Visual communication for smoke-free homes

A community-based health promotion intervention in rural indonesia

Authors

  • Emmi Bujawati Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Islam Negeri Alauddin Makassar, Makassar, Indonesia
  • Bs. Titi Haerana Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Islam Negeri Alauddin Makassar, Makassar, Indonesia
  • Evi Aprianti Radjiman Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Islam Negeri Alauddin Makassar, Makassar, Indonesia

DOI:

https://doi.org/10.24252/sociality.v5i2.68181

Keywords:

community-based intervention, health promotion, secondhand smoke, smoke-free home, visual communication

Abstract

Although tobacco-control interventions in Indonesia have largely emphasized public smoke-free areas, limited evidence exists on participatory visual communication strategies for reducing cigarette smoke exposure within rural households. This community service program aimed to improve community awareness and encourage the implementation of smoke-free homes through the installation of “Smoke-Free Home” stickers in Kasimburang Village. The program employed a Participatory Action Research approach with a pre–post test without control intervention design, involving initial screening, health education, sticker installation, interviews, and field observations. Respondents’ knowledge increased from a mean score of 9.12 at pre-test to 9.62 at post-test I and 9.81 at post-test II, accompanied by decreasing score variability. Among 26 respondents, reported indoor smoking declined from 88.5% before counseling to 53.8% afterward, while 73.1% reported implementing household no-smoking rules. Field evaluation of 58 households showed that 81.0% of stickers remained installed and 77.6% remained intact and readable. These findings indicate that combining health education with visible household reminders may strengthen awareness, behavioral commitment, and smoke-free home practices. This low-cost, community-based intervention has potential to support protection from secondhand smoke and contribute to the prevention of tobacco-related non-communicable diseases in rural communities.

Author Biography

Emmi Bujawati, Department of Public Health, Faculty of Medicine and Health Sciences, Universitas Islam Negeri Alauddin Makassar, Makassar, Indonesia

References

Akib, N., et al. (2026). Edukasi kesehatan untuk meningkatan pengetahuan mengenai bahaya rokok pada masyarakat wilayah pesisir Kabupaten Konawe Utara. ASPIRASI: Publikasi Hasil Pengabdian dan Kegiatan Masyarakat, 4(4), 56–65. https://journal.aspirasi.or.id/index.php/ASPIRASI/article/view/2832

Andrews, J. O., et al. (2012). Community-based participatory research and smoking cessation interventions: A review of the evidence. Nursing Clinics of North America, 47(1), 81–96. https://www.sciencedirect.com/science/article/pii/S0029646511000867

Asfaw, S. M., et al. (2024). Protecting young lives: A systematic review of the impact of secondhand smoke exposure and legislative measures on children’s health. Cureus, 16(10), e72548. https://doi.org/10.7759/cureus.72548

Berardi, V., et al. (2022). Real-time feedback of air quality in children’s bedrooms reduces exposure to secondhand smoke. Tobacco Prevention & Cessation, 8, 23.

Cheah, Y. K., Lim, K. K., Kee, C. C., & Tan, L. K. (2024). Demographic and lifestyle factors associated with perception about risk of passive smoking in the Malaysian adolescent population. Perspectives in Public Health. Advance online publication.

Constantino, S. M., et al. (2022). Scaling up change: A critical review and practical guide to harnessing social norms for climate action. Psychological Science in the Public Interest, 23(2), 50–97. https://doi.org/10.1177/15291006221105279

Datanovia. (2023). Friedman test in R: Non-parametric repeated measures. https://www.datanovia.com/learn/biostatistics/anova/friedman-test-in-r#run-the-friedman-test

Delcroix-Gomez, C., Delcroix, M. H., Jamee, A., Gauthier, T., Marquet, P., & Aubard, Y. (2022). Fetal growth restriction, low birth weight, and preterm birth: Effects of active or passive smoking evaluated by maternal expired CO at delivery, impacts of cessation at different trimesters. Tobacco Induced Diseases, 20, 70. https://doi.org/10.18332/TID/152111

Dima, D. C., Sium, A., Giuliani, M., & Papadakos, J. (2026). Enduring power of print: How health information pamphlets promote equity and trust in patient education. JCO Oncology Practice, 22(4), 555–558. https://ascopubs.org/doi/abs/10.1200/OP-25-00739

Gadsden, T., et al. (2025). A quality improvement approach to scaling up a complex health system intervention for the prevention and management of cardiovascular disease in rural Indonesia. PLOS Global Public Health, 5(12), e0005577.

Gallucci, G., et al. (2020). Cardiovascular risk of smoking and benefits of smoking cessation. Journal of Thoracic Disease, 12(7). https://jtd.amegroups.org/article/view/37685

Hasanica, N., et al. (2020). The effectiveness of leaflets and posters as a health education method. Materia Socio-Medica, 32(2), 135–139.

Jaber, H. M. A., Bugrein, H., & Al Jaber, K. H. M. (2025). Nudging for public health improvement: A review of global experiences and applications in diverse cultures. Journal of Community Medicine & Public Health, 9, 496.

Kementerian Kesehatan Republik Indonesia. (2022). Temuan survei GATS: Perokok dewasa di Indonesia naik 10 tahun terakhir. https://kemkes.go.id/id/temuan-survei-gats-perokok-dewasa-di-indonesia-naik-10-tahun-terakhir

Kopa-Stojak, P. N., & Pawliczak, R. (2024). Comparison of the effects of active and passive smoking of tobacco cigarettes, electronic nicotine delivery systems and tobacco heating products on the expression and secretion of oxidative stress and inflammatory response markers: A systematic review. Inhalation Toxicology, 36(2), 75–89.

Nawawi, M., et al. (2025). Effectiveness of smoke-free home-based interventions in reducing second-hand smoke exposure in children and adults: A systematic review. Asian Pacific Journal of Cancer Prevention, 26(9), 3145–3156.

Nitami, M., Situngkir, D., & Wahidin, M. (2023). Promosi kesehatan media poster membuang sampah yang baik dan benar untuk mengendalikan penyakit berbasis lingkungan Jakarta Utara tahun 2022. Jurnal Pelayanan dan Pengabdian Masyarakat Indonesia, 2(3), 77–87. https://journal-stiayappimakassar.ac.id/index.php/jppmi/article/view/435

O’Donnell, R., et al. (2025). COmmunities Facilitating IncREasing Smoke-Free Homes (CO-FRESH): Co-developing a toolkit with local stakeholders in Indonesia and Malaysia. BMJ Global Health, 10(10).

Ravi, K., Indrapriyadharshini, K., & Madankumar, P. D. (2021). Application of health behavioral models in smoking cessation: A systematic review. Indian Journal of Public Health, 65(2), 103–109.

Sheldon, M. R., Fillyaw, M. J., & Thompson, W. D. (1996). The use and interpretation of the Friedman test in the analysis of ordinal-scale data in repeated measures designs. Physiotherapy Research International, 1(4), 221–228. https://onlinelibrary.wiley.com/doi/abs/10.1002/pri.66

Sidhu, A. K., et al. (2022). Cognitive and emotional responses to pictorial warning labels and their association with quitting measures after continued exposure. Addictive Behaviors, 124, 107121. https://www.sciencedirect.com/science/article/pii/S0306460321003063

Silvia, V., Taufiqurrahman, T. M., Sofiaturrahmi, S., & Ahmad, F. (2025). Peningkatan kepedulian lingkungan melalui pemasangan poster edukasi di Desa Lam Keumok. Karya Nyata: Jurnal Pengabdian kepada Masyarakat, 2(3), 154–162. https://doi.org/10.62951/karyanyata.v2i3.1600

Technology Networks. (2024). Friedman test explained: When and how to use it. https://www.technologynetworks.com/tn/articles/the-friedman-test-387454

Trisnowati, H., Ahsan, A., & Kramer, E. (2024). Youth empowerment in tobacco control: Community-based participatory research in rural Indonesia. Health Education, 124(5–6), 221–242. https://doi.org/10.1108/HE-05-2023-0050

Uthayakumar, T., et al. (2023). Passive smoking and oral health of infants, preschoolers, and children: A systematic review. Nicotine & Tobacco Research, 25(10), 1625–1632.

van der Vlegel-Brouwer, W., Eelderink, M., & Bussemaker, J. (2023). Participatory action research as a driver for health promotion and prevention: A co-creation process between professionals and citizens in a deprived neighbourhood in The Hague. International Journal of Integrated Care.

World Health Organization. (2023). WHO report on the global tobacco epidemic, 2023: Protect people from tobacco smoke. https://www.who.int/publications/i/item/9789240077164

World Health Organization. (2026). Melindungi masyarakat dari paparan asap rokok orang lain. https://www.who.int/indonesia/id/news/detail/19-01-2026-protecting-communities-from-second-hand-smoke

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Published

2026-08-13

How to Cite

Bujawati, E., Haerana, B. T., & Radjiman, E. A. (2026). Visual communication for smoke-free homes: A community-based health promotion intervention in rural indonesia. Sociality: Journal of Public Health Service , 5(2), 129–138. https://doi.org/10.24252/sociality.v5i2.68181