adult Tobacco Survey

Children are vulnerable to second hand smoke (SHS) exposure because of limited control over their indoor environment, especially at homes. This study determines the magnitude, patterns and determinants of SHS exposure in the home among children in India. Data collected under the Global Adult Tobacco Survey (GATS) data, a household survey of adults ≥15 years of age during 2016-2017 conducted in India were analyzed to estimate the proportion of children exposed to SHS in their homes. GATS estimates and national census population projections for 2020 were also used to estimate the number of children exposed to SHS in the homes. Nearly half (46.5%) of the children <15 years of age were exposed to SHS in their homes in India which extrapolates to nearly an estimated 170 million. Children living in rural households, north-east and central regions and households with an adult smoker were more likely to be exposed to SHS. SHS exposure among children in home is high in India which calls for adoption of voluntary smoke-free homes initiative and promoting cessation among smokers.

Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey

Although secondhand smoke (SHS) exposure is predominant in Bangladesh, the adverse effect of SHS exposure on health-related behaviors, such as sleep quality, have remained an under-investigated area of the country's public health landscape. Therefore, the purpose of this study was to examine the association between SHS exposure and poor sleep quality among non-smoking university students in Bangladesh. A cross-sectional survey was carried out between May and September 2022. SHS exposure (main predictor variable) and other covariates (e.g., age, sex, etc.) were measured using a self-reported questionnaire and sleep quality (outcome variable) was measured via the Pittsburgh Sleep Quality Index. Multiple logistic regression models investigated the association between SHS exposure and poor sleep quality. The study included 390 students (mean age: 22 years, 53.8% male). Approximately 41.8% of the participants reported SHS exposure, and 50.5% had poor sleep quality. Students exposed to SHS were more likely to have poor sleep quality compared to their counterparts (AOR = 1.61; 95% CI 1.01, 2.58). Subgroup analysis revealed poor sleep quality was 2-times higher among male students exposed to SHS than those male students without SHS exposure (AOR = 2.03; 95% CI 1.05, 3.93). No association was found in female students. Findings from this study warrant increased awareness and public health initiatives on the implications of SHS on health behaviors, such as sleep quality, in non-smoking Bangladeshi university students.

Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): a combined evidence and theory-based plus partnership intervention development approach

Introduction

Deaths from second-hand smoke (SHS) exposure are increasing, but there is not sufficient evidence to recommend a particular SHS intervention or intervention development approach. Despite the available guidance on intervention reporting, and on the role and nature of pilot and feasibility studies, partial reporting of SHS interventions is common. The decision-making whilst developing such interventions is often under-reported. This paper describes the processes and decisions employed during transitioning from the aim of adapting an existing mosque-based intervention focused on public health messages, to the development of the content of novel community-based Smoke-Free Home (SFH) intervention. The intervention aims to promote smoke-free homes to reduce non-smokers’ exposure to SHS in the home via faith-based messages.

Methods

The development of the SFH intervention had four sequential phases: in-depth interviews with adults in households in Dhaka, identification of an intervention programme theory and content with Islamic scholars from the Bangladesh Islamic Foundation (BIF), user testing of candidate intervention content with adults, and iterative intervention development workshops with Imams and khatibs who trained at the BIF.

Results

It was judged inappropriately to take an intervention adaptation approach. Following the identification of an intervention programme theory and collaborating with stakeholders in an iterative and collaborative process to identify barriers, six potentially modifiable constructs were identified. These were targeted with a series of behaviour change techniques operationalised as Quranic verses with associated health messages to be used as the basis for Khutbahs. Following iterative user testing, acceptable intervention content was generated.

Conclusion

The potential of this community-based intervention to reduce SHS exposure at home and improve lung health among non-smokers in Bangladesh is the result of an iterative and collaborative process. It is the result of the integration of behaviour change evidence and theory and community stakeholder contributions to the production of the intervention content. This novel combination of intervention development frameworks demonstrates a flexible approach that could provide insights for intervention development in related contexts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01100-5.

Need for sensitization on serious threats of second-hand smoke: Findings from a national study in Mauritius, a small island developing state in the Indian Ocean

This study had the following objectives: To assess the level of knowledge of Mauritians aged ≥ 20 years on the health effects of Second Hand Smoke (SHS), to investigate their behaviour when exposed to SHS and to look for any association between SHS-related knowledge and behaviour towards exposure. A national cross-sectional online survey was conducted. With the total population of Mauritians above the age of 20 years being 941,719, the calculated sample size was 400. A validated questionnaire was used to collect data among respondents from all 9 districts of the island of Mauritius, with representative district-wise samples. Data analysis was carried out using SPSS version 19.0. Considering the findings of the study, there were 408 respondents: Two-thirds of participants showed good knowledge of the harmful effects of SHS. Participants were aware of the link of SHS to respiratory diseases, nonetheless, they were not aware of its causes for non-respiratory diseases. One out of four participants (25.5%) were not aware that maternal passive smoking causes preterm delivery. More than one-third of the participants (37.3%) did not know that passive smoking causes sudden infant death syndrome. Inadequate levels of knowledge were also revealed by authors in other developing countries. We thus recommend bold sensitization campaigns about the serious threats of SHS. We highlight the pertinence of longitudinal cohort studies with assessment of SHS-related knowledge/behaviour before and after health education campaigns, in Mauritius and other developing countries.

Social measures for reducing exposure to secondhand smoke in migrant workers of sugarcane harvest in the lower northern region of Thailand

INTRODUCTION

The sugarcane harvest migrant workers are an underprivileged group in Thailand and have a high risk of exposure to secondhand smoke but are potentially neglected in health promotion interventions.

METHODS

This three-phase study applied a mixed-method research approach. The data were collected from February to December 2019 from the Sukhothai province of Thailand. In Phase 1, the level of secondhand smoke exposure of the sugarcane harvest migrant workers at the worker camp was explored. The data were collected from 462 workers by questionnaires and from 24 sample participants in the group discussions about the factors leading to the exposure to secondhand smoke. Phase 2 was the provision and implementation of social measures for the health protection of migrant workers and families from exposure to secondhand smoke. In Phase 3, an evaluation of the health protection model for the migrant workers and families from secondhand smoke exposure was explored.

RESULTS

Workers aged ≤40 years had 1.9 times higher exposure to secondhand smoke than workers aged ≥41 years (OR=1.93; 95% CI: 1.24–3.01). Those who worked overtime had 1.7 times higher exposure to secondhand smoke than those who did not work overtime (OR=1.71; 95% CI: 1.10–2.66). Social measures to prevent secondhand smoke were: given a warning, no rewards for cigarettes, designated smoking area, not asking the children to buy cigarettes, stop displaying cigarettes at grocery shops, and empowering woman to go against the smoking husband in the camp and the sugarcane field when the women, children, and nonsmokers are present. After implementing the measures, there was no exposure to secondhand smoke inside the room, cooking area, and at the quad in the camp center.

CONCLUSIONS

Appropriate social measures for health protection can help to reduce exposure to secondhand smoke.