Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact
Abstract
:1. Introduction
2. Materials and Methods
2.1. Conceptual Framework
2.2. Qualitative Data Collection
2.3. Resident Surveys
2.4. Data Analysis
3. Results
3.1. Qualitative Findings
3.1.1. Outer Setting
HUD Resources
PHA Partnerships
Marijuana Policy
3.1.2. Intervention Characteristics
3.1.3. Individual Characteristics
3.1.4. Inner Setting
Structural and Environmental Barriers
Interpersonal Safety Concerns
Community Cohesiveness
Lack of Smoking Cessation Support
Relative Priority of SFH Policy
Compatibility
3.1.5. Implementation Process
Planning and Community Engagement
Enforcement
3.1.6. Strategies for Improving SFH Policy Implementation
3.2. Survey Findings
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Development 1 | Development 2 | Development 3 | Development 4 | Total | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | n | (%) | n | (%) | |
Gender | ||||||||||
Male | 8 | (40.0) | 2 | (12.5) | 2 | (22.2) | 2 | (11.1) | 14 | (21.9) |
Female | 12 | (60.0) | 14 | (87.5) | 7 | (77.8) | 16 | (88.9) | 49 | (76.6) |
Mean age, Year (SD) | 58.1 | (13.8) | 63.7 | (10.1) | 52.4 | (20.8) | 64.2 | (15.2) | 60.3 | (15.1) |
Smoking status | ||||||||||
Current smoker | 10 | (50.0) | 7 | (43.8) | 5 | (55.6) | 4 | (21.1) | 26 | (40.6) |
Non-current smoker | 10 | (50.0) | 9 | (56.3) | 4 | (44.4) | 15 | (78.9) | 38 | (59.4) |
Race/ethnicity | ||||||||||
Non-Hispanic white | 3 | (18.8) | 1 | (6.3) | 2 | (22.2) | 11 | (61.1) | 17 | (26.6) |
Non-Hispanic black | 6 | (37.5) | 15 | (93.8) | 7 | (77.8) | 5 | (27.8) | 33 | (51.6) |
Non-Hispanic other | 5 | (31.3) | 0 | (0) | 0 | (0) | 2 | (11.1) | 7 | (10.9) |
Asian | 1 | (6.3) | 0 | (0) | 0 | (0) | 2 | (11.1) | 3 | (4.7) |
American Indian or Alaska Native | 3 | (18.8) | 0 | (0) | 0 | (0) | 0 | (0) | 3 | (4.7) |
Education | ||||||||||
Less than high school | 4 | (20.0) | 2 | (12.5) | 1 | (11.1) | 2 | (10.5) | 9 | (14.1) |
High school graduate | 4 | (20.0) | 8 | (50.0) | 4 | (44.4) | 7 | (36.8) | 23 | (35.9) |
Greater than high school | 11 | (55.0) | 6 | (37.5) | 4 | (44.4) | 10 | (52.7) | 31 | (48.4) |
Unreported | 1 | (5.0) | 0 | (0) | 0 | (0) | 0 | (0) | 1 | (1.6) |
Domains | Sample Quotes |
---|---|
Domain 1: Outer Setting | |
PHA partnerships | “We’re going to be in the next year trying to think of new ways to partner with people who are both into health care and community space we will certainly work to integrate all the different, healthy-home topics around that, so smoke-free alongside with the pest management and the mold work” (Staff #2). |
Marijuana policy | “If you’re going to ban smoking, you have to ban the people who are smoking marijuana. It’s permeating the house the same way” (Smoker, FG #6), “Y’all talking about cigarette smoke, [but] if somebody is smoking marijuana and it’s coming in my apartment,’ that’s not a problem”? (Nonsmoker, FG #1) “[Marijuana use] is blatantly in the open, and nobody cares anymore” (Staff #4). |
Domain 2: Intervention characteristics | “I just don’t think no one could come in my house and tell me what to do, when I pay my rent” (Smoker, FG #2). “Each person has the right to do whatever they please. I can’t say anything to them about it” (Nonsmoker, FG #3). “People have rights. And you sort of invading their privacy when you tell a tenant you can’t smoke in your apartment” (Staff #5). |
Domain 3: Individual characteristics | “That no-smoking policy is just another rule to set residents up for eviction” (Smoker, FG#2). “I think it’s unfair. You’re going to lose your apartment just because someone complained about cigarette smoke”? (Nonsmoker, FG #3). |
Domain 4: Inner Setting | |
Interpersonal safety concerns | “You’re creating an enemy when you start the reporting” (Nonsmoker, FG #3). “I wouldn’t dare ask somebody to not smoke” (Nonsmoker, FG #8). “[Staff] are told never, ever confront anybody, not for smoking or anything else” (Staff #5). |
Structural and environmental barriers | “They are all close-knit buildings. To move 25 feet away from this one you’re only going back in front of this one. Right in front of the next one” (Smoker, FG #9). “I’m not going outside in a snow blizzard to smoke, and in the rain” (Smoker, FG #6). |
Community cohesiveness | “Everybody’s been here for ages. Everybody knows each other, and pretty much respects each other” (Smoker, FG#2). “It’s basically every man for themselves. They [other residents] don’t even bother with rules” (Nonsmoker, FG #3). |
Lack of smoking cessation services | “I think it would be helpful if they [PHA] started offering an onsite smoking cessation program” (Smoker, FG #9). “What would be nice if we can get a class for people or maybe go around to give out patches” (RA #3). |
Relative priority of SFH policy | “They [PHA] should take some of that energy and enforce the policies that already put in place and leave us alone” (Smoker, FG #4). “You’re saying smoking? But there’re a lot of things inside the apartment that are not being dealt with as well” (Nonsmoker, FG #1). |
Compatibility | “A lot of property managers feel like they’re overwhelmed, and this is just one more thing that they have to deal with” (Staff #2). |
Domain 5: Implementation Process | |
Planning and community engagement | “This [roll out] could have worked better and been a more positive experience for us had the PHA staff first come in and done this focus group before, and along with some smoking cessation” (Smoker, FG #4). “They could’ve made us more aware by providing more information. And make a list of pros of why you shouldn’t smoke in your apartment” (Smoker, FG #9). “Get out more information and more material to the people” (Nonsmoker, FG #8). |
Enforcement | “Housing doesn’t enforce that policy” (Nonsmoker, FG #1). “Their [Housing’s] own employees walking in and out of the building with a cigarette in their mouth. Who are you to tell me not to smoke”? (Smoker, FG #6). “The housing staffs themselves smoke at the front. So why would they implement that rule, if they are the first ones to break it” (Nonsmoker, FG #7). “I’m not going to go into somebody’s house to see whether or not they’re smoking”. (Staff #4) |
Pre-Launch (April–July 2018) N = 153 | Post-Launch (May–September 2019) N = 130 | p-Value | |||
---|---|---|---|---|---|
n | (%) | n | (%) | ||
Support for NYCHA SFH policy | 146 | (94.8) | 125 | (96.2) | 0.655 |
Satisfaction with NYCHA’s introduction of SFH policy | 123 | (81.5) | 91 | (70.5) | 0.033 |
Satisfaction with enforcement of SFH policy | 89 | (60.1) | 62 | (48.8) | 0.047 |
Which of the following have you experienced in the past 6 months related to SFH policy? | |||||
Saw signs, posters or other materials about the policy in building | 78 | (50.7) | 62 | (47.7) | 0.593 |
Received an invitation or seen posters/flyers about meetings to discuss the policy | 54 | (36.1) | 24 | (18.5) | 0.001 |
Attended resident meetings where this policy was discussed | 14 | (9.1) | 12 | (9.2) | 0.999 |
Submitted a complaint about others smoking in the building | 22 | (14.3) | 28 | (21.5) | 0.170 |
Complained directly to a smoker | 42 | (27.3) | 39 | (30.0) | 0.695 |
Heard about new smoking cessation services available | 22 | (14.3) | 32 | (24.6) | 0.071 |
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Jiang, N.; Gill, E.; Thorpe, L.E.; Rogers, E.S.; de Leon, C.; Anastasiou, E.; Kaplan, S.A.; Shelley, D. Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact. Int. J. Environ. Res. Public Health 2021, 18, 12565. https://doi.org/10.3390/ijerph182312565
Jiang N, Gill E, Thorpe LE, Rogers ES, de Leon C, Anastasiou E, Kaplan SA, Shelley D. Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact. International Journal of Environmental Research and Public Health. 2021; 18(23):12565. https://doi.org/10.3390/ijerph182312565
Chicago/Turabian StyleJiang, Nan, Emily Gill, Lorna E. Thorpe, Erin S. Rogers, Cora de Leon, Elle Anastasiou, Sue A. Kaplan, and Donna Shelley. 2021. "Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact" International Journal of Environmental Research and Public Health 18, no. 23: 12565. https://doi.org/10.3390/ijerph182312565