Background: Exposure to secondhand smoke among pregnant women and children may adversely affect child growth and development. The implementation of Smoke-Free Areas (SFAs) is an important tobacco control strategy for reducing exposure to secondhand smoke and may contribute to stunting prevention efforts. However, evidence regarding the implementation of SFAs as part of stunting prevention strategies, particularly across urban and rural settings, remains limited. Purpose: To analyze the implementation of Smoke-Free Areas (SFAs) as a strategy for stunting prevention by examining community knowledge, daily practices, and support for stunting prevention strategies in urban and rural areas. Method: A mixed-methods design using a sequential explanatory approach. The study was conducted in the service areas of Lepo-Lepo Public Health Center in Kendari City and Lambandia Public Health Center in East Kolaka Regency. A total of 200 participants were selected using simple random sampling, comprising 100 participants from urban areas and 100 from rural areas. Quantitative data were analyzed using the Chi-Square test, while qualitative data were analyzed thematically. Results: Knowledge was significantly associated with the implementation of SFAs. Daily practices were also significantly associated with SFA implementation, while community support for stunting prevention strategies showed a significant association with SFA implementation. The qualitative analysis identified four major themes: community awareness of the relationship between smoking and stunting, implementation of smoke-free policies, barriers to implementation, and optimization of smoke-free policies as a stunting prevention strategy. The main barriers included deeply rooted smoking culture, weak policy enforcement, limited resources, and the absence or inadequate implementation of effective sanctions. Conclusion: The implementation of smoke-free and tobacco control policies has the potential to support stunting prevention efforts by reducing secondhand smoke exposure among pregnant women and children. Strengthening health education, social support, policy enforcement, and the integration of tobacco control programs with stunting reduction programs is necessary to enhance the effectiveness of Smoke-Free Areas as a public health strategy. Keywords: Smoke-Free Areas; Stunting Prevention; Secondhand Smoke; Policy Implementation; Tobacco Control.
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