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Introduction Despite the health risks associated with second-hand smoke (SHS) exposure, smoking in the home is common in Malaysia, and almost exclusively a male behaviour. This study explored male smokers’ knowledge, beliefs and behaviours related to SHS exposure and smoking in the home, to guide future intervention development. Methods Twenty-four men who smoked and lived in Klang Valley, Kuantan or Kuala Terengganu took part in semi-structured interviews which explored knowledge and beliefs regarding SHS in the home, and associated home smoking behaviours. Data were managed and analysed using the framework approach. Results There was limited knowledge regarding the health risks associated with SHS: the smell of SHS in the home was a more prominent concern in most cases. Many had no rules in place restricting home-smoking, and some suggested that smoking in specific rooms and/or near windows meant SHS was not ‘shared’ with other household members. A few fathers had created but not maintained a smoke-free home prior to and/or after their children were born. Desire to smoke in the home conflicted with men’s sense of responsibility as the head of the household to protect others and set a good example to their children. Conclusions Men’s home-smoking behaviours are shaped by a lack of understanding of the health risks associated with SHS exposure. Gaining a broader understanding of the factors that shape men’s decisions to create a smoke-free home is important to facilitate the development of culturally-appropriate interventions that address their responsibility to protect other household members from SHS exposure. Implications Our findings highlight the need for public information campaigns in Malaysia to educate men who smoke regarding the health harms associated with SHS in the home and the ways in which SHS travels and lingers in household air. This is important given men’s concerns about SHS often focus on the smell of cigarette smoke in the home. Our findings suggest a number of potential avenues for future intervention development, including household and community-level initiatives which could build on men’s sense of responsibility as the head of the household and/or their general desire to protect their family.
Introduction Despite the health risks associated with second-hand smoke (SHS) exposure, smoking in the home is common in Malaysia, and almost exclusively a male behaviour. This study explored male smokers’ knowledge, beliefs and behaviours related to SHS exposure and smoking in the home, to guide future intervention development. Methods Twenty-four men who smoked and lived in Klang Valley, Kuantan or Kuala Terengganu took part in semi-structured interviews which explored knowledge and beliefs regarding SHS in the home, and associated home smoking behaviours. Data were managed and analysed using the framework approach. Results There was limited knowledge regarding the health risks associated with SHS: the smell of SHS in the home was a more prominent concern in most cases. Many had no rules in place restricting home-smoking, and some suggested that smoking in specific rooms and/or near windows meant SHS was not ‘shared’ with other household members. A few fathers had created but not maintained a smoke-free home prior to and/or after their children were born. Desire to smoke in the home conflicted with men’s sense of responsibility as the head of the household to protect others and set a good example to their children. Conclusions Men’s home-smoking behaviours are shaped by a lack of understanding of the health risks associated with SHS exposure. Gaining a broader understanding of the factors that shape men’s decisions to create a smoke-free home is important to facilitate the development of culturally-appropriate interventions that address their responsibility to protect other household members from SHS exposure. Implications Our findings highlight the need for public information campaigns in Malaysia to educate men who smoke regarding the health harms associated with SHS in the home and the ways in which SHS travels and lingers in household air. This is important given men’s concerns about SHS often focus on the smell of cigarette smoke in the home. Our findings suggest a number of potential avenues for future intervention development, including household and community-level initiatives which could build on men’s sense of responsibility as the head of the household and/or their general desire to protect their family.
Introduction Secondhand smoke exposure during pregnancy is a significant cause of negative health effects. This study aims to identify barriers and facilitators for implementing a smoke-free home and car among expectant Israeli fathers. ` Methods Twenty-four qualitative semi-structured telephone interviews were audio-recorded, transcribed, and analyzed according to a reflexive and collaborative thematic approach. Inclusion criteria were being male, Hebrew speaker, age ≥18 years, smoking at least one cigarette a day, and living with their non-smoking pregnant spouse. The Capability, Opportunity and Motivation for Behavior (COM-B) model was used as a theoretical model for analysis. Results Participants reported feeling a strong responsibility for their pregnant spouse’s comfort and health, stating that they are doing the best they can to reduce their spouse’s secondhand smoke exposure (Motivation). Participants had a low level of knowledge about specific secondhand smoke health consequences, effective strategies to reduce secondhand smoke exposure, with incorrect perceptions about what constitutes exposure (Capability). Couple relationships were not affected by the husband’s smoking habits, and participants expressed mutual consideration and understanding (Opportunity). Participants also expressed positive attitudes regarding smoke-free home and car implementation but emphasized that any changes have to be their own decision (Motivation). Conclusions The present study identified principal Capability, Opportunity and Motivation barriers and facilitators that influence Israeli expectant fathers’ decision to implement a smoke-free home and car. Those findings will inform the development of a digital behavioral intervention targeting expectant fathers to reduce prenatal secondhand smoke exposure. Implications Secondhand smoke exposure during pregnancy is a significant cause of negative health effects. Interventions among expectant fathers that focus on creating a smoke-free home and car may be effective because pregnancy has been identified as a "window of opportunity" that generates a strong motivation and creates a sense of urgency to change smoking behavior, while being considered more achievable than smoking cessation. Interventions might be effective if they focus on strengthening the parental responsibility among expectant fathers and emphasize the benefits of a smoke-free home and car, while maintaining male autonomy and increasing skills to effectively implement a smoke-free home and car.
Introduction: Exposure to second-hand tobacco smoke generates a considerable health burden globally. In south-east Asia, most of that burden falls on women and children who are exposed to second-hand smoke from male smoking in their home. Interventions to encourage smoke-free homes have tended to target smokers individually or within their family unit, although some evidence suggests a community-wide approach holds promise. This study co-developed an intervention toolkit that could be applied to small village/town communities in Indonesia and Malaysia. Methods: The CO-FRESH study used four work packages to: (i) create online training materials to equip local health professionals to tackle smoking in the home; (ii) create a local public information campaign on the benefits of a smoke-free home; (iii) establish methods to provide household air quality feedback to highlight the impact of smoking in the home; and (iv) map local existing services to support families to create smoke-free homes. Results: Four specific communities (two in each country) were involved in intervention development. Training materials for health professionals and a toolkit for use by communities to encourage smoke-free homes were co-created. Communities welcomed the concept of tackling smoking in the home, however there was a lack of knowledge about how second-hand smoke moved around the home and could enter indoor spaces from outdoor smoking. The concept of a smoke-free home was often misunderstood, alongside what constitutes indoor versus outdoor space. In addition, findings of high background air pollution levels mean that household air quality measurement may not be suited to providing second-hand smoke information in these communities. Conclusions: Communities in Malaysia and Indonesia recognised the importance of reducing smoking in the home, and welcomed the approach of co-developing community-wide methods of tackling the issue. The CO-FRESH toolkit requires evaluation to determine effectiveness and how it can be implemented at scale.
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