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Introduction Extensive regulations have been introduced to reduce secondhand smoke (SHS) exposure among non-smokers in Malaysia. However, there is still a need to encourage behavior change of smokers in relation to making homes smokefree. This feasibility study aimed to use low-cost air pollution monitors to quantify SHS concentrations in Malaysian households and to explore the practicality of using personalized feedback in educating families to make their homes smoke-free. Methods A total of 35 smokers in three states in Malaysia were recruited via snowball and convenience sampling methods. Indoor fine particulate (PM 2.5 ) concentrations in participants’ homes were measured for 7 days before and after educational intervention using a pre-defined template, which included personalized airquality feedback, and information on SHS impacts were given. The feedback was delivered over two 20-minute phone calls or in-person sessions following the completion of the air-quality measurements. Data were corrected for outdoor PM 2.5 concentrations from the nearest environmental monitor. Results Despite the challenges in conducting the project during COVID-19 pandemic, the delivery of the intervention was found to be feasible. Twenty-seven (77%) out of 35 participants completed PM 2.5 measurements and received a complete intervention. The median (IQR: 25th –75th percentile concentrations) SHS-PM 2.5 concentrations at baseline and follow-up were 18.3 μg/m 3 (IQR: 13.3–28.3) and 16.2 μg/m 3 (IQR: 10.4 – 25.6), respectively. There was a reduction of SHS-PM 2.5 concentrations at follow-up measurement in the houses of 17 participants (63%). The change in corrected indoor PM 2.5 concentrations between baseline and followup was not statistically significant (Z= -1.01, p=0.29). Conclusions This educational intervention, combining the use of a low-cost air particle counter with personalized air-quality feedback, was found to be feasible in the Malaysian setting. It has potential to trigger behavior change among smokers, reducing indoor smoking and consequent SHS concentrations, and increasing smoke-free home implementation. A large-scale trial is needed.

Introduction Secondhand smoke (SHS) in the home is a serious cause of ill-health, especially for children. SHS indoors can be indirectly measured using particulate matter monitors, and interventions have been developed using feedback from these monitors to encourage smoke-free homes. These interventions often use data that are several days out of date, as the data must be downloaded manually from monitors. It would be advantageous to access this information remotely in real-time to provide faster feedback to intervention participants. Methods Using off-the-shelf computer components and the Dylos DC1700 air quality monitor, a portable internet-connected monitor was developed that can send data to a server remotely. Four of these monitors were tested in homes in Israel to test the reliability of the connection. Data were downloaded from the monitor’s onboard memory and compared to the data sent to the server. Results Eight homes were monitored for 4 to 6 days, with a combined total count of 44 days. Less than 1% of data was lost, with no outage lasting longer than 1 hour 45 minutes. There was no significant difference in the mean concentrations measured in homes between mobile-transmitted data and data downloaded directly. Conclusions This system appears to be a reliable way to monitor remotely home air quality for use in intervention studies, and could potentially have applications in other related research. Laboratories that own Dylos DC1700s may wish to consider converting them to such a system to obtain a cost-effective way of overcoming limitations in the Dylos design.