Other Titles
Secondhand Tobacco Smoke and Mental Illnesses:A Systematic Review and Meta-analysis [Title Slide]
Abstract
Background: SHSe remains a major global public health concern and contributes to preventable morbidity and mortality across populations (World Health Organization 2021). While SHSe is well recognized as a risk factor for cardiovascular and respiratory illness, emerging evidence suggests an association with MI and Substance use disorders (SUDs) (Carreras et al., 2019; Nadhiroh et al., 2020; U.S. Department of Health and Human Services, 2024; Van der Eijk & Woh 2023, Lee et al., 2025). Addressing SHSe requires acknowledging its impact and transforming new discovery about the complex factors contributing to MI into action that shapes the future of nursing research.
Purpose: This systematic review and meta-analysis quantified the prevalence of SHSe among adults with MI or SUDs, and examined the associations between SHSe and MI symptoms, and SUDs. The findings may contribute needed clarity to an evolving evidence base and support future nursing research aimed at reducing social and environmental exposure-related mental health risks.
Methods: We conducted a comprehensive search of CINAHL, PsycINFO, and PubMed for studies published before November 2024. Eligible studies included those among adults who reported SHSe, either through self-report or biomarker validation, and assessed MI or SUDs using standardized diagnostic criteria or validated screening tools.
Results: The results of 52 eligible studies indicated that people with SHSe are more likely to report depression, anxiety, psychological distress, suicide ideation, dementia, and substance use problems. The meta-analysis found that individuals with SHSe have 38% higher odds of depressive symptoms (OR=1.38, 95% CI:1.22–1.56), 29% higher odds of psychological distress (OR=1.29, 95% CI:1.20–1.38), and 61% higher odds of risky alcohol use (OR=1.61, 95% CI:1.50-1.74) compared with those without SHSe.
Implication: SHSe disproportionately affects individuals with MI and SUDs. Nurses are essential in identifying and addressing SHSe by delivering targeted education on exposure reduction and integrating environmental risk assessment into psychiatric care. The findings support the need for nursing leadership in advancing tobacco-free policies, strengthening community-based prevention strategies, and guiding future research to reduce the mental health burden associated with SHSe. By applying evidence from this study, nurses can translate emerging discoveries into meaningful actions that improve mental health outcomes.
Notes
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References:
1. World Health Organization. (2021). Tobacco and its environmental impact: An overview. Retrieved from: https://www.who.int/publications/i/item/9789241512497
2.Carreras, G., Lugo, A., Gallus, S., Cortini, B., Fernández, E., López, M. J., Soriano, J. B., López-Nicolás, A., Semple, S., Gorini, G., & TackSHS Project Investigators (2019). Burden of disease attributable to second-hand smoke exposure: A systematic review. Preventive medicine, 129, 105833. https://doi.org/10.1016/j.ypmed.2019.105833
3. Nadhiroh, S. R., Djokosujono, K., & Utari, D. M. (2020). The association between secondhand smoke exposure and growth outcomes of children: A systematic literature review. Tobacco induced diseases, 18, 12. https://doi.org/10.18332/tid/117958
4. U.S. Department of Health and Human Services (2024). Eliminating Tobacco-Related Disease and Death: Addressing Disparities—A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. https://www.cdc.gov/tobacco-surgeon-general-reports/about/2024-end-tobacco-disparities.html
5. van der Eijk, Y., & Woh, J. (2023). Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications. Health policy (Amsterdam, Netherlands), 136, 104900. https://doi.org/10.1016/j.healthpol.2023.104900
6. Lee, D., Kim, H. C., Jung, Y. C., & Jung, S. J. (2025). Association between perceived exposure to secondhand smoke and depression independent of biomarker-measured exposure. BMC public health, 25(1), 2917. https://doi.org/10.1186/s12889-025-23967-8
Sigma Membership
Delta Psi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Quantitative Research
Keywords:
Health Equity or Social Determinants of Health, Public and Community Health, Policy and Advocacy, Mental Illness, Tobacco Smoke, Passive Smoking, Environmental Exposure
Recommended Citation
Bhattarai, Pooja; Abufarsakh, Bassema; and Okoli, Chizimuzo T. C., "Discovering Secondhand Smoke Exposure Impact on Mental Illness: A Systematic Review & Meta-Analysis" (2026). International Nursing Research Congress (INRC). 273.
https://www.sigmarepository.org/inrc/2026/presentations_2026/273
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-15
Discovering Secondhand Smoke Exposure Impact on Mental Illness: A Systematic Review & Meta-Analysis
Toronto, Ontario, Canada
Background: SHSe remains a major global public health concern and contributes to preventable morbidity and mortality across populations (World Health Organization 2021). While SHSe is well recognized as a risk factor for cardiovascular and respiratory illness, emerging evidence suggests an association with MI and Substance use disorders (SUDs) (Carreras et al., 2019; Nadhiroh et al., 2020; U.S. Department of Health and Human Services, 2024; Van der Eijk & Woh 2023, Lee et al., 2025). Addressing SHSe requires acknowledging its impact and transforming new discovery about the complex factors contributing to MI into action that shapes the future of nursing research.
Purpose: This systematic review and meta-analysis quantified the prevalence of SHSe among adults with MI or SUDs, and examined the associations between SHSe and MI symptoms, and SUDs. The findings may contribute needed clarity to an evolving evidence base and support future nursing research aimed at reducing social and environmental exposure-related mental health risks.
Methods: We conducted a comprehensive search of CINAHL, PsycINFO, and PubMed for studies published before November 2024. Eligible studies included those among adults who reported SHSe, either through self-report or biomarker validation, and assessed MI or SUDs using standardized diagnostic criteria or validated screening tools.
Results: The results of 52 eligible studies indicated that people with SHSe are more likely to report depression, anxiety, psychological distress, suicide ideation, dementia, and substance use problems. The meta-analysis found that individuals with SHSe have 38% higher odds of depressive symptoms (OR=1.38, 95% CI:1.22–1.56), 29% higher odds of psychological distress (OR=1.29, 95% CI:1.20–1.38), and 61% higher odds of risky alcohol use (OR=1.61, 95% CI:1.50-1.74) compared with those without SHSe.
Implication: SHSe disproportionately affects individuals with MI and SUDs. Nurses are essential in identifying and addressing SHSe by delivering targeted education on exposure reduction and integrating environmental risk assessment into psychiatric care. The findings support the need for nursing leadership in advancing tobacco-free policies, strengthening community-based prevention strategies, and guiding future research to reduce the mental health burden associated with SHSe. By applying evidence from this study, nurses can translate emerging discoveries into meaningful actions that improve mental health outcomes.
Description
Secondhand tobacco smoke exposure (SHSe) represents a frequently overlooked contributor to mental illness (MI). Addressing SHSe involves acknowledging its health impacts and the complex interactions with mental health. This systematic review and meta-analysis explored the bidirectional interlink between SHSe and MI by summarizing existing studies. In response, nurses can mitigate SHSe effects on mental health by driving tobacco-free policies, community-based interventions and focused research.