Impact of Nursing Interventions on Secondary Smokers’ Health:
A Community-Based Approach
Singampalli. Nohini. Sandhya1, Alexander. P.C2
1Vice Principal, School of Nursing, Paralakhemundi Campus,
Centurion University of Technology and Management, Odisha.
2Nursing Officer, ESIC Medical College Hospital, Sanath Nagar, Hyderabad.
*Corresponding Author E-mail: singampalli.sandhya@cutm.ac.in, alextheboss001@gmail.com
ABSTRACT:
Secondary smoking, or passive smoking, continues to be a major public health issue worldwide, contributing to respiratory illnesses, cardiovascular diseases, and increased morbidity. Nurses, as frontline healthcare professionals, play a critical role in reducing exposure to second hand smoke (SHS) and mitigating its health impacts. This study investigates the effectiveness of nursing-led interventions, such as education, smoking cessation programs, and advocacy for smoke-free environments, in improving health outcomes for secondary smokers in rural and urban communities. Using a mixed-method approach, data were collected through pre- and post-intervention health surveys and in-depth interviews with participants and nurses. The results demonstrated significant improvements in respiratory symptoms, increased adoption of smoke-free policies, and enhanced community awareness. Challenges, including resource constraints and resistance from primary smokers, were also identified. The study concludes by emphasizing the necessity of integrating nursing interventions with public health policies to achieve long-term reduction in secondary smoking exposure.
KEYWORDS: Secondary smoking, Nursing interventions, Second hand smoke, Community health, Smoke-free environments, Public health policy.
INTRODUCTION:
Secondary smoking, also known as passive or second-hand smoking (SHS), is involuntary exposure to tobacco smoke emitted from burning cigarettes or exhaled by active smokers. The World Health Organization (WHO) estimates that SHS causes 1.2 million deaths annually, with non-smokers bearing the brunt of this preventable health risk. Vulnerable populations, including children, pregnant women, and individuals with pre-existing health conditions, are disproportionately affected, suffering from conditions like asthma, respiratory infections, and heart diseases.
Despite growing awareness, secondary smoking remains a significant public health challenge, especially in developing countries where smoke-free policies are weakly enforced. Nurses, given their direct involvement with patients and communities, are uniquely positioned to address this issue. By providing education, facilitating behavioural change, and advocating for policy enforcement, nurses can significantly reduce SHS exposure and its associated health risks.
This study aims to evaluate the impact of nursing interventions on secondary smokers’ health outcomes, with a focus on community-based approaches that involve education, advocacy, and cessation support.
REVIEW OF LITERATURE:
Health Impacts of Secondary Smoking:
Respiratory and Cardiovascular Diseases: According to Glantz et al. (2020), SHS increases the risk of developing chronic obstructive pulmonary disease (COPD) by 25% and cardiovascular diseases by 30%. Children exposed to SHS are more likely to suffer from asthma and recurrent respiratory infections.
Developmental Delays: WHO (2023) reported that prenatal exposure to SHS is linked to low birth weight, premature births, and developmental delays.
Economic and Social Burden of SHS:
Max et al. (2021) estimated the global economic burden of SHS at $150 billion annually, considering healthcare costs and productivity losses.
The indirect costs, including emotional stress on families, exacerbate the societal impact of SHS.
Role of Nurses in Public Health:
Nurses are pivotal in tobacco control due to their direct access to affected populations. Sarna et al. (2019) found that nurse-led smoking cessation programs reduced household SHS exposure by 40%.
Nurses’ ability to build trust and provide culturally sensitive education enhances the effectiveness of interventions (Piasecki et al., 2020).
Community-Based Nursing Interventions:
Community-based interventions have demonstrated superior outcomes compared to hospital-based programs. Greenhalgh et al. (2018) emphasized that localized approaches tailored to cultural contexts are more effective in achieving behavioural change.
Borrelli et al. (2017) highlighted the importance of integrating smoking cessation into broader community health programs, noting a 25% increase in household smoke-free policies.
Policy Integration and Advocacy:
Faber et al. (2022) reviewed the effectiveness of integrating nursing advocacy with smoke-free policies, which resulted in a 50% reduction in SHS exposure in public spaces.
Jamrozik et al. (2021) stressed the need for active nurse participation in policy formulation to strengthen community health initiatives.
METHODOLOGY:
Study Design:
This study employed a mixed-method approach to combine quantitative analysis of health outcomes with qualitative insights from participant experiences.
Study Population:
Sample Size:
200 secondary smokers from rural and urban communities.
Inclusion Criteria:
Non-smokers with at least six months of SHS exposure in households or public spaces.
Exclusion Criteria:
Individuals with unrelated pre-existing conditions.
Intervention Strategies:
1. Educational Programs:
Nurses conducted awareness sessions on the risks of SHS and benefits of smoke-free environments.
Distribution of educational materials, including pamphlets and posters, in local languages.
2. Smoking Cessation Support:
Counselling services for primary smokers in households.
Referral to smoking cessation clinics for long-term support.
3. Community Advocacy:
Workshops to promote smoke-free public areas.
Collaboration with local leaders to implement community-specific smoke-free initiatives.
Data Collection:
Quantitative: Pre- and post-intervention health surveys measured respiratory symptoms, lung function (spirometry), and general health indicators.
Qualitative: Semi-structured interviews with participants and nurses explored their experiences and perceptions of the interventions.
Data Analysis:
Quantitative: Paired t-tests were used to assess statistical significance of changes in health indicators pre- and post-intervention.
Qualitative: Thematic analysis identified recurring themes related to intervention effectiveness and challenges.
RESULTS:
1. Health Improvements:
78% of participants reported a reduction in respiratory symptoms, including coughing, shortness of breath, and wheezing.
Lung function tests showed a significant improvement (p<0.01) in 65% of participants.
2. Behavioral Changes:
72% of households adopted smoke-free policies post-intervention.
Smoking cessation rates among primary smokers in the community increased by 20%.
3. Community Impact:
Awareness of SHS risks increased by 85% among participants.
Local leaders committed to implementing smoke-free public spaces in two communities.
4. Challenges:
Resistance from primary smokers in 25% of households.
Limited resources and staffing for conducting follow-up interventions.
DISCUSSION:
The study underscores the critical role of nursing interventions in reducing SHS exposure and improving health outcomes. Educational programs were particularly effective in raising awareness, while smoking cessation support directly reduced SHS at the household level. Community engagement was instrumental in fostering behavioral change and promoting policy advocacy.
Challenges, such as resistance from smokers and resource constraints, highlight the need for sustained efforts and collaboration with policymakers to enhance the reach and impact of these interventions. Future research should focus on developing scalable models and integrating technology, such as mobile health applications, to support nursing interventions.
CONCLUSION:
Nursing-led interventions are a powerful tool in addressing the health impacts of secondary smoking. This study demonstrates their effectiveness in reducing SHS exposure and improving community health outcomes. To ensure long-term success, these interventions must be supported by robust policies, adequate funding, and continuous professional development for nurses.
REFERENCES:
1. World Health Organization. Global Report on the Tobacco Epidemic. WHO Press. 2023
2. Glantz, S. A., and Bareham, D. Secondhand Smoke: Health Effects and Impact on Non-Smokers. The Lancet. 2020; 25(3): 432-440.
3. Max, W., Sung, H. Y., and Shi, Y. The Economic Burden of Secondhand Smoke Exposure. Tobacco Control Journal. 2021; 30(4): 453-459.
4. Sarna, L., and Bialous, S. A. Nurses’ Role in Tobacco Control and Reducing Exposure to Secondhand Smoke. Nursing Outlook. 2019; 67(4): 299-305.
5. Piasecki, T. M., and Baker, T. B. Brief Interventions for Reducing Secondary Smoking Exposure in Families. American Journal of Nursing. 2020; 120(6): 45-52.
6. Greenhalgh, E. M., and Scollo, M. M. Community-Based Approaches to Reducing Tobacco Smoke Exposure. Public Health Reviews. 2018; 39(2): 141-153.
7. Borrelli, B., and Hecht, J. The Role of Nurses in Community Health and Smoke-Free Advocacy. Journal of Nursing Education. 2017; 56(3): 215-220.
8. Faber, T., and Stevens, A. Systematic Review of Policy Interventions on Secondhand Smoke. Journal of Public Health Policy. 2022; 43(1): 45-63.
9. Jamrozik, K., and Chapman, S. Policy and Advocacy in Tobacco Control: Nurses’ Impact. Health Policy Journal. 2021; 72(3): 342-350.
10. National Institute of Nursing Research (NINR). Evidence-Based Practices for Tobacco Cessation in Communities. 2019.
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Received on 09.12.2024 Revised on 14.03.2025 Accepted on 23.05.2025 Published on 16.08.2025 Available online from August 25, 2025 Int. J. Nursing Education and Research. 2025;13(3):137-139. DOI: 10.52711/2454-2660.2025.00029 ©A and V Publications All right reserved
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