Determinants of indoor secondhand smoke exposure in Lesotho: evidence from the Lesotho Demographic and Health Survey (DHS) data 2023-24.

Although tobacco use is high in Lesotho, research on indoor secondhand smoke (SHS) exposure is limited. We assessed the prevalence and predictors of indoor SHS exposure using Lesotho DHS 2023-24 data of 36,161 household individuals of all ages. Binomial logistic regression was carried out. The prevalence of indoor SHS exposure in Lesotho was 24%. Maseru district (27%) had the highest prevalence. Sex, wealth quintile, household size, and district showed significant associations with indoor SHS. Females, compared to males, were less likely to have indoor SHS exposure (aOR 0.77, 95% CI 0.73-0.81). Compared to the poorest quintile, individuals in all other wealth quintiles had lower odds of indoor SHS. Compared to residents of Butha-Buthe, residents of Berea (aOR 3.28; 95% CI 2.37-4.55) were three times more likely to get indoor SHS exposure. Conclusively, in Lesotho, every fourth household member is exposed to indoor SHS. Male gender, higher household size, and poverty are linked with higher indoor SHS exposure, suggesting targeted interventions creating awareness and advocating for smoke-free homes among these at-risk groups. The findings also highlight crucial socio-demographic determinants that can guide the revision of tobacco control policies and the development of smoke-free homes interventions in Lesotho.