Assessment of Residents’ Attitudes and Satisfaction Before and After Implementation of a Smoke-free Policy in Boston Multiunit Housing

Assessment of Residents’ Attitudes and Satisfaction Before and After Implementation of a Smoke-free Policy in Boston Multiunit Housing

Slawa Rokicki, Gary Adamkiewicz, Shona C. Fang, Nancy A. Rigotti, Jonathan P. Winickoff, Doug E. Levy

Nicotine & Tobacco Research, Forthcoming
http://ntr.oxfordjournals.org/content/early/2015/10/26/ntr.ntv239

Abstract

Introduction

In 2012, the Boston Housing Authority (BHA) implemented a smoke-free policy prohibiting smoking within its residences. We sought to characterize BHA resident experiences before and after the smoke-free policy implementation, and compare them to that of residents of the Cambridge Housing Authority (CHA), which had no such policy.

Methods

We recruited a convenience sample of nonsmoking residents from the BHA and CHA. We measured residents’ awareness and support of their local smoking policies before and 9-12 months after the BHA’s policy implementation, as well as respondents’ attitudes towards the smoke-free policy. We assessed tobacco smoke exposure (TSE) via saliva cotinine, airborne apartment nicotine, and self-reported number of days smelling smoke in the home. We evaluated predictors of general satisfaction at follow-up using linear regression.

Results

At follow-up, 91% of BHA respondents knew that smoking was not allowed in apartments and 82% were supportive of such a policy in their building. BHA residents believed enforcement of the smoke-free policy was low. Fifty-one percent of BHA respondents indicated that other residents “never” or “rarely” followed the smoke-free rule and 41% of respondents were dissatisfied with policy enforcement. Dissatisfaction with enforcement was the strongest predictor of general housing satisfaction, while objective and self-reported measures of TSE were not predictive of satisfaction. At follow-up, 24% of BHA participants had complained to someone in charge about policy violations.

Conclusions

Resident support for smoke-free policies is high. However, lack of enforcement of smoke-free policies may cause frustration among residents, potentially leading to a decrease in housing satisfaction.