الفهرس 
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Abstract
Summary
Passive smoking refers to the involuntary inhalation of smoke from cigarettes or other tobacco products smoked by others. Smokers not only put themselves at risk of serious health problems but people around them can also be exposed to much potential dangers. Exposure to tobacco smoke contributes to cancer risk, particularly lung and colorectal cancers among men and breast and cervix cancers among women. So, improving knowledge, attitude, and practice is considered an effective solution to reducing exposure to PS. Knowledge about PS is very important if women have relevant knowledge regarding the risks of PS, they will be able to change their attitudes towards the acceptability of exposing to PS and increase their support for smokefree environments.
The present study aimed to assess Knowledge, Attitudes and Avoidance behaviors regarding passive smoking among women attending outpatient clinics of Women Health Hospital. Descriptive Cross-sectional design was used in this study.
Study setting:
The study was carried out in three outpatient clinics of Women Health Hospital (Antenatal clinic, Family planning and Gynecological clinic) at Assiut University. The total number of the studied sample was 700 women.
Study tools:
Three tools were used in this study:
The first tool: A structured interview questionnaire was developed by the researcher to collect information from the studied women, it included two parts:
Part 1: Socio-economic scale which was developed by (Abd El-Tawab, 2012) was used to assess socio-econoic status of the women. It included four items: level of education (6 items), family income (6 items), job and life styles (3 items).
Part 2: It includes women’s’ exposure to passive smoking such as number of smokers at home, place of exposure to passive smoking, number of cigarettes they are exposed to, duration of exposure every day and number of days / weeks which they were exposed to passive smoking .
The second tool: A modified Passive Smoking Exposure Questionnaire was used to assess women’s knowledge and attitude regarding PS. The questionnaire consisted of 2 parts: -
Part 1: knowledge of the adverse effects associated with PS exposure. It included 11 questions to assess women’s knowledge regarding passive smoking.
Part 2: Attitude and personal feelings toward PS exposure. It included 12 statements to assess attitude of women regarding PS.
The third tool: Avoidance of PS exposure scale was used to assess avoidance or preventive efforts undertaken by the person when exposed to PS in their immediate environment. It consisted of 19 statements. Data was collected in the period from (1st of April to the end of September, 2019). The data was collected two days weekly about (14 – 15) sheets / day.
The main results of the present study were:
• As regards the Socio- demographic characteristics of the studied sample, it was founded that 41.3 % of the studied women aged < 30 year, 31.7% of them had secondary education. According to their occupation, 66.6 % were housewife.
• Concerning exposure to passive smoking, it was observed that 73.3 % of the studied women were exposed to passive smoking, 72.3% of them exposed to passive smoking at home.
• Regarding the studied sample knowledge about passive smoking, it revealed that 93.7 % of studied women reported that smoking is dangerous for non-smoker’s health. According to knowledge about harmful effects of passive smoking on pregnancy, 56.4% and 58.6% didn’t know that PS increases the risk of spontaneous abortion and LBW respectively.
• According to studied sample attitude toward passive smoking, it revealed that 51.0% of the studied women agreed that smoke from other people’s cigarettes is harmful and 48.4% agreed that the parents or adults should not smoke near children.
• Concerning to studied sample avoidance behaviors of passive smoking, it showed that 72.0% mentioned that they allow people to smoke in their homes. Also, 50.4% of them reported that the are routinely associate with people who smoke.
• It was found that less than half (45.7%) of studied sample had poor knowledge about PS, and less than half (43.9%) of them had inappropriate avoidance behaviors regarding PS exposure.
• There was statistical significance difference between total scores of studied women exposures to PS with their occupational status and residence.
• There was statistical significance difference between total scores of studied women’s knowledge about and some sociodemographic characteristics such as their educational level, occupation, husband education, residence and social class.
• There was statistical significance difference between total scores of studied women’s attitudes and their educational level, occupation, husband education, social class and residence.
• There was statistical significance difference between the studied women’s avoidance behaviors of PS and their educational level, occupation, husband education, social class and residence.
Conclusion:
The majority of participated women are exposed to second hand smoking at their homes although, more than one - third of women have poor knowledge regarding second hand smoking, the majority of them had positive attitude. Also, more than two fifths of women had inappropriate avoidance behaviors of passive smoking. Furthermore, the present study found that knowledge, attitude and avoidance behaviors regarding passive smoking were affected by women’s education, residence, occupation and social class.
The study recommended that:
1. Development of training courses and education programs for the decision makers and workers in health care settings to increase awareness of the seriousness of exposure to PS among women and their families
2. Prohibit smoking in all enclosed public places (including health care facilities, schools, and education facilities), workplaces and public transport.
3. Train and instruct health care workers, especially gynecologists and nurses to give women advice on PS health hazards during prenatal care.
4. The curriculum should contain topics to explain the effect of PS exposure on health at all levels.
5. Further studies can be done to investigate specific effect of passive smoking on maternal and child health