DOI: https://doi.org/10.14710/jpki.20.4.%25p

Secondhand Smoke as an Indirect Cause of Stunting: A Study at Nipah Health Center in North Lombok

*Yuniar Wardani orcid scopus  -  Faculty of Public Health, Universitas Ahmad Dahlan, Indonesia
Irin Azzahra Nugraheni  -  Faculty of Public Health, Universitas Ahmad Dahlan, Indonesia
Baiq Qatrunnada Hariyanti  -  Faculty of Public Health, Universitas Ahmad Dahlan, Indonesia
Open Access Copyright (c) 2025 http://creativecommons.org/licenses/by-sa/4.0 under http://creativecommons.org/licenses/by-sa/4.0.

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Abstract

Background: Stunting is a growth and development disorder in children resulting from poor nutrition, repeated infections, and inadequate psychosocial stimulation. Children affected by stunting are more vulnerable to various diseases. Long-term consequences include impaired cognitive and motor development, along with increased healthcare costs. Exposure to secondhand smoke, whether direct or indirect, is believed to contribute to stunting. This study aimed to investigate secondhand smoke exposure as an indirect cause of stunting.

Method: This study used a cross-sectional approach with a sample of 99 children under five years old residing in the Nipah Health Center area, Malaka Village, North Lombok. The sample was taken using stratified proportional random sampling. Descriptive statistics and Chi-square tests were employed to analyze the data and test the research hypothesis.

Result The prevalence of stunting was 38.38%. Although none of the mothers reported smoking during pregnancy, 98.98% of them were exposed to cigarette smoke from their husbands, family members, or neighbors. Exposure occurred multiple times in both home and public environments, typically lasting less than 15 minutes. The statistical analysis showed no significant association between secondhand smoke exposure and stunting. Despite the lack of a statistically significant relationship, exposure to secondhand smoke remains a public health concern. Preventive measures should be prioritized. Health promoters are encouraged to intensify anti-smoking campaigns. Smoking cessation counseling should be delivered door-to-door, particularly targeting households with pregnant women and toddlers. Educational materials such as flyers, short messages, and inspirational stories disseminated via social media platforms like WhatsApp can serve as effective health promotion tools.

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Keywords: secondhand smoke;stunting;toddlers;smoking cessation

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Section: Research Article
Language : EN
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  1. Aditianti A, Raswanti I, Sudikno S, Izwardy D, Irianto SE. Prevalensi dan Faktor Risiko Stunting pada Balita 24-59 Bulan di Indonesia: Analisis Data Riset Kesehatan Dasar 2018 (Prevalence and Stunting Risk Factors in Children 24-59 Months in Indonesia: Analysis of Basic Health Research Data 2018). Penelit Gizi dan Makanan (The J Nutr Food Res. 2021;43(2):51–64
  2. Arfaeinia H, Ghaemi M, Jahantigh A, Soleimani F, Hashemi H. Secondhand and thirdhand smoke: a review on chemical contents, exposure routes, and protective strategies. Environ Sci Pollut Res [Internet]. 2023;30(32):78017–29. Available from: https://doi.org/10.1007/s11356-023-28128-1
  3. Assani MY, Kusrini, Kusnawi. Analisis Kejadian Stunting Di Provinsi Nusa Tenggara Barat Menggunakan Metode Path Analysis. Tek Teknol Inf dan Multimed. 2024;5(1):47–55
  4. Astuti DD, Handayani TW, Astuti DP. Cigarette smoke exposure and increased risks of stunting among under-five children. Clin Epidemiol Glob Heal [Internet]. 2020;8(3):943–8. Available from: https://doi.org/10.1016/j.cegh.2020.02.029
  5. Azhar ME, Nurdin DU, Siswadi Y. Pengaruh Disiplin Kerja Dan Kompensasi Terhadap Kepuasan Kerja Karyawan. J Hum J Ilmu Sos Ekon dan Huk. 2020;4(1):46–60
  6. Bhargava M, Bhargava A, Ghate SD, Rao RS, Prasad. Nutritional status of Indian adolescents (15-19 years) from National Family Health Surveys 3 and 4: Revised estimates using WHO 2007 Growth reference. PLoS One [Internet]. 2020;15(6):1–24. Available from: http://dx.doi.org/10.1371/journal.pone.0234570
  7. Choirunnisa A, Febriyana F, Sari ETP, Ambarwati NM, Nurdiantami Y. Pengaruh Asap Rokok Pada Ibu Hamil : Studi Literatur. J Kesehat Tambusai. 2022;3(2):183–92
  8. Edi M, Chin YS, Woon FC, Appannah G, Lim PY. Inadequate gestational weight gain and exposure to second-hand smoke during pregnancy increase the risk of low birth weight: A cross-sectional study among full-term infants. Int J Environ Res Public Health. 2021;18(3):1–12
  9. Fan C, Huang T, Cui F, Gao M, Song L, Wang S. Paternal factors to the offspring birth weight: The 829 birth cohort study. Int J Clin Exp Med. 2015;8(7):11370–8
  10. Fanny L, Sukmawati, Mas’ud H, Sirajuddin. Hubungan Riwayat BBLR Dengan Stunting Pada Anak Balita Di Kelurahan Boribellaya Kecamatan Turikale. Media Gizi Pangan. 2023;30(2):138–45
  11. Fitri RJ, Huljannah N, Rochmah TN. Program Pencegahan Stunting di Indonesia: A systematic review. Media Gizi Indonesia (National Nutr Journal). 2022;17(3):281–92
  12. Howe LD, Matijasevich A, Tilling K, Brion MJ, Leary SD, Smith GD, et al. Maternal smoking during pregnancy and offspring trajectories of height and adiposity: Comparing maternal and paternal associations. Int J Epidemiol. 2012;41(3):722–32
  13. Inoue S, Naruse H, Yorifuji T, Kato T, Murakoshi T, Doi H, et al. Impact of maternal and paternal smoking on birth outcomes. J Public Heal. 2017;39(3):1–10
  14. Kelley ST, Liu W, Quintana PJE, Hoh E, Dodder NG, Mahabee-Gittens EM, et al. Altered microbiomes in thirdhand smoke-exposed children and their home environments. Pediatr Res. 2021;90(6):1153–60
  15. Kemenkes. Mengenal Lebih Jauh tentang Stunting. 2023
  16. Kemenkes. Survei Kesehatan Indonesia dalam Angka. 2023
  17. Ko TJ, Tsai LY, Chu LC, Yeh SJ, Leung C, Chen CY, et al. Parental Smoking During Pregnancy and Its Association with Low Birth Weight, Small for Gestational Age, and Preterm Birth Offspring: A Birth Cohort Study. Pediatr Neonatol [Internet]. 2014;55(1):20–7. Available from: http://dx.doi.org/10.1016/j.pedneo.2013.05.005
  18. Kumar H, Kumar D, Kumar B, Sinha RK, Singh R. Nutritional Assessment of Rural Children (6-12 years) of North Bilar: A Cross-Sectional Study. Indian J Child Health. 2019;6(1):25–9
  19. Lemaking VB, Manimalai M, Djogo HMA. Hubungan Pekerjaan Ayah, Pendidikan Ibu, Pola Asuh, dan Jumlah Anggota Keluarga dengan Kejadian Stunting pada Balita di Kecamatan Kupang Tengah, Kabupaten Kupang. Ilmu Gizi Indones. 2022;5(2):123–32
  20. Maidartati, Parsaulian P. Gambaran Pengetahuan Ibu Hamil Trimester I Tentang Pengaruh Rokok Terhadap Tumbuh Kembang Janin di Polikandungan RSUD Kota Bandung. J Ilmu Keperawatan. 2015;3(1):38–50
  21. Merianos AL, Matt GE, Stone TM, Jandarov RA, Hoh E, Dodder NG, et al. Contamination of surfaces in children’s homes with nicotine and the potent carcinogenic tobacco-specific nitrosamine NNK. J Expo Sci Environ Epidemiol. 2024;34(4):727–34
  22. Muchlis N, Yusuf RA, Rusydi AR, Mahmud NU, Hikmah N, Qanitha A, et al. Cigarette Smoke Exposure and Stunting Among Under-five Children in Rural and Poor Families in Indonesia. Environ Health Insights. 2023;17:1–7
  23. Muhammad Tahir Saenong, Sulaeman, Bakhtiar, Purnama J, Kenre I. The Relationship between Cigarette Smoke Exposure and Stunting among Children in the Working Area of the Pangkajene Health Center, Sidrap Regency in 2023. J Nurs Pract. 2024;7(2):325–34
  24. Nadhiroh SR, Djokosujono K, Utari DM. The association between secondhand smoke exposure and growth outcomes of children: A systematic literature review. Tob Induc Dis. 2020;18:1–12
  25. Nepali S, Simkhada P, Davies I. Trends and Inequalities in Stunting in Nepal: A secondary data analysis of four Nepal demographic health surveys from 2001 to 2016. BMC Nutr. 2019;5(1):1–10
  26. Nurhayati. Hubungan Perilaku Merokok Orang Tua dengan Kejadian Stunting di Wilayah Kerja Puskesmas Mangkoso Kabupaten Barru. J Pendidik Keperawatan dan Kebidanan. 2023;2(1):90–9
  27. Patimah S, Sharief SA, Muhsanah F, Nukman N, Rachmat M. Pendampingan Pencegahan Risiko Anak Stunting pada Masyarakat, Kader Kesehatan, dan Guru PAUD/TK. War LPM. 2024;27(2):259–68
  28. Pertiwi ANAM, Dwinata I, Qurniyawati E, Rismayanti. Faktor Yang Berhubungan Dengan Kejadian Stunting Pada Baduta Di Kabupaten Bone Dan Enrekang. J Kesehat Lingkung Indones. 2024;23(1):101–10
  29. Purba IG, Sunarsih E, Trisnaini I, Sitorus RJ. Environmental Sanitation and Incidence of Stunting in Children Aged 12-59 Months in Ogan Ilir Regency. J Kesehat Lingkung. 2020;12(3):189–99
  30. Purnamasari I, Kapalawi I. Analisis Proses Manajemen Sumber Daya Manusia di Rumah Sakit Stella Maris Makassar. J MKMI. 2018;9(2):120–4
  31. Safitri MD, Hastuti J, Palupi IR. Hubungan Pola Asuh dalam Pemberian Makan dan Paparan Asap Rokok dengan Status Gizi (IMT/U) Siswa Sekolah Dasar di Kulon Progo. 2024
  32. Sari NAME, Resiyanthi NKA. Kejadian Stunting Berkaitan Dengan Perilaku Merokok Orang Tua. J Ilmu Keperawatan Anak [Internet]. 2020;3(2):24–30. Available from: http://dx.doi.org/10.26594/jika.1.2.2020
  33. Satriawan D. Gambaran Kebiasaan Merokok Penduduk Di Indonesia. J Litbang Sukowati Media Penelit dan Pengemb. 2022;5(2):51–8
  34. Setiyawati ME, Ardhiyanti LP, Hamid EN, Muliarta NAT, Raihanah YJ. Studi Literatur: Keadaan Dan Penanganan Stunting Di Indonesia. IKRA-ITH Hum J Sos dan Hum. 2024;8(2):179–86
  35. Simanjuntak BY, Annisa R, Saputra AI. Mikrobiota Vs Stunting. 1st ed. Yogykarta: Rapha Publishing; 2022
  36. Sharma V, Katz J, Mullany LC, Khatry SK, LeClerq SC, Shrestha SR, et al. Young Maternal Age and the Risk of Neonatal Mortality in Rural Nepal. Arch Pediatr Adolesc Med. 2008;162(9):828–35
  37. Soleymani D, Pougheon-Bertrand D, Gagnayre R. A Digital Behavior Change Intervention for Health Promotion for Adults in Midlife: Protocol for a Multidimensional Assessment Study. JMIR Res Protoc. 2025;14:1–14
  38. UNICEF, WHO GW. Levels and trends in Child Malnutrition: Key Findings of the 2023 edition. Asia Pacifik Popul J. 2023;24(2)
  39. WHO. Childhood Stunting : Context, Causes, and Consequences. 2013
  40. WHO. Global Adult Tobacco Survey Indonesia Report 2021. Jakarta, Indonesia: World Health Organization, Regional Office for South-East Asia; 2020. Licence:CC BY-NC SA 3.0 1GO; 2024
  41. Wijaya-Erhardt M. Nutritional Status of Indonesian Children in Low-Income Households with Fathers that Smoke. Osong Public Heal Res Perspect. 2019;10(2):64–71
  42. Zhang AL, Liu S, White BX, Liu XC, Durantini M, Chan M pui S, et al. Health-Promotion Interventions Targeting Multiple Behaviors: A Meta-Analytic Review of General and Behavior-Specific Processes of Change. Psycho Bull. 2024;150(7):798–838

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