BACKGROUND-AIM:
Second-hand smoke (SHS) exposure during pregnancy is linked to adverse maternal and neonatal outcomes. Few interventions have addressed this issue via social media, particularly among pregnant women. Social media platforms offer accessible and scalable opportunities for delivering health interventions. This study aimed to evaluate the feasibility and preliminary effectiveness of a Facebook-based intervention to reduce household SHS exposure among non-smoking pregnant Israeli women.

METHODS:
A quasi-experimental pretest-posttest pilot study enrolled non-smoking pregnant women living with a partner who smokes. Over eight weeks, participants engaged in a private Facebook group offering posts about SHS risks, behavioral tools, communication strategies, and motivational support. A composite Facebook engagement score (0-100) was calculated based on five Likert items (0–4) such as liking posts and commenting. Pre- and post-intervention questionnaires assessed household and car smoking rules, perceived SHS exposure, knowledge and attitudes to create a smoke-free home.

RESULTS:
Thirty-four women completed the baseline assessment; 25 (73.5%) completed follow-up. Engagement was moderate (Mean 30.00, SD 19.63). Most reported restrictive household smoking rules at baseline, with little change. However, 7 participants (29.2%) reported stricter car smoking rules at follow-up (p = 0.02). Knowledge improved significantly (pre mean 57.49, SD = 22.24 vs. post mean 72.36, SD 20.24; p = 0.02). Attitudes showed a positive, non-significant trend (pre mean 65.53, SD 23.14 vs. post mean 74.33, SD 21.25; p = 0.085).

CONCLUSIONS:
A Facebook-based intervention to reduce SHS exposure during pregnancy appears moderately feasible and acceptable. The intervention improved knowledge and car-related smoking rules but had limited impact on household smoking rules. Future interventions should consider involving partners and addressing household dynamics directly.