Parental Smoking Behavior Inside the Home and Pneumonia Incidence Among Under-Five Children

Abstract

Pneumonia is an acute lower respiratory tract infection that remains a major health problem among infants and young children worldwide, including in Indonesia. Globally, pneumonia poses a serious health threat, with more than 700,000 deaths occurring among infants and young children each year. This situation is also evident in Gorontalo Province, where reported cases of pneumonia have increased annually from 2021 to 2024, with the highest number of cases in Gorontalo City recorded at the Dungingi Community Health Center. Exposure to secondhand smoke indoors is a modifiable risk factor for pneumonia; however, local evidence regarding the association between parental smoking behavior and the incidence of pneumonia among infants in Gorontalo City remains limited. This study aims to analyze the association between parental smoking behavior indoors and the incidence of pneumonia among toddlers in the service area of the Dungingi Community Health Center in Gorontalo City. The study employed an analytical observational design with a cross-sectional approach involving 95 respondents selected using accidental sampling. Data on smoking behavior were collected via a structured questionnaire, while data on pneumonia incidence were obtained from medical records. Analyses were conducted using univariate and bivariate methods, including the Kolmogorov-Smirnov test. The results showed that the majority of respondents exhibited moderate smoking behavior (80.0%), followed by high (15.8%) and low (4.2%) levels, and 18.9% of toddlers were diagnosed with pneumonia. Bivariate analysis revealed a significant association between parental smoking behavior indoors and the incidence of pneumonia in toddlers (p=0.011). These findings suggest that exposure to secondhand smoke in the home environment is associated with an increased incidence of pneumonia in toddlers. The study results can serve as a basis for strengthening education on smoke-free homes as part of pneumonia prevention efforts at the family level and in primary health care.