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

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.

Keywords

• Secondhand smoke
• Smoke-free home
• Behavior change
• Meta-analysis

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

Abstract

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.

Keywords

• İkinci el sigara dumanı
• Dumansız ev
• Davranış değişikliği
• Meta-analiz

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