Subst Use Addctn J. 2026 Jul 5:29767342261454121. doi: 10.1177/29767342261454121. Online ahead of print.
ABSTRACT
OBJECTIVE: The aim of this study is to examine the associations between smoking self-efficacy, health anxiety, and women’s awareness of third-hand smoke (THS).
METHODS: This descriptive, cross-sectional study was conducted in Türkiye between June and July 2025 through an online survey with 335 women aged ≥18 years. Data were collected using a Descriptive Information Form, the Third-hand Smoke Awareness Scale, the Smoking Self-Efficacy Scale, and the Health Anxiety Inventory. Data were analyzed using descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Spearman’s correlation, multiple linear regression, and mediation analysis.
RESULTS: A total of 335 women were included in the study (mean age: 34.67 ± 12.31 years). Significant differences in THS awareness, smoking self-efficacy, and health anxiety were observed across several sociodemographic and behavioral variables. Higher educational level was associated with greater THS awareness, while participants with children and those whose partners smoked had lower awareness levels (P < .05). Smoking self-efficacy was higher among nonsmokers and individuals with higher education, whereas health anxiety was higher among smokers and those exposed to smoking in their environment (P < .05). Spearman’s correlation analysis revealed weak but significant associations, including a negative correlation between number of children and THS awareness (ρ = -.213, P < .01), and a positive correlation between THS awareness and smoking self-efficacy (ρ = .154, P < .05). Multiple linear regression analysis showed that the model explained a small proportion of variance (R2 = .06). Only the number of children was significantly associated with THS awareness (β = -.16, P = .02), while smoking self-efficacy and health anxiety were not significant predictors. Mediation analysis indicated that smoking self-efficacy did not mediate the relationship between THS awareness and health anxiety (P > .05).
CONCLUSION: THS awareness was associated with several sociodemographic and behavioral factors; however, smoking self-efficacy and health anxiety were not significant predictors in the adjusted model. These findings suggest that awareness alone may be insufficient and that broader contextual and individual factors should be considered in strategies aimed at reducing tobacco exposure.
PMID:42402132 | DOI:10.1177/29767342261454121
