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Health Needs and Challenges in Preventing Secondhand Smoke Exposure Among Rural Adolescents: Implications for
Yu-Shuan Wan1, Tung-Jung Huang2,3, Chia-Hao Chang1
1Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
The Journal of Nursing Research : JNR
|January 23, 2026
Summary
Adolescents in rural areas face significant secondhand smoke (SHS) exposure. A pilot program teaching them to advise family smokers (AFS) showed some success but highlighted cultural barriers and the need for policy changes.
Area of Science:
- Public Health
- Adolescent Health
- Tobacco Control
Background:
- Secondhand smoke (SHS) exposure poses health risks to adolescents.
- Adolescents living with smokers are at higher risk for tobacco use.
- School nurses play a key role in SHS prevention but often lack strategies for advising family smokers (AFS).
Purpose of the Study:
- To determine SHS exposure prevalence in rural adolescents.
- To assess the impact of a pilot program using innovative AFS strategies.
Main Methods:
- A school-based educational intervention was conducted in four middle schools.
- A 6-hour SHS prevention program with AFS strategies was integrated into health curricula.
- Anonymous questionnaires collected data on SHS exposure, AFS attempts, and barriers.
Main Results:
- 67% of adolescents lived with a smoker; 91.4% reported indoor smoking.
- After the program, 46.9% attempted AFS, but only 8.1% felt successful.
- Barriers included parental refusal, cultural values (filial piety), and moral dilemmas.
Conclusions:
- SHS exposure is a significant problem for rural adolescents.
- Teaching AFS strategies can reduce home exposure, especially for boys.
- Cultural values in Eastern societies create challenges for AFS; regulatory changes are needed to protect youth.
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