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Influence of Second-Hand Smoke Awareness on Smoke-Exposure Prevention Practices among Non-Smoking Adults in Nigeria

Abstract

Second-hand smoke exposure is an important public health concern because non-smoking individuals who inhale tobacco smoke from other people's smoking may be exposed to harmful substances associated with respiratory diseases, cardiovascular conditions, and other adverse health outcomes. Non-smoking adults may be exposed to second-hand smoke in homes, workplaces, social environments, hospitality venues, and other shared spaces. Second-hand smoke awareness provides individuals with information about the health risks associated with involuntary tobacco smoke exposure, common sources of exposure, vulnerable populations, smoke-free environments, methods of reducing exposure, and the importance of supporting smoke-free policies and environments. Smoke-exposure prevention practices refer to behaviours adopted by non-smoking adults to prevent or reduce exposure to second-hand smoke, including avoiding smoking environments, maintaining smoke-free homes, requesting that others do not smoke around them, supporting smoke-free workplace and public-space policies, and leaving areas where smoking occurs. In Nigeria, awareness of the health consequences of second-hand smoke may vary among adults, while social norms, household smoking, workplace practices, hospitality settings, and inadequate enforcement of smoke-free policies may contribute to continued exposure. Effective second-hand smoke awareness may improve risk perception and encourage individuals to adopt appropriate practices for preventing or reducing exposure. Against this background, this study investigates the influence of second-hand smoke awareness on smoke-exposure prevention practices among non-smoking adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding individuals' decisions to avoid second-hand smoke exposure. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping preventive health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from second-hand smoke awareness may influence smoke-exposure prevention practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how second-hand smoke awareness may influence smoke-exposure prevention practices among non-smoking adults in Nigeria. The study will adopt a quantitative cross-sectional or quasi-experimental research design, depending on the implementation of the awareness intervention. Primary data will be collected from non-smoking adults in selected communities, workplaces, educational institutions, and other appropriate settings in Nigeria using a structured anonymous questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities or institutions, and eligible non-smoking adults. Where a quasi-experimental design is adopted, participants will be assigned to intervention and comparison groups, and the intervention group will receive structured second-hand smoke awareness education covering the health effects of passive smoking, sources of exposure, household and workplace exposure, smoke-free environments, strategies for avoiding exposure, and available tobacco-control policies and support resources. Smoke-exposure prevention practices will be assessed using indicators such as maintenance of smoke-free homes, avoidance of smoking environments, requesting smokers not to smoke nearby, leaving areas where smoking occurs, supporting smoke-free workplace and public-space policies, and other appropriate measures for reducing involuntary exposure. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, second-hand smoke awareness, exposure patterns, and prevention practices. Inferential statistical techniques, including chi-square tests and logistic or multiple regression analysis, will be used to determine the influence of second-hand smoke awareness on smoke-exposure prevention practices. Where an intervention is implemented, paired-sample and independent-sample tests will also be used to compare changes between groups. Appropriate diagnostic tests will be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that second-hand smoke awareness has a significant positive influence on smoke-exposure prevention practices among non-smoking adults in Nigeria. Adults exposed to adequate information about the health risks of second-hand smoke are expected to demonstrate greater awareness of exposure sources and increased adoption of protective practices. Awareness may encourage adults to maintain smoke-free homes, avoid smoking environments, communicate smoke-free preferences to household members and peers, and support smoke-free policies in workplaces and public spaces. However, awareness alone may not eliminate second-hand smoke exposure because adults may continue to face environmental and social barriers such as household smoking, workplace smoking, social pressure, limited control over shared environments, and weak enforcement of smoke-free policies. Consequently, second-hand smoke awareness is expected to be most effective when supported by comprehensive tobacco-control measures, smoke-free policies, effective enforcement, public health campaigns, and supportive social and community environments. The study is expected to contribute to the literature on tobacco control, second-hand smoke exposure, health education, environmental health, non-communicable disease prevention, health promotion, and public health in Nigeria by providing empirical evidence on the influence of second-hand smoke awareness on smoke-exposure prevention practices among non-smoking adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, tobacco-control programmes, state ministries of health, local government health authorities, workplaces, educational institutions, public health practitioners, community organizations, development partners, and policymakers regarding strategies for reducing involuntary tobacco smoke exposure. The study will also provide evidence-based recommendations for strengthening second-hand smoke education, promoting smoke-free homes and workplaces, improving public awareness of tobacco-related health risks, strengthening enforcement of smoke-free policies, and creating healthier environments for non-smoking adults across Nigeria.

Keywords: Second-hand smoke awareness, smoke-exposure prevention practices, non-smoking adults, passive smoking, tobacco smoke exposure, tobacco control, smoke-free environments, health education, environmental health, non-communicable disease prevention, public health, Nigeria.