Document Type : Systematic Review and Meta-analysis
Authors
1
Department of Public Health, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
2
Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
3
Department of Community Medicine Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
4
Adult Cardiology and Public Health Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Abstract
Background: Second-hand smoke (SHS) exposure is a major health risk that causes thousands of deaths every year. Most countries have laws banning smoking in public places, but not in homes, where non-smoking children and women, are exposed to SHS. A comprehensive review on effectiveness of smoke free home interventions in reducing SHS is limited. Objective: To evaluate the effectiveness of home-based interventions to reduce SHS exposure among non-smoking household members of any age group. Methods: The following sources were searched for this systematic review: MEDLINE, CINAHL, Scopus, Proquest, Embase, and Google scholar. Interventions: Randomized controlled trials that compared home-based interventions with usual or standard care intervention were included. Studies that measured SHS exposure using biochemical or environmental indicators, such as cotinine in urine, saliva and hair were considered and the risk of bias was assessed using standardized criteria. Results: We included 34 studies with a total of 10,727 participants from various countries and settings. The interventions varied in type, intensity, duration, method of education, counselling, feedback, incentives, and support. As far as urinary outcomes were considered 4 studies showed a significant decrease among infants and children whereas two others showed no change. Whereas, atmospheric 2.5 particulate matter seemed to be a more sensitive objective measure with all studies demonstrating either a decrease or significant decrease. Smoking ban policies at home were found to be more effective in the intervention groups compared to control group. Conclusions: Home-based educational and behavioural interventions show considerable promise in reducing secondhand smoke exposure. These interventions offer a practical, scalable approach to addressing SHS exposure, particularly in vulnerable populations such as children. Future research should focus on evaluating long- term outcomes. Protocol registration number: The review was prospectively registered in PROSPERO CRD42023398093.
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