Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing

Abstract

Objectives Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. Methods In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Results Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%–80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (−0.19 μg/m3, p = .03). Conclusions Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement.

Evaluation of Secondhand Smoke Exposure in New York City Public Housing After Implementation of the 2018 Federal Smoke-Free Housing Policy

“…The findings of this study are consistent with those of other studies examining the association of SFH policies with SHS exposure. 15,16,18 One recent study 18 studies, these authors found that Boston SFH policy implementation was associated with greater decreases in PM 2.5 and airborne nicotine concentration 1 year after the policy implementation compared with housing that had no policy, although the association was not equal at all sites. 16 To our knowledge, evidence of persistently reduced SHS over time has not been published.…”

A protocol for measuring the impact of a smoke-free housing policy on indoor tobacco smoke exposure

“…Only a few studies have measured changes in SHS exposure before and after implementation of housing-wide bans [21, 22]. While several studies have examined the post-implementation impacts of SFH on self-reported SHS exposure [21, 23–25], as of early 2019 only researchers in Boston and Philadelphia have evaluated a smoking ban in public housing apartments using state-of-the-art objective measures of SHS exposure such as airborne nicotine and particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) concentrations [22, 26–29]. An early cross-sectional study in Boston ( n = 32 non-smoker apartments) found significantly lower PM2.5 concentrations and airborne nicotine levels in buildings with smoke-free policies compared with buildings without a similar ban [28].…”

“…An early cross-sectional study in Boston ( n = 32 non-smoker apartments) found significantly lower PM2.5 concentrations and airborne nicotine levels in buildings with smoke-free policies compared with buildings without a similar ban [28]. However, results from these studies were inconsistent with respect to whether such policies result in detectable reductions in airborne nicotine or particulate matter (PM) in the homes of non-smoking residents, in part due to the challenges of small sample sizes and limited durations of post-policy follow up [22, 27, 29]. To foster harmonization of methods across studies examining similar policies, we present our detailed protocol here.…”

In-Home Secondhand Smoke Exposure Among Urban Children With Asthma: Contrasting Households With and Without Residential Smokers

“…The majority of children are exposed to SHS at home, and the most common source of inhome SHS are household members, such as smoking parents 5,6 . However, children can also be exposed at home from external sources: smoking visitors 6 , incursion of SHS from the outside environment 7,8 , and attendant "thirdhand" smoke from these elements 9 .…”