Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact

Nan Jiang, Emily Gill, Lorna E. Thorpe, Erin S. Rogers, Cora de Leon, Elle Anastasiou, Sue A. Kaplan and Donna Shelley
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Nan Jiang: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Emily Gill: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Lorna E. Thorpe: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Erin S. Rogers: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Cora de Leon: Silver School of Social Work, New York University, New York, NY 10003, USA
Elle Anastasiou: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Sue A. Kaplan: Department of Population Health, Grossman School of Medicine, New York University, New York, NY 10016, USA
Donna Shelley: School of Global Public Health, New York University, New York, NY 10003, USA

IJERPH, 2021, vol. 18, issue 23, 1-13

Abstract: In 2018, the U.S. Department of Housing and Urban Development required public housing authorities to implement a smoke-free housing (SFH) policy that included individual apartments. We analyzed the policy implementation process in the New York City Public Housing Authority (NYCHA). From June–November 2019, we conducted 9 focus groups with 64 NYCHA residents (smokers and nonsmokers), 8 key informant interviews with NYCHA staff and resident association leaders, and repeated surveys with a cohort of 130 nonsmoking households pre- and 12-month post policy. One year post policy implementation, participants reported widespread smoking violations and multi-level factors impeding policy implementation. These included the shared belief among residents and staff that the policy overreached by “telling people what to do in their own apartments”. This hindered compliance and enforcement efforts. Inconsistent enforcement of illegal marijuana use, staff smoking violations, and a lack of accountability for other pressing housing issues created the perception that smokers were being unfairly targeted, as did the lack of smoking cessation resources. Resident support for the policy remained unchanged but satisfaction with enforcement declined (60.1% vs. 48.8%, p = 0.047). We identified multilevel contextual factors that are influencing SFH policy implementation. Findings can inform the design of strategies to optimize policy implementation.

Keywords: smoke-free policy; public housing; implementation (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 (3)

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