Abstract

Background: Secondhand tobacco smoke (SHS) exposure represents a significant yet often overlooked public health challenge affecting over a billion people globally (World Health Organization 2021). Individuals exposed to SHS exposure inhale over 7,000 chemicals, including nicotine and other toxic substances, which adversely impact physical health (Carreras et al., 2019; Nadhiroh et al., 2020; U.S. Department of Health and Human Services, 2024). However, growing evidence suggests SHS exposure may increase the likelihood of poor mental health outcomes (Van der Eijk & Woh 2023, Zeng et al., 2016) Addressing SHS exposure not only requires acknowledging its impact but also respecting the complex interplay of factors contributing to mental illness. Reviews in this field have responded by primarily addressing SHS as a potential antecedent to mental illness.

Purpose: This systematic review aims to build on existing literature and respond to gaps by exploring the potential bidirectional relationship between SHS exposure and mental illness.

Methods: We conducted a comprehensive search of articles published before November 2024 in the CINAHL, PsycINFO, and PubMed databases. We focused on studies that reported SHS exposure (either self-reported or validated by biomarkers) and assessed mental illness outcomes using validated tools. Data extraction focused on population demographics, SHS exposure and mental illness metrics.

Results: Anticipated results include: 1) the quantification of SHS exposure among individuals with mental illnesses, 2) elucidating causal mechanisms related to a bidirectional relationship between SHS exposure and mental illness, and 3) developing a comprehensive model explaining biopsychosocial factors involved in the relationship between SHS exposure and mental illness.

Discussion: By responding to the relationship between SHS exposure and mental illness, nurses play a key role in tackling this issue through preventing SHS exposure, providing support to affected individuals, and advocating for mental illness treatment as a holistic approach. Moreover, nurses can support policy-driven actions and community-level interventions such as mental health screenings, promoting public health campaigns, and leading research on SHS-related mental health risks. Future nursing-led studies can drive equitable, global solutions to reduce mental illness burdens linked to SHS.

Notes

References:

1) World Health Organization. (2021). Tobacco and its environmental impact: An overview.

2) Carreras, G., Lugo, A., Gallus, S., Cortini, B., Fernández, E., López, M. J., ... & Perez, P. (2019). Burden of disease attributable to second-hand smoke exposure: a systematic review. Preventive Medicine, 129, 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.

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) Zeng, Y. N., & Li, Y. M. (2016). Secondhand smoke exposure and mental health in adults: a meta-analysis of cross-sectional studies. Social psychiatry and psychiatric epidemiology, 51, 1339-1348.

6) 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, 104900.

Description

Secondhand tobacco smoke (SHS) exposure represents an underrecognized contributor to mental health. Addressing SHS involves acknowledging its health impacts and the complex interactions with mental health outcomes. This systematic review explores whether SHS exposure and mental health are interlinked in a bidirectional manner by summarizing existing studies. In response, nurses can mitigate SHS effects by driving tobacco-free policies, community-based interventions, and focused research.

Author Details

Pooja Bhattarai, PhD student, MSN, RN; Bassema Abu-Farsakh, PhD, MSN, RN; Chizimuzo T.C. Okoli, PhD, MPH, PMHNP-BC, APRN, FAAN

Sigma Membership

Delta Psi at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Health Equity or Social Determinants of Health, Policy and Advocacy, Public and Community Health

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

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

2025-12-04

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Responding to the Association of Secondhand Tobacco Smoke and Mental Illness: A Systematic Review

Indianapolis, Indiana, USA

Background: Secondhand tobacco smoke (SHS) exposure represents a significant yet often overlooked public health challenge affecting over a billion people globally (World Health Organization 2021). Individuals exposed to SHS exposure inhale over 7,000 chemicals, including nicotine and other toxic substances, which adversely impact physical health (Carreras et al., 2019; Nadhiroh et al., 2020; U.S. Department of Health and Human Services, 2024). However, growing evidence suggests SHS exposure may increase the likelihood of poor mental health outcomes (Van der Eijk & Woh 2023, Zeng et al., 2016) Addressing SHS exposure not only requires acknowledging its impact but also respecting the complex interplay of factors contributing to mental illness. Reviews in this field have responded by primarily addressing SHS as a potential antecedent to mental illness.

Purpose: This systematic review aims to build on existing literature and respond to gaps by exploring the potential bidirectional relationship between SHS exposure and mental illness.

Methods: We conducted a comprehensive search of articles published before November 2024 in the CINAHL, PsycINFO, and PubMed databases. We focused on studies that reported SHS exposure (either self-reported or validated by biomarkers) and assessed mental illness outcomes using validated tools. Data extraction focused on population demographics, SHS exposure and mental illness metrics.

Results: Anticipated results include: 1) the quantification of SHS exposure among individuals with mental illnesses, 2) elucidating causal mechanisms related to a bidirectional relationship between SHS exposure and mental illness, and 3) developing a comprehensive model explaining biopsychosocial factors involved in the relationship between SHS exposure and mental illness.

Discussion: By responding to the relationship between SHS exposure and mental illness, nurses play a key role in tackling this issue through preventing SHS exposure, providing support to affected individuals, and advocating for mental illness treatment as a holistic approach. Moreover, nurses can support policy-driven actions and community-level interventions such as mental health screenings, promoting public health campaigns, and leading research on SHS-related mental health risks. Future nursing-led studies can drive equitable, global solutions to reduce mental illness burdens linked to SHS.