Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions
Previous Research on Smoke-Free Policies
2.1. Study Sample
2.2. Data Collection
2.2.1. Demographic Information
2.2.2. Focus Groups
2.2.3. Individual Interviews
2.3. Data Analysis
3.1. Participant Demographics
3.2. Overall Study Themes
4.5. Public Policy
4.7. Future Direction
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Rule Components||Implementation Suggestions|
|Ban the use of tobacco products:|
Waterpipes (hookahs), cigarettes, cigars, and pipes in all outdoor areas up to 25 feet from the public housing and administrative office buildings.
|Advertise as smoke-free buildings.|
Include signage and communication to remind existing tenants, guests, and maintenance workers.
|All public housing other than dwelling units in mixed-finance buildings.||The Department of Housing and Urban Development may use the periodic inspections and units to help monitor and confirm whether the policy is being enforced and will take whatever action it seems necessary and appropriate in case of violation.|
|Public housing authorities may further restrict residents with repeated violations.||Offer cessation support (voluntarily).|
The Department of Housing and Urban Development encourages public housing authorities to use a graduated enforcement approach that includes written warnings for repeated policy violations before pursuing lease termination or eviction.
|Public housing authorities are required to document their smoke-free policies in their plans and require resident engagement and public meetings.||Inform tenants and communicate widely:|
Articles in the tenant newsletter, meetings, sending letters, supplying information on the harmful effects of secondhand smoke.
|The use of prohibited tobacco products must be included in a tenant’s lease.|
Tenants renew their lease annually.
Residents are responsible for the actions of their household, their guests, and visitors.
Failures constitute a material and non-compliance with lease agreement. Responsible for all costs to remove smoke odor or residue upon any violation.
Residents can be charged for property damage that is beyond normal wear and tear, in accordance with 24 CFR 966.4(b) (2). Violation of the smoke-free policy will constitute a lease violation.
The Department of Housing and Urban Development has not included enforcement provisions in this rulemaking because lease enforcement policies are typically at the discretion of public housing authorities.
|Focus Group Number||Smoking Status||Total Participants|
|Cessation support (n = 100 meaning units)||Describes cessation services provided to or requested by residents when the rule went into effect.|
|Communication (n = 150 meaning units)||How and when administrators and residents heard about the smoke-free rule, including roles and any information for the tenants.|
|Enforcement (n = 69 meaning units)||Describes enforcement activities that make sure that residents comply with the rule. May include barriers and facilitators for enforcement as any mention of a resident informing an admin about another resident violating the non-smoking policy.|
|Lease (n = 38 meaning units)||Any mention of residents’ leases, including signing an agreement to continue living there and eviction.|
|Resident engagement (n 185 meaning units)||Activities to involve tenants in supporting and adhering to the smoke-free rule.|
|Signage (n = 414 meaning units)||Signs to promote District of Columbia Housing Authority units as smoke-free. Includes communication to remind existing tenants, guests, and maintenance workers of the smoke-free rule.|
|Violations (n = 568 meaning units)||Failures to follow the smoke-free rule, including non-compliance with the lease agreement.|
|Socio-Ecological Model Levels||Theme||Illustrative Quote|
|Administrator||Resident Smoker||Resident Non-Smoker|
|Individual||Lease||“The fact that you sign the new lease and— that little fine print that you didn’t read, is in there. You see, and that’s what’s gon’ get you. ‘Cause you know it’s a no smokin…”||“And then we had to go to the rental office and sign a paper that we knew about the rule was goin’ into effect and we’re going to improve our health all.”||“A couple of months ago, they sent us a letter through the mail saying we had to go sign a new lease stating there’s no smokin’ in your unit or on the property, which is good because of health reasons to everyone.”|
|Resident Engagement||“And residents had to sign an addendum saying that they’ve been, met with that information. It is the only way that people will follow the rule. And then also, on our part, uh, we were, uh, instructed to do some smoke-free workshops, uh, with them.”||“I’ve heard that there was going to be classes to quit smoking, but people really don’t wanna just walk over there and just be—who wants to be in a class to stop smoking? That’s your own choice, besides we have not been given any support yet.”||“I think that people who smoke were given resources to help them quit smoking, but they don’t wanna quit. They may not smoke outside, but they’ll smoke in their apartment, and it’ll stay in.”|
|Violations||“If for instance someone is seen smoking where it’s not designated or not allowed, it hasn’t been made very clear the consequence, but there would be a couple of warnings, and then there would be a 30-day notice, initiated.”||“Now I really don’t know where to smoke. I don’t go outside on the property no more. And then I can’t do too much walking to many places like that, so I might take a puff or two and stuff like that in the halls. But, you know, that’s it because I don’t want problems.”||“I reported a violation, and management say that I needed to write a letter and they were gonna report to the attorney. Then I guess they probably get a warning on what they will do the next time.”|
|Interpersonal||Communication||“I don’t even know what are the consequences for the person who’s caught smoking might be or if it is said in the policy we received. I think it is a good strategy to decrease second hand smoke for all. But, I’m not sure who is responsible to enforce it.”||“We heard about the rule over the summer, we weren’t prepared for it. Because, number one, they just came out with one letter from HUD that came to us. Probably, we got a letter about—it’s just before August. Then they postponed it a month before they put it in effect.”||“I think that, for the time frame, it was a couple of months. But, it could’ve been, announced or managed better. Like ‘Okay, guys, you know, we’ll have this amount of time, and then maybe another reminder.’ As opposed to, ‘This went into effect—’ it’s just like, ‘You just have to know on your own, but this is what it is.’”|
|Enforcement||“Overall, the biggest challenge for actually enforcing it is to identify, unless you know a person is doing it in a unit, but I can’t pinpoint where the smell is coming from because it travels through the air vents. So how do you tell that that’s coming from a particular unit? So, it’s hard to enforce something that- it’s like trying to catch air. Even then, you have to prove it, you know.”||“If I knew somebody was smoking in a place where they’re not supposed to be, I wouldn’t do anything about it. I would mind my business, ‘cause it ain’t none of my business.”||If I see somebody smoking where they’re not supposed to be smoking, I really don’t know what I would do. I probably would tell them, ‘You are not in the right place to be smokin’ and contributing to air pollution.’”|
|Lease||“It’s supposed to be three warnings. On that third warning, that’s what they’re supposed to do, somethin’ about it but the rules are not being followed. The rules are not being followed neither by HUD, neither by the District of Columbia Housing Authority, nor by the residents.”||“I signed mine when I paid my rent. They said, ‘Before we—accept your rent, you have to sign this document right here.”||“A couple of months ago, they sent us a letter through the mail saying we had to go sign a new lease—stating there’s no smokin’ in your unit or on the property... We heard talk about it in a couple of the meetings that they had, that they was gonna stop everybody from smokin’ on the property…”|
|Organizational||Cessation Support||“I’ve got good responses from folk who said that they wanna quit. They want more information. But what we lacking is some of the products that help you to stop smoking, it was gonna be available, but we haven’t connected with a source to have that.”||“Yes (cessation services were provided). There was a lot of them. They even was giving people the number to get some free patches from some—free cigarette no-smoking patches and everything.”||“I don’t recall gettin’ no type of resources other than sayin’ that you could smoke in public places—not public but outside places like at a park or somethin’ like that…”|
|Enforcement||“We don’t enforce it at all. That’s not our role at all, to enforce. Enforcement side is the management side.”||“Well, they said they gonna put these smoke things in our apartment, monitors or whatever they were.”||“No, I would not (report it to the building management)... I would just remind them that it’s in effect, but I wouldn’t report it to the management, no.”|
|Signage||“There are signs indicating that the District of Columbia Housing Authority is a smoke-free area, they came from the District of Columbia Housing Authority. There are not enough signs, because some places should have the signs and there are no signs out in areas like the courtyards because kids are up there.”||“There are reminders of the rule around the property, they finally put signs up, No Smoking, but they still smoke.”||“There’s no way to tell, like, where you can smoke and where you can’t smoke. You know, they have signs that say (you can’t smoke) within 25 feet, and then they have another sign that say within 50 feet.”|
|Violations||“They said, ‘No, we’re not gonna do that (put detectors in unit).’ So how can you enforce it? And they said, well kinda like we really can’t enforce it unless other people enforce it for us. So, you’re gonna have to have someone tell on you, on the smoker, or if maintenance goes into your unit and see an ash tray or a pack of cigarettes.”||“I’m just sayin’ it’s certain management and certain security patrols wanna make their own rules up where you should be. It is not clear what happens if someone doesn’t follow the rule.”||“What happens if someone is, uh, smoking, where it’s not allowed? Nothing. They just ask ‘em—when there was security officer could tell them that they couldn’t smoke on the property, and they would go across the street.”|
|Community||Signage||“And one in particular had built a gazebo. They had ashtrays that were mounted, and then they end up smoking outside the property line because of the smoke-free area signs. They end up smoking across the street, which caused a problem in the community.”||“Around the property there aren’t signs that reminds about the no smoking, but there are when you’re inside, but when you’re outside the fence, they don’t have no signs out there.”||“They finally put signs up, “No Smoking,” but they still smoke. I can see how it is when it’s winter and it’s cold out there, some people don’t like to go outside standin’ out in that cold to smoke a cigarette.”|
|Violations||“You know, they were told about it, but, they smoked all in their place and in here all the way up to the time they say they couldn’t smokin’ because it is too cold, or dangerous, or even some for mobility issues and then some they started goin’ cross the street, which caused a problem in the community.”||“You don’t wanna be walkin’ out there every 15 min. The weather don’t permit. It’s cold. It’s windy, and it—people that livin’ across the street look at you like you’re hoodlums or bums or whatever. It’s dangerous.”||“I don’t like it. I mean, why can’t she smoke in her own home? because she has a young kid, and it’s not safe to leave her alone. I will let her smoke on the balcony.”|
|Public policy||Lease||“I‘ll probably tell you, ‘And you get one more we’re gonna evict you.’”||“Before the rule went into effect, we all got the last notice that the rule was goin’ into effect. And then we had to go to the rental office and sign a paper that we knew about the rule was goin’ into effect.”||“I think the D.C. Housing Authority included the smoke-free rule into the leases because they want everyone to be safe in their homes, and they don’t want to increase any health problem within D.C. Housing.”|
|Violations||“But housin’, um, even when they, I don’t know if they gonna let us know or whatever. But it’s gonna be a thing whereas they’re gonna have to give you warnings, and after so many warnings I have housin’ puttin’ you out.”||“They just put the rule down, but they didn’t enforce it. They just put the rules out there, but they did nothing about the rules.”||“It’s just, when they have a designated-smoking area, they had benches where they could sit down at. It’s a gazebo, and the ashtray, designated ashtray, there that the public housing put up. But then when the law came, they say now they cannot use ‘em. It doesn’t make good sense.”|
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Horn, K.; Johnson, S.B.; Patiño, S.R.-G.; Krost, K.; Gray, T.; Dearfield, C.; Du, C.; Bernat, D. Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions. Int. J. Environ. Res. Public Health 2021, 18, 8908. https://doi.org/10.3390/ijerph18178908
Horn K, Johnson SB, Patiño SR-G, Krost K, Gray T, Dearfield C, Du C, Bernat D. Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions. International Journal of Environmental Research and Public Health. 2021; 18(17):8908. https://doi.org/10.3390/ijerph18178908Chicago/Turabian Style
Horn, Kimberly, Sallie Beth Johnson, Sofía Rincón-Gallardo Patiño, Kevin Krost, Tiffany Gray, Craig Dearfield, Chenguang Du, and Debra Bernat. 2021. "Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions" International Journal of Environmental Research and Public Health 18, no. 17: 8908. https://doi.org/10.3390/ijerph18178908