The HUD smoke-free rule: Perceptions of residents post-implementation

In July 2018, the U.S. Department of Housing and Urban Development (HUD) implemented a new Public health Agency rule prohibiting the use of tobacco in and within 25 feet of HUD housing. A convenience sample of 574 residents living in Milwaukee, Wisconsin multi-unit HUD complexes completed a survey from May through July 2019, designed to assess their perceptions of the new policy and its impact. Knowledge of the policy was strong, although continued educational efforts are needed. Attitudes about the policy were generally positive, although smokers held more negative attitudes than non-smokers. Some residents desired more and fairer policy enforcement. Most residents reported that smoke incursions were reduced post policy compared to pre policy, although such incursions still occurred. The policy has had a favorable health impact on smokers; over 80% made at least one positive change in their smoking, including 6.4% who said the policy motivated them to quit. There was no evidence that residents with mobility challenges were differentially affected by the policy. Overall, the HUD smoke-free policy was well received, reduced self-reported exposure to smoke and led most smokers to make positive changes in their smoking. Additional education on the policy, improved enforcement, and cessation services are needed.