Skip to main content
SpringerLink
Log in

Smoke-Free Multi-unit Housing Policies Show Promise in Reducing Secondhand Smoke Exposure Among Racially and Ethnically Diverse, Low-Income Seniors

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Secondhand smoke (SHS) exposure is a public health issue for residents of multi-unit housing (MUH) properties. We evaluated the impact of smoke-free policy implementation on reported SHS exposure among racially, ethnically diverse seniors living in low-income MUH properties. In Spring 2013 and Summer 2014, we surveyed residents (n = 960) at 15 MUH properties in Broward and Miami-Dade Counties, Florida. The percentage of residents reporting SHS exposure within their apartments from elsewhere in or around their building decreased from 31.1 %, before policy implementation, to 23.6 % at follow-up (p = 0.02). In multivariate analysis of non-smoking residents after policy implementation, residents who reported having one or more comorbidities were two times more likely to report SHS exposure (aOR 2.23, 95 % CI 1.12–4.40). Considering the vulnerability of low-income seniors to SHS exposure, our findings are relevant to residents, property owners/managers, and public health professionals making decisions about smoke-free policies for MUH properties in which seniors reside.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wilson KM, Torok M, McMillen R, Tanski S, Klein JD, Winickoff JP. Tobacco smoke incursions in multiunit housing. Am J Public Health. 2014;104(8):1445–53.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pizacani B, Laughter D, Menagh K, Stark M, Drach L, Hermann-Franzen C. Moving multiunit housing providers toward adoption of smoke-free policies. Prev Chronic Dis. 2011;8(1, A21). http://www.cdc.gov/pcd/issues/2011/jan/10_0015.htm. Accessed 2 Mar 2014.

  3. King BA, Cummings KM, Mahoney MC, Juster HR, Hyland AJ. Multiunit housing residents’ experiences and attitudes toward smoke-free policies. Nicotine Tob Res. 2010;12(6):598–605. doi:10.1093/ntr/ntq053.

    Article  PubMed  PubMed Central  Google Scholar 

  4. King BA, Travers MJ, Cummings KM, Mahoney MC, Hyland AJ. Secondhand smoke transfer in multiunit housing. Nicotine Tob Res. 2010;12(11):1133–41. doi:10.1093/ntr/ntq162.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kraev TA, Adamkiewicz G, Hammond SK, Spengler JD. Indoor concentrations of nicotine in low-income, multi-unit housing: associations with smoking behaviors and housing characteristics. Tob Control. 2009;18(6):438–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kaufmann RB, Babb S, O’Halloran A, Asman K, Bishop E, Tynan M, Caraballo RS, Pechacek TF, Bernert JT, Blount B. Vital signs: nonsmokers’ exposure to secondhand smoke—United States, 1999–2008. Morb Mortal Wkly Rep. 2010;59(35):1141–6.

    Google Scholar 

  7. Pizacani B, Maher J, Rohde K, Drach L, Stark M. Implementation of a smoke-free policy in subsidized multiunit housing: effects on smoking cessation and secondhand smoke exposure. Nicotine Tob Res. 2012;14(9):1027–34.

    Article  PubMed  Google Scholar 

  8. Eisner MD, Iribarren C, Yelin EH, Sidney S, Katz PP, Sanchez G, Blanc PD. The impact of SHS exposure on health status and exacerbations among patients with COPD. Int J Chronic Obstruct Pulm Dis. 2009;4:169–76.

    Article  Google Scholar 

  9. Helburn A. A case for smoke-free housing. Asthma Regional Council of New England. 2007. http://hria.org/uploads/catalogerfiles/smoke-free-housing/HRIA-Smoke_Free_Housing_2007.pdf. Accessed 24 Sept 2014.

  10. Department of Health and Human Services; United States Office of Smoking and Health. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention; 2006. http://www.ncbi.nlm.nih.gov/books/NBK44324/. Accessed 3 Mar 2014.

  11. Barnes DE, Haight TJ, Mehta KM, Carlson MC, Kuller LH, Tager IB. Secondhand smoke, vascular disease, and dementia incidence: findings from the cardiovascular health cognition study. Am J Epidemiol. 2010;171(3):292–302. doi:10.1093/aje/kwp376.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Department of Housing and Urban Development. Notice: PIH-2012-25. Smoke-free policies in public housing. 2012; http://portal.hud.gov/hudportal/documents/huddoc?id=12-25pihn.pdf. Accessed 30 Sept 2014.

  13. Russo ET, Hulse TE, Adamkiewicz G, Levy DE, Bethune L, Kane J, Reid M, Shah SN. Comparison of indoor air quality in smoke-permitted and smoke-free multiunit housing: findings from the Boston Housing Authority. Nicotine Tob Res. 2015;17(3):316–22. doi:10.1093/ntr/ntu146.

    Article  CAS  PubMed  Google Scholar 

  14. Licht AS, King BA, Travers MJ, Rivard C, Hyland AJ. Attitudes, experiences, and acceptance of smoke-free policies among US multiunit housing residents. Am J Public Health. 2012;102(10):1868–71. doi:10.2105/AJPH.2012.300717.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ballor DL, Henson H, MacGuire K. Support for no-smoking policies among residents of public multiunit housing differs by smoking status. J Community Health. 2013;38(6):1074–80. doi:10.1007/s10900-013-9716-7.

    Article  PubMed  Google Scholar 

  16. Hood NE, Ferketich AK, Klein EG, Wewers ME, Pirie P. Individual, social, and environmental factors associated with support for smoke-free housing policies among subsidized multiunit housing tenants. Nicotine Tob Res. 2013;15(6):1075–83. doi:10.1093/ntr/nts246.

    Article  PubMed  Google Scholar 

  17. Baezconde-Garbanati LA, Weich-Reushe K, Espinoza L, Portugal C, Barahona R, Garbanati J, Seedat F, Unger JB. Secondhand smoke exposure among Hispanics/Latinos living in multiunit housing: exploring barriers to new policies. Am J Health Promot. 2011;25(5 Suppl):S82–90.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cook NJ, Hollar TL, Chavez S, Quinn DL, Phillips T, DeLucca M, Corrales L. Support for smoke-free multi-unit housing policies among racially and ethnically diverse, low-income seniors in South Florida. J Cross Cult Gerontol. 2014;29(4):405–15. doi:10.1007/s10823-014-9247-4.

    Article  PubMed  PubMed Central  Google Scholar 

  19. King BA, Mahoney MC, Cummings KM, Hyland AJ. Intervention to promote smoke free policies among multiunit housing operators. J Public Health Manag Pract. 2011;17(3):E1–8. doi:10.1097/PHH.0b013e3181ffd8e3.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Synder K, Vick J, King B. Smoke-free multiunit housing: a review of the scientific literature. Tob Control. 2015;. doi:10.1136/tobaccocontrol-2014-051849.

    Google Scholar 

  21. Levy DE, Adamkiewicz G, Rigotti NA, Fang SC, Winickoff JP. Changes in tobacco smoke exposure following the institution of a smoke-free policy in the Boston Housing Authority. PLoS ONE. 2015;10(9):e0137740. doi:10.1371/journal.pone.0137740.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kennedy RD, Ellens-Clark S, Nagge L, Douglas O, Madill C, Kaufman P. A smoke-free community housing policy: changes in reported smoking behaviour—findings from Waterloo region, Canada. J Community Health (Epub ahead of print). 2015.

  23. Department of Housing and Urban Development. Section 202 Supportive Housing for the Elderly Program. 2014. http://portal.hud.gov/hudportal/HUD?src=/program_offices/housing/mfh/progdesc/eld202. Accessed 30 Sept 2014.

  24. Department of Health and Human Services. Community transformation grants (CTG). Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Community Health. 2013. http://www.cdc.gov/nccdphp/dch/programs/communitytransformation/index.htm. Accessed 5 Mar 2014.

  25. U.S. Public Law 111-148, Sec 4201. Government Printing Office. 2010; http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf.

  26. Broward Regional Health Planning Council. About TOUCH: Transforming Our Community’s Health. 2014; http://touchbroward.org/about/. Accessed 27 Oct 2014.

  27. Centers for Disease Control and Prevention, Division of Community Health, National Evaluation Team. MUH resident survey. Unpublished survey instrument. 2012.

  28. Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention. 2010. http://www.ncbi.nlm.nih.gov/books/NBK53017/. Accessed 25 Mar 2016.

  29. Karam-Hage M, Cinciripini P, Gritz E. Tobacco use and cessation for cancer survivors: an overview for clinicians. CA Cancer J Clin. 2014;64(4):272–90. doi:10.3322/caac.21231.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Aspropoulos E, Lazuras L, Rodafinos A, Eiser JR. Can you please put it out? Predicting non-smokers’ assertiveness intentions at work. Tob Control. 2010;19:148–52. doi:10.1136/tc.2009.031161.

    Article  PubMed  Google Scholar 

  31. Sivri C, Lazuras L, Rodafinos A, Eiser JR. Smoke-free policies and non-smokers’ reactions to SHS exposure in small and medium enterprises. Int J Occup Med Environ Health. 2013;26(6):940–8.

    Article  PubMed  Google Scholar 

  32. Germain D, Wakefield M, Durkin S. Non-smokers’ responses when smokers light up: a population-based study. Prev Med. 2007;45(1):21–5.

    Article  PubMed  Google Scholar 

  33. Agaku IT, King BA, Dube SR. Current cigarette smoking among adults—United States, 2005–2012. Morb Mortal Wkly Rep. 2014;63(02):29–34.

    Google Scholar 

  34. Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States, 2013: with special feature on prescription drugs. Hyattsville, MD; 2014. http://www.cdc.gov/nchs/data/hus/hus13.pdf. Accessed 30 Oct 2014.

  35. Department of Health and Human Services. The health consequences of smoking—50 years of progress. 2014. http://www.surgeongeneral.gov/library/reports/50-years-of-progress. Accessed 5 Mar 2014.

Download references

Acknowledgments

This paper was supported in part by a cooperative agreement (#U58DP003661) with the Centers for Disease Control and Prevention. Portions of this project’s work involve the Communities Transforming initiative supported by CDC funding. However, the findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Users of this document should be aware that every funding source has different requirements governing the appropriate use of those funds. Under U.S. law, no Federal funds are permitted to be used for lobbying or to influence, directly or indirectly, specific pieces of pending or proposed legislation at the federal, state, or local levels. Organizations should consult appropriate legal counsel to ensure compliance with all rules, regulations, and restriction of any funding sources. The authors acknowledge and warmly thank Matthew Competiello from the American Lung Association in Broward County, Florida; Juana Mejia and all the property managers and social service staff from Catholic Health Services; and the volunteers and staff from Tobacco Free Florida, Area Health Education Centers in Broward and Miami-Dade Counties, the Florida Department of Health in Broward County, the Florida Department of Health in Miami-Dade County, TOUCH Broward, and the Broward Regional Health Planning Council. The authors are also grateful to the Centers for Disease Control and Prevention and to ICF International, particularly Dr. Janice Vick, for support during manuscript training and writing; to Dr. George Rutherford of the University of California, San Francisco, for manuscript writing assistance; and to the writing workshop colleagues who provided peer review.

Author information

Authors and Affiliations

  1. Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL, 33328, USA

    T. Lucas Hollar & Nicole Cook

  2. Area Health Education Center, Nova Southeastern University, Fort Lauderdale, FL, USA

    David Quinn

  3. Broward Regional Health Planning Council, Hollywood, FL, USA

    Teina Phillips & Michael DeLucca

Authors
  1. T. Lucas Hollar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicole Cook
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Teina Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael DeLucca
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Lucas Hollar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hollar, T.L., Cook, N., Quinn, D. et al. Smoke-Free Multi-unit Housing Policies Show Promise in Reducing Secondhand Smoke Exposure Among Racially and Ethnically Diverse, Low-Income Seniors. J Immigrant Minority Health 19, 1281–1289 (2017). https://doi.org/10.1007/s10903-016-0430-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-016-0430-2

Keywords

Search

Navigation