Secondhand smoke exposure among patients with coronary heart disease in a tertiary Grade A hospital in China: A qualitative study of lived experience and sociocultural challenges.

INTRODUCTION: Secondhand smoke (SHS) exposure is a known cardiovascular risk factor, but little is understood about how patients with coronary heart disease (CHD) perceive and manage this exposure in daily life. This study aimed to explore the perceptions, lived experiences, and sociocultural challenges of SHS exposure among Chinese patients with CHD. METHODS: Face-to-face semi-structured interviews were conducted from December 2023 to April 2024 in the cardiovascular ward of a tertiary Grade A hospital in China, using a descriptive phenomenological approach, among twelve participants. Purposive sampling was used to recruit patients with CHD who reported SHS exposure. Data were analyzed using the Colaizzi seven-step method. RESULTS: Five themes were identified: 1) Limited and fragmented understanding of SHS; 2) Difficulty avoiding SHS exposure across everyday settings; 3) Aversion to SHS and sociocultural constraints on speaking up; 4) Reliance on smoke-free policies and their enforcement; and 5) Smoke-free homes as an ideal yet difficult-to-achieve goal. CONCLUSIONS: These qualitative findings suggest that everyday exposure settings, social and relational norms, and the perceived implementation of smoke-free policies shaped SHS exposure among patients with CHD in this study context. Future research with broader and more diverse samples is needed to examine the transferability of these findings and to inform interventions aimed at reducing SHS exposure in high-risk cardiovascular populations.