Attitudes and Experiences with Secondhand Smoke and Smoke-free Policies Among Subsidised and Market-rate Multiunit Housing Residents Living in Six Diverse Communities in the USA
Overview
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Background: Given that higher smoking rates persist among lower socioeconomic populations, multiunit housing (MUH) environments may result in higher secondhand smoke (SHS) exposures among subsidised MUH residents. This cross-sectional assessment compares experiences with SHS and smoke-free policies among subsidised and market-rate MUH residents living in six US communities.
Methods: MUH residents (n=1565) were surveyed regarding their smoke-free rules (home and building), SHS exposures and preferences towards smoke-free policies. Binary logistic regression identified predictors of each outcome, focusing on differences by subsidised housing status (subsidised vs market rate).
Results: Among residents enforcing smoke-free home rules (76%, overall), 50% reported SHS incursions into their unit. Only 23% reported living in a smoke-free building; 56% of those living in smoking-allowable buildings reported preferences towards smoke-free building policies. Among market-rate housing residents, smoke-free home (OR=4.18) and building (OR=2.26) rules were significantly higher when children were present. Smoke-free building rules reduced the odds of SHS incursions among market-rate housing residents (OR=0.50), but no association was observed among subsidised housing residents. Non-smoking subsidised housing residents exhibited stronger preferences for smoke-free policies compared with those in market-rate housing.
Discussion: Smoke-free home rules may not protect MUH residents from SHS exposures, particularly in subsidised MUH. Although strong preferences towards smoke-free policies were present overall, subsidised MUH residents may have fewer alternative smoke-free housing options available. Therefore, all publicly funded housing should be smoke free to protect these vulnerable populations. However, continued efforts to encourage privately owned MUH operators to adopt smoke-free policies are also necessary.
Indoor Air Quality in Multi-Family Housing: Drivers and Interventions.
Levy J, Kibilko K Curr Environ Health Rep. 2025; 12(1):4.
PMID: 39804430 PMC: 11729057. DOI: 10.1007/s40572-024-00470-7.
Kibria M, Hossain A, Islam T, Islam K, Mahmud H, Nabi M PLoS One. 2023; 18(9):e0291746.
PMID: 37733729 PMC: 10513191. DOI: 10.1371/journal.pone.0291746.
Reyes-Guzman C, Patel M, Wang T, Corcy N, Chomenko D, Slotman B Int J Environ Res Public Health. 2023; 20(14).
PMID: 37510588 PMC: 10379655. DOI: 10.3390/ijerph20146356.
Boderie N, Sheikh A, Lo E, Sheikh A, Burdorf A, van Lenthe F EClinicalMedicine. 2023; 59:101982.
PMID: 37256097 PMC: 10225670. DOI: 10.1016/j.eclinm.2023.101982.
Widome R Am J Epidemiol. 2022; 192(1):34-38.
PMID: 36255180 PMC: 10144725. DOI: 10.1093/aje/kwac184.