Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions

Kimberly Horn, Sallie Beth Johnson, Sofía Rincón-Gallardo Patiño, Kevin Krost, Tiffany Gray, Craig Dearfield, Chenguang Du and Debra Bernat
Additional contact information
Kimberly Horn: Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Riverside Circle, Roanoke, VA 24016, USA
Sallie Beth Johnson: Department of Public Health and Healthcare Leadership, Radford University Carilion, 101 Elm Avenue, SE, Roanoke, VA 24013, USA
Sofía Rincón-Gallardo Patiño: Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24060, USA
Tiffany Gray: Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA
Craig Dearfield: Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA
Chenguang Du: Department of Leadership, Counseling, and Research, Virginia Tech, Blacksburg, VA 24060, USA
Debra Bernat: Department of Epidemiology, The Milken Institute School of Public Health, The George Washington University, 905 New Hampshire Avenue, Northwest, Washington, DC 20052, USA

IJERPH, 2021, vol. 18, issue 17, 1-16

Abstract: In July 2018, the United States Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing. This study assessed administrator and resident perceptions of rule implementation during its initial year in the District of Columbia Housing Authority (DCHA). Assessment included nine focus groups ( n = 69) with residents and in-depth interviews with administrators ( n = 7) and residents ( n = 26) from 14 DCHA communities (family = 7 and senior/disabled = 7). Semi-structured discussion guides based on the multi-level socio-ecological framework captured dialogue that was recorded, transcribed verbatim, and coded inductively. Emerging major themes for each socio-ecological framework level included: (1) Individual: the rule was supported due to perceived health benefits, with stronger support among non-smokers; (2) Interpersonal: limiting secondhand smoke exposure was perceived as a positive for vulnerable residents; (3) Organizational: communication, signage, and cessation support was perceived as a need; (4) Community: residents perceived mobility, disability, weather, and safety-related issues as barriers; and (5) Public Policy: lease amendments were perceived as enablers of rule implementation but expressed confusion about violations and enforcement. A majority of administrators and residents reported favorable implications of the mandated HUD rule. The novel application of a socio-ecological framework, however, detected implementation nuances that required improvements on multiple levels, including more signage, cessation support, clarification of enforcement roles, and addressing safety concerns.

Keywords: smoke-free policy; housing; tobacco control; smoking; health policy; socio-ecological framework; qualitative (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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