Effectiveness of a Comic Book Intervention in Preventing Second-hand Smoke Exposure for Pregnant Indonesian Women: A Randomised Controlled Trial

This randomised controlled trial evaluated the effectiveness of a comic book intervention to promote second-hand smoke (SHS) avoidance among pregnant women and appropriate smoking behaviours among their male partners. We allocated 140 couples to the experimental group (EG) and 146 couples to the control group (CG), who received usual care. The primary outcome was women’s self-reported SHS exposure and their male partners’ smoking behaviours. Secondary outcomes included knowledge and awareness of SHS. Independent t -tests revealed that three months post-intervention, more male partners in the EG intended to quit smoking ( t -test ( df  = 205) = 2.12, MD  = .24, p -value = .035). Significantly more pregnant women in the EG recognised their partners’ intentions to quit smoking ( t -test ( df  = 205) = 2.72, MD  = .30, p -value = .007), reported that they distanced themselves from smoking ( t -test ( df  = 210) = 2.09, MD  = 0.19, p -value = .038), and avoided exposure to SHS ( t -test ( df  = 184) = 2.30, MD  = .02, p -value = .023). These findings suggest that a comic book intervention might be effective against SHS exposure by providing several cues to action through knowledge and awareness of SHS.