METHODS: This study employed a mixed-methods design, conducted in two rural settlement areas in 2022. Data were collected through surveys on SHS and SFH knowledge and face-to-face interviews using a topic guide. The quantitative data were analyzed using SPSS software while the qualitative data were analyzed using the thematic approach via NVivo 12.
RESULTS: Sixty participants completed the survey. Most of the respondents had a good (38%) or moderate (48%) knowledge level of SHS. No association was found between sociodemographic factors and knowledge level. Seven of the nine interviewees knew specific SHS-related health risks. Most participants believed that implementing SFH requires quitting or reducing smoking. Barriers to establishing a SFH included personal convenience, habits, attitudes, and social influence. Family encouragement, practicability, government, and quitting smoking were the facilitators for SFH.
CONCLUSIONS: These rural communities had moderate knowledge level of SHS and SFH. Men's knowledge, beliefs and perceptions like associating SFH with quitting smoking may prevent SFH adoption. It is critical for the government and stakeholders to disseminate information and develop socially and culturally acceptable health promotion programs, incorporating the considerations from this study to increase the chances of SFH implementation in rural areas.
AIMS AND METHODS: This study explored male smokers' knowledge, beliefs, and behaviors related to SHS exposure and smoking in the home, to guide future intervention development. 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 behaviors. Data were managed and analyzed 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 for their children.
CONCLUSIONS: Men's home-smoking behaviors 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 that could build on men's sense of responsibility as the head of the household and/or their general desire to protect their families.