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.