Awareness regarding the effect of passive smoking among adults: a cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260691Keywords:
Passive smoking, Awareness, AdultsAbstract
Background: Passive smoking is a major public health concern that contributes significantly to morbidity and mortality among non-smokers. Despite increasing awareness campaigns, adults often underestimate the health risks of passive smoke exposure. This study aimed to assess the level of awareness regarding the effects of passive smoking among adults, to examine the association between awareness and selected demographic variables, and to develop and distribute an educational leaflet to enhance awareness.
Methods: A descriptive cross-sectional study was conducted among 120 adults attending the Outpatient Department of a selected hospital in Thalassery. Participants were selected using a convenience sampling technique, and informed consent was obtained prior to the data collection. Data were collected using a structured self-administered questionnaire consisting of two sections: demographic variables and awareness-related items. The collected data were analyzed using descriptive and inferential statistics to assess the level of awareness and to determine its association with selected variables.
Results: Findings revealed that the level of awareness regarding the health hazards of passive smoking varied among participants. A statistically significant association was observed between the level of awareness and educational status as well as previous exposure to educational programs on smoking-related health risks.
Conclusions: The findings of this cross-sectional study highlight the need for sustained public health education to enhance adult awareness of the harmful effects of passive smoking. Despite existing knowledge, gaps remain, necessitating targeted educational interventions. Integrating structured health education strategies into routine public health programs may promote preventive behaviours, reduce exposure to passive smoking, and ultimately improve overall community health outcomes.
Metrics
References
World Health Organization. WHO report on the global tobacco epidemic: Protect people from tobacco smoke. Geneva: WHO; 2008. Available at: https://iris.who.int/bitstream/handle/10665/43819/9789241596282_eng.pdf. Accessed on 06 December 2025.
U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention. 2006.
United States Environmental Protection Agency. Respiratory health effects of passive smoking: Lung cancer and other disorders. Washington (DC): EPA; 1992.
World Health Organization. Global burden of disease from second-hand smoke. Geneva: WHO; 2010. Available at: https://www.who.int/publications-detail-redirect/9789241564076. Accessed on 06 December 2025.
International Agency for Research on Cancer. Tobacco smoke and involuntary smoking. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 83. Lyon: IARC; 2004.
He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK. Passive smoking and the risk of coronary heart disease-a meta-analysis of epidemiologic studies. N Engl J Med. 1999;340(12):920-6. DOI: https://doi.org/10.1056/NEJM199903253401204
U.S. Department of Health and Human Services. How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease. Atlanta (GA): CDC. 2010.
Barnoya J, Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation. 2005;111(20):2684-98. DOI: https://doi.org/10.1161/CIRCULATIONAHA.104.492215
U.S. Surgeon General. The health consequences of smoking-50 years of progress. Atlanta (GA): CDC. 2014.
World Health Organization. Second-hand smoke: Assessing the burden of disease at national and local levels. Geneva: WHO; 2010. Available at: https://tobacco.cleartheair.org.hk/?p=2592. Accessed on 06 December 2025.
Cook DG, Strachan DP. Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax. 1999;54(4):357-66. DOI: https://doi.org/10.1136/thx.54.4.357
Li S, Zhang M, Jiang Y, Wu F. Co-residence with smokers and childhood asthma hospitalization in Hong Kong. Pediatrics. 2015;135(3):e643-52.
Anderson HR, Cook DG. Passive smoking and sudden infant death syndrome: review of the epidemiological evidence. Thorax. 1997;52(11):1003-9. DOI: https://doi.org/10.1136/thx.52.11.1003
Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ. 1997;315(7114):973-80. DOI: https://doi.org/10.1136/bmj.315.7114.973
Oberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139-46.
GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of behavioural, environmental and occupational risks. Lancet. 2017;390(10100):1345-422.
European Commission. Special Eurobarometer 458: Attitudes of Europeans towards tobacco and electronic cigarettes. Brussels. 2017.
Yang G, Fan L, Tan J, Qi G, Zhang Y, Samet JM, et al. Smoking in China: findings of the 1996 National Prevalence Survey. JAMA. 1999;282(13):1247-53. DOI: https://doi.org/10.1001/jama.282.13.1247
International Institute for Population Sciences (IIPS), Ministry of Health and Family Welfare. Global Adult Tobacco Survey (GATS-2), India 2016-17. Mumbai: IIPS. 2018.
Ministry of Health and Family Welfare. Report on tobacco-related mortality in India. New Delhi: Government of India. 2017.
Kumar R, Goel N, Singh K. Lung function impairment among non-smokers exposed to second-hand smoke in urban India. Indian J Chest Dis Allied Sci. 2021;63(2):75-80.
Suresh K, Mahalakshmi R. Knowledge and awareness regarding second-hand smoke among adults in Kanchipuram district, Tamil Nadu. Int J Community Med Public Health. 2020;7(5):1862-7.
Thankappan KR, Thresia CU. Exposure to second-hand smoke and respiratory morbidity among women in Kerala, India. Tob Control. 2016;25(4):e26-30.
Goel P, Radotra A, Singh I, Aggarwal A. Effects of passive smoking on birth weight of newborns in North India. Indian J Pediatr. 2004;71(10):903-6. DOI: https://doi.org/10.1007/BF02830833
Zhang X, Martinez-Donate AP, Jones NR. Exposure to second hand tobacco smoke and interventions among pregnant women in China: a systematic review. Prev Chronic Dis. 2013;10:E62.
Oberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139-46. DOI: https://doi.org/10.1016/S0140-6736(10)61388-8
World Health Organization. WHO report on the global tobacco epidemic, 2019: Offer help to quit tobacco use. Geneva: WHO; 2019. Available at: https://www.who.int/publications/i/item/9789241516204. Accessed on 06 December 2025.
Thakur JS, Prinja S, Bhatnagar N, Rana SK, Sinha DN. Socioeconomic inequality in the exposure to secondhand smoke in India. Nicotine Tob Res. 2013;15(8):1346-52.
Palipudi KM, Gupta PC, Sinha DN, Andes LJ, Asma S, McAfee T, et al. Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey. PLoS One. 2012;7(3):e33466. DOI: https://doi.org/10.1371/journal.pone.0033466
Singh A, Ladusingh L. Prevalence and determinants of tobacco use in India: evidence from recent global adult tobacco survey data. PLoS One. 2014;9(12):e114073. DOI: https://doi.org/10.1371/journal.pone.0114073
Okoli CTC, Kodet J. A systematic review of secondhand tobacco smoke exposure and smoking behaviors: smoking status, susceptibility, initiation, dependence, and cessation. Addict Behav. 2015;47:22-32. DOI: https://doi.org/10.1016/j.addbeh.2015.03.018
Sreeramareddy CT, Ramakrishnareddy N, Harsha Kumar HN, Sathian B, Arokiasamy JT. Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006. Subst Abuse Treat Prev Policy. 2011;6:33. DOI: https://doi.org/10.1186/1747-597X-6-33
Nazar GP, Lee JT, Arora M, Millett C. Socioeconomic inequalities in second hand smoke exposure at home and at work in 15 low- and middle-income countries. Nicotine Tob Res. 2016;18(5):1230-9. DOI: https://doi.org/10.1093/ntr/ntv261
Hyland A, Barnoya J, Corral JE. Smoke-free air policies: past, present and future. Tob Control. 2012;21(2):154-61. DOI: https://doi.org/10.1136/tobaccocontrol-2011-050389
Government of India, Ministry of Health and Family Welfare. Global Adult Tobacco Survey (GATS) India 2016-17. New Delhi: MOHFW; 2017.
Sinha DN, Palipudi KM, Jones CK, Gupta PC, Indrayan A, Asma S. Levels and trends of smokeless tobacco use among youth in countries of the World Health Organization South-East Asia Region. Indian J Cancer. 2012;49(4):373-9. DOI: https://doi.org/10.4103/0019-509X.107726
Wang CP, Ma SJ, Xu XF, Wang JF, Mei CZ, Yang GH. The prevalence of household second-hand smoke exposure and its correlated factors in six counties of China. Tob Control. 2009;18(2):121-6. DOI: https://doi.org/10.1136/tc.2008.024836