Journals / Türk Doğa ve Fen Dergisi / 2025 / Cilt: 14 Sayı: 4

Effectiveness of Behavior Change Theory-Based Interventions for Reducing Secondhand Smoke Exposure in the Home: A Meta-Analysis

Davranış Değişikliği Teorilerine Dayalı Müdahalelerin Ev Ortamında İkinci El Sigara Dumanı Maruziyetini Azaltmadaki Etkililiği: Bir Meta-Analiz

Ercan Asi(BURDUR MEHMET AKİF ERSOY ÜNİVERSİTESİ)0000-0003-3265-2268
Sebahat Gözüm(AKDENİZ ÜNİVERSİTESİ)0000-0001-8672-8016
Pages
222–230
Publication Date
2025-12-30
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Future research should include longer follow-up periods to assess sustainability of outcomes.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The aim of this meta-analysis is to evaluate the effectiveness of behavior change theory–based interventions in reducing SHS exposure in the home environment.
📊
Key Findings & Data:A meta-analysis was conducted by searching Cochrane Library, CINAHL Complete, PubMed, Scopus, and Web of Science for randomized controlled trials published in English between January 2013 and October 2025.
💡
Conclusion & Impact:Future research should include longer follow-up periods to assess sustainability of outcomes.
🔬Design:Modeling & Simulation
📍Scope:2013 Verileri
⚙️Variables:İkinci el sigara dumanı · Dumansız ev · Davranış değişikliği

Abstract

The aim of this meta-analysis is to evaluate the effectiveness of behavior change theory–based interventions in reducing SHS exposure in the home environment. A meta-analysis was conducted by searching Cochrane Library, CINAHL Complete, PubMed, Scopus, and Web of Science for randomized controlled trials published in English between January 2013 and October 2025. Studies implementing behavior-change–based interventions to reduce SHS exposure at home were included. Exposure to secondhand smoke in the home was assessed using data from biomarker tests, environmental measurements, and participant self-reports. Twelve trials with a total of 5,822 participants were included. Most interventions were grounded in behavior change theories, particularly the Health Belief Model. Interventions demonstrated a significant medium effect in reducing SHS exposure (Hedges’ g = −0.216; 95% CI = -0.319 to −0.113; p ≤ .001), with moderate heterogeneity (I² = 60.64%). No publication bias was identified. Theory-based interventions are effective in reducing SHS exposure to the home environment, outperforming education-only approaches. Integrating structured behavior change strategies, such as self-efficacy enhancement, and goal setting, into public health programs may improve smoke-free home practices. Future research should include longer follow-up periods to assess sustainability of outcomes.

Özet

Bu meta-analizin amacı, davranış değişikliği teorilerine dayalı müdahalelerin ev ortamında ikinci el sigara dumanı maruziyetini azaltmadaki etkinliğini değerlendirmektir. Ocak 2013-Ekim 2025 arasında yayımlanan rastgele kontrollü çalışmalar Cochrane Library, CINAHL Complete, PubMed, Scopus ve Web of Science veri tabanlarında taranmıştır. Evde İESD maruziyetini azaltmaya yönelik davranış değişikliği odaklı müdahaleler dahil edilmiştir. İkinci el sigara dumanına maruziyete ilişkin sonuçları değerlendirmek için biyobelirteçlerden, çevresel ölçümlerden ve katılımcıların öz-bildirimlerinden elde edilen veriler kullanılmıştır. Meta-analiz çalışmasına toplam 12 çalışma dahil edilmiştir (Toplamda 5.822 katılımcılı) Müdahalelerin çoğu Sağlık İnanç Modeli gibi davranış değişikliği teorilerine dayanmaktadır. Müdahaleler, İESD maruziyetinde orta düzeyde anlamlı bir azalma sağlamıştır (Hedges’ g = −0.216; %95 GA = -0.319, -0.113; p ≤ .001) ve heterojenite orta düzeydedir (I² = %60.64). Yayın yanlılığı saptanmamıştır. Teori temelli müdahaleler, ev ortamında İESD maruziyetini azaltmada etkilidir ve yalnızca eğitim içeren yaklaşımlardan daha başarılıdır. Öz-yeterlik güçlendirme, hedef belirleme ve geribildirim gibi davranışsal stratejilerin halk sağlığı programlarına entegrasyonu dumansız ev uygulamalarını destekleyebilir. Gelecek çalışmaların daha uzun izlem süreleri kullanması önerilir.

🔖

Cite This Article

Asi, E., Gözüm, S. (2025). Effectiveness of Behavior Change Theory-Based Interventions for Reducing Secondhand Smoke Exposure in the Home: A Meta-Analysis. Türk Doğa ve Fen Dergisi, Cilt: 14 Sayı: 4, 222–230. https://doi.org/10.46810/tdfd.1817019

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (43)

  1. 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.
  2. Walton K, Gentzke AS, Murphy-Hoefer R, Kenemer B, Neff LJ. Exposure to secondhand smoke in homes and vehicles among US Youths, United States, 2011-2019. Prev Chronic Dis. 2020;17:1–5.
  3. Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, et al. Burden of disease attributable to second-hand smoke exposure: A systematic review. Prev Med (Baltim). 2019;129:105833
  4. United States Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress A Report of the Surgeon General. A Report of the Surgeon General. Atlanta: Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
  5. Carreras G, Lachi A, Cortini B, Gallus S, López MJ, López-Nicolás Á, et al. Burden of disease from second-hand tobacco smoke exposure at home among adults from European Union countries in 2017: an analysis using a review of recent meta-analyses. Prev Med (Baltim). 2021;145:106412.
  6. Yousuf H, Hofstra M, Tijssen J, Leenen B, Lindemans JW, van Rossum A, et al. Estimated Worldwide Mortality Attributed to Secondhand Tobacco Smoke Exposure, 1990-2016. JAMA Netw open. 2020;3(3):e201177.
  7. Karimiankakolaki Z, Mazloomy Mahmoodabad SS, Kazemi A, Fallahzadeh H. Designing an educational intervention on second-hand smoke in smoker men on the exposure of pregnant wives: A protocol for a randomized controlled trial. Reprod Health. 2019;16(1):1–5.
  8. Zhou YH, Mak YW, Ho GWK. Effectiveness of interventions to reduce exposure to parental secondhand smoke at home among children in China: A systematic review. Int J Environ Res Public Health. 2019;16(1):107
  9. Nwosu C, Angus K, Cheeseman H, Semple S. Reducing secondhand smoke exposure among nonsmoking pregnant women: a systematic review. Nicotine Tob Res. 2020;22(12):2127–2133.
  10. Rosen LJ, Myers V, Winickoff JP, Kott J. Effectiveness of interventions to reduce tobacco smoke pollution in homes: A systematic review and meta-analysis. Int J Environ Res Public Health. 2015;12(12):16043–59.
  11. Rosen LJ, Myers V, Hovell M, Zucker D, Noach M Ben. Meta-analysis of parental protection of children from tobacco smoke exposure. Pediatrics. 2014;133(4):698–714.
  12. Tong VT, Dietz PM, Rolle I V., Kennedy SM, Thomas W, England LJ. Clinical interventions to reduce secondhand smoke exposure among pregnant women: A systematic review. Tob Control. 2015;24(3):217–23.
  13. Öberg 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.
  14. Hochbaum G, Rosenstock I, Kegeles S. Health belief model. United states public Heal Serv. 1952;1:78–80.
  15. Prochaska JO, Velicer WF. The Transtheoretical Model of Health Behavior Change. Am J Heal Promot [Internet]. 1997;12(1):38–48.
  16. Pender N. Health promotion model manual. 2011.
  17. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.
  18. Nawawi M, Balachandran P, Janakiram C, Sreedevi A, Menon JC, Thankappan KR. Effectiveness of Smoke-Free Home-based Interventions in Reducing Second-Hand Smoke Exposure in Children and Adults: A Systematic Review. Asian Pac J Cancer Prev. 2025;26(9):3145–56.
  19. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):1–11.
  20. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd Editio. New York: Routledge; 1988.
  21. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.
  22. Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al. Cochrane Handbook for Systematic Reviews of Interventions (version 6.3). Cochrane; 2022.
  23. Dettori JR, Norvell DC, Chapman JR. Fixed-Effect vs Random-Effects Models for Meta-Analysis: 3 Points to Consider. Glob Spine J. 2022;12(7):1624–6.
  24. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Br Med J. 1997;315(7109):629–34.
  25. Abdullah AS, Hua F, Khan H, Xia X, Bing Q, Tarang K, et al. Secondhand Smoke Exposure Reduction Intervention in Chinese Households of Young Children: A Randomized Controlled Trial. Acad Pediatr. 2015;15(6):588–98.
  26. Kegler MC, Bundy L, Haardörfer R, Escoffery C, Berg C, Yembra D, et al. A minimal intervention to promote smoke-free homes among 2-1-1 callers: A randomized controlled trial. Am J Public Health. 2015;105(3):530–7.
  27. Chi YC, Wu CL, Chen CY, Lyu SY, Lo FE, Morisky DE. Randomized trial of a secondhand smoke exposure reduction intervention among hospital-based pregnant women. Addict Behav. 2015;41:117–23.
  28. Chi YC, Sha F, Yip PSF, Chen JL, Chen YY. Randomized comparison of group versus individual educational interventions for pregnant women to reduce their secondhand smoke exposure. Med (United States). 2016;95(40):1–7.
  29. Williams RS, Stollings JH, Bundy U, Haardörfer R, Kreuter MW, Mullen PD, et al. A minimal intervention to promote smoke-free homes among 2-1-1 callers: North Carolina randomized effectiveness trial. PLoS One. 2016;11(11):1–15.
  30. Yang L, Tong EK, Mao Z, Hu TW, Lee AH. A Clustered Randomized Controlled Trial to Reduce Secondhand Smoke Exposure Among Nonsmoking Pregnant Women in Sichuan Province, China. Nicotine Tob Res. 2016;18(5):1163–70.
  31. Alagiyawanna AMAAP, Rajapaksa-Hewageegana N, Gunawardena N. The impact of multiple interventions to reduce household exposure to second-hand tobacco smoke among women: A cluster randomized controlled trial in Kalutara district, Sri Lanka. BMC Public Health. 2017;17(1):1–13.
  32. Hughes SC, Bellettiere J, Nguyen B, Liles S, Klepeis NE, Quintana PJE, et al. Randomized Trial to Reduce Air Particle Levels in Homes of Smokers and Children. Am J Prev Med. 2018;54(3):359–67.
  33. Hovell MF, Bellettiere J, Liles S, Nguyen B, Berardi V, Johnson C, et al. Randomised controlled trial of real-time feedback and brief coaching to reduce indoor smoking. Tob Control. 2020;29(2):183–90.
  34. Soltani F, Barzegar F, Sangestani G, Roshanaii G, Maleki A. The effectiveness of family counselling on reducing exposure to secondhand smoke at home among pregnant women in Iran. Tob Prev Cessat. 2019;5:41.
  35. Sahebi Z, Kazemi A, Loripour M, Shams N. An educational intervention to men for reducing environmental tobacco smoke exposure in their pregnant wives. J Matern Neonatal Med. 2019;32(10):1595–601.
  36. Wahabi HA, Massis A, Fayed AA, Esmaeil SA. Effectiveness of health education in reducing secondhand smoke exposure among pregnant women visiting the antenatal clinic in Saudi Arabia: A randomized controlled trial. Indian J Public Health. 2020;64(2):102–8.
  37. Skinner CS, Tiro J, Champion VL. The Health Belief Model. In: Health Behavior: Theory, Research, and Practice. 5th ed. Jossey-Bass: San Francisco; 2015.
  38. Kegler MC, Regine Haardörfer, Berg C, Escoffery C, Bundy L, Williams R, et al. Challenges in Enforcing Home Smoking Rules in a Low-Income Population: Implications for Measurement and Intervention. Nicotine Tob Res. 2016;18(5):976–81.
  39. Bandura A. Social foundations of thought and action. 1st ed. New Jersey, America: Prentice Hall; 1986.
  40. Koulouvari A dimitra, Margariti A, Sakellari E, Barbouni A, Lagiou A. Applications of Behavioral Change Theories and Models in Health Promotion Interventions: A Rapid Review. 2025; 15(5):580
  41. Kirat H El, Belle S Van, Khattabi A, Belrhiti Z. Behavioral change interventions, theories, and techniques to reduce physical inactivity and sedentary behavior in the general population: a scoping review. BMC Public Health. 2024; 24(1):2099
  42. Koulouvari A dimitra, Margariti A, Sakellari E, Barbouni A, Lagiou A. Applications of Behavioral Change Theories and Models in Health Promotion Interventions: A Rapid Review. 2025; 15(5):580
  43. Kirat H El, Belle S Van, Khattabi A, Belrhiti Z. Behavioral change interventions, theories, and techniques to reduce physical inactivity and sedentary behavior in the general population: a scoping review. BMC Public Health. 2024; 24(1):2099