Resident Support for the Federally Mandated Smoke-Free Rule in Public Housing: 2018-2022

Area of Science:

• Public Health
• Health Policy
• Tobacco Control

Background:

• The Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing.
• Understanding resident support for smoke-free policies is crucial for their successful implementation and long-term effectiveness.

Purpose of the Study:

• To examine support for HUD's mandatory smoke-free rule among smokers and non-smokers up to four years post-implementation.
• To identify factors influencing support for the smoke-free policy over time.

Main Methods:

• A repeated cross-sectional survey design was employed with 529 District of Columbia public housing residents aged 18+.
• Data were collected at three time points: pre-rule (July 2018), post-rule (November 2018-March 2020), and post-rule with COVID-19 (September 2020-December 2022).
• Support was defined as agreement that smoking should be prohibited indoors and within 25 feet of buildings.

Main Results:

• Overall support for the smoke-free rule was low across all time points.
• Smokers showed significantly lower support (5.3% pre-rule, 30.7% post-rule, 22.5% post-rule + COVID-19) compared to non-smokers (48.2% pre-rule, 52.2% post-rule, 40.0% post-rule + COVID-19).
• Pre-rule support was lower than post-rule support, and tobacco users were less likely to support the rule.

Conclusions:

• Support for HUD's smoke-free rule remains low, even up to four years after implementation.
• Targeted engagement with residents and promotion of health benefits may enhance policy acceptance.
• Further research is needed to understand long-term trends and optimize public health interventions in public housing.