Peer-reviewed article
Sociocultural family determinants and secondhand smoke exposure with respiratory disorders, stunting in children: Scoping review
Pascoela da Costa de Jesus Xavier, Dewi Rokhanawati, Ismarwati Ismarwati ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This scoping review looked at how family and cultural habits around smoking affect children under five in developing countries. It combined findings from 11 studies across 9 countries, including one from South Africa, to see how household smoke exposure relates to breathing problems and stunted growth in children. The review found that certain family and cultural smoking behaviours increase children's exposure to secondhand smoke, which in turn raises the risk of respiratory illness and poor growth. It also found that there is very little research yet on programs designed to reduce this exposure within families.
Key points
- Eleven studies from 9 countries were reviewed, including one from South Africa.
- Family sociocultural determinants shape household smoking behaviour and children's exposure to secondhand smoke.
- Secondhand smoke exposure is linked to increased respiratory disorders and stunting in children aged 0-59 months.
- Evidence on family-based interventions to reduce this exposure is limited.
- The authors call for culturally appropriate health promotion and community midwifery policies.
Limitations
The review is based on only one South Africa-specific study, so findings are not strongly representative of African contexts, and it does not evaluate the effectiveness of any specific intervention.
Abstract
Background: Exposure to cigarette smoke indoors remains a concern among children in developing countries. Smoking poses serious health risks to children, as no safe level of secondhand smoke exposure exists. Family sociocultural determinants play a crucial role in shaping household smoking behaviors, thereby influencing children’s respiratory health and nutritional status. However, evidence remains fragmented and incomprehensively mapped. Objective: This study aimed to map evidence on family sociocultural determinants of household tobacco smoke exposure and their association with respiratory disorders and stunting among children aged 0–59 months in developing countries. Methods: This scoping review searched PubMed, ScienceDirect, Wiley Online Library, and Google Scholar for original studies published in English between 2015 and 2025 in developing countries. Eligible studies involved children aged 0–59 months or their caregivers/households exposed to cigarette smoke and examined family sociocultural determinants of smoking related to respiratory and nutritional outcomes. Irrelevant studies were excluded, and data were descriptively analyzed. Results: Eleven articles were included: 10 country-specific and 1 multi-country study, representing 9 unique countries. Country-specific studies were from India (4), Indonesia (2), South Africa (1), Albania (1), Malaysia (1), and Turkey (1), while the multi-country study included Cambodia, Indonesia, Lao PDR, and Timor-Leste. Studies showed that family sociocultural determinants influence children's exposure to secondhand smoke and increase the risk of respiratory disorders and stunting. Evidence on family-based interventions remains limited. Conclusion: Family sociocultural determinants shape tobacco smoke exposure and its adverse effects on children’s respiratory and nutritional health. These findings support culturally appropriate health promotion strategies and community midwifery policies.