The HUD smoke-free rule: Perceptions of residents post-implementation.
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ABSTRACT:
SUBMITTER: Lathen LS
PROVIDER: S-EPMC7381686 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
The HUD smoke-free rule: Perceptions of residents post-implementation.
Lathen Lorraine S LS Plears Monique L ML Shartle Emile L EL Conner Karen L KL Fiore Michael C MC Christiansen Bruce A BA
Preventive medicine reports 20200709
In July 2018, the U.S. Department of Housing and Urban Development (HUD) implemented a new Public health Agency rule prohibiting the use of tobacco in and within 25 feet of HUD housing. A convenience sample of 574 residents living in Milwaukee, Wisconsin multi-unit HUD complexes completed a survey from May through July 2019, designed to assess their perceptions of the new policy and its impact. Knowledge of the policy was strong, although continued educational efforts are needed. Attitudes about ...[more]
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Project description:IntroductionIn 2012, the Boston Housing Authority (BHA) in Massachusetts implemented a smoke-free policy prohibiting smoking within its residences. We sought to characterize BHA resident experiences before and after the smoke-free policy implementation, and compare them to that of nearby residents of the Cambridge Housing Authority, which had no such policy.MethodsWe recruited a convenience sample of nonsmoking residents from the BHA and Cambridge Housing Authority. We measured residents' awareness and support of their local smoking policies before and 9-12 months after the BHA's policy implementation, as well as BHA respondents' attitudes towards the smoke-free policy. We assessed tobacco smoke exposure via saliva cotinine, airborne apartment nicotine, and self-reported number of days smelling smoke in the home. We evaluated predictors of general satisfaction at follow-up using linear regression.ResultsAt follow-up, 91% of BHA respondents knew that smoking was not allowed in apartments and 82% were supportive of such a policy in their building. BHA residents believed enforcement of the smoke-free policy was low. Fifty-one percent of BHA respondents indicated that other residents "never" or "rarely" followed the new smoke-free rule and 41% of respondents were dissatisfied with policy enforcement. Dissatisfaction with enforcement was the strongest predictor of general housing satisfaction, while objective and self-reported measures of tobacco smoke exposure were not predictive of satisfaction. At follow-up, 24% of BHA participants had complained to someone in charge about policy violations.ConclusionsResident support for smoke-free policies is high. However, lack of enforcement of smoke-free policies may cause frustration and resentment among residents, potentially leading to a decrease in housing satisfaction.ImplicationsSmoke-free housing laws are becoming increasingly prevalent, yet little is known about satisfaction and compliance with such policies post-implementation. We evaluated nonsmoking residents' attitudes about smoke-free rules and their satisfaction with enforcement 1 year after the BHA implemented its comprehensive smoke-free policy. We found that while residents were supportive of the policy, they believed enforcement was low, a perception that was associated with a drop in housing satisfaction. Our findings point to a desire for smoke-free housing among public housing residents, and the importance of establishing systems and guidelines to help landlords monitor and enforce these policies effectively.
| S-EPMC6407845 | biostudies-literature
Project description:BackgroundIn Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15-20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the implementation of smoke-free psychiatric clinics.AimsTo investigate the attitudes and experiences regarding smoke-free policies among managers and staff involved in the implementation processes of smoke-free psychiatric clinics at hospitals in Malmö (Sweden) and Barcelona (Spain).MethodWe used a qualitative methodology, with 15 semi-structured interviews. The interviews were conducted with each participant individually, and were subsequently transcribed. The data were analysed with systematic text condensation.ResultsThere were notable differences in how the smoke-free policies were carried out and experienced, and attitudes regarding the policy changes differed in the two settings. Key differences were the views on the right to smoke in compulsory care and to stay in smoke-free surroundings supported by smoking cessation intervention; the prioritisation of staff facilitation of smoking breaks; and views on smoking and smoke-free psychiatry. In contrast, participants agreed on the importance of staff education and management support. A smoking ban by law and belonging to a network of smoke-free hospitals were also relevant.ConclusionsStaff education, and support from staff and management for the patients' right to stay in smoke-free surroundings, facilitated successful implementation of smoke-free policies in the psychiatric clinics, whereas supporting the right to smoke was a barrier.
| S-EPMC8086391 | biostudies-literature
Project description:ObjectivesHigh levels of particulate pollution due to secondhand smoke (SHS) have previously been recorded in English prisons. As part of an evaluation to ascertain whether a new comprehensive smoke-free policy introduced in the first four prisons in England was successfully implemented, this study compares indoor air quality on prison wing landing locations three months before and three months after going smoke-free.DesignAn indoor air quality monitoring study, comparing SHS levels before and after a comprehensive smoke-free prison policy.SettingThe first four prisons in England to implement a comprehensive smoke-free policy.Primary and secondary measuresWe compared concentrations of airborne particulate matter <2.5 microns in diameter (PM₂.₅), as a marker for SHS, on wing landing locations three months before and three months after the smoke-free policy was implemented. Static battery operated aerosol monitors were used to sample concentrations of PM₂.₅ on wing landings.ResultsAfter discarding data from monitors that had been tampered with we were able to analyse paired data across four prisons from 74 locations, across 29 wing landing locations, for an average sampling time of five hours and eight minutes. When comparing samples taken three months before with the paired samples taken three months after policy implementation (paired for prison, day of the week, time of day, wing location and position of monitor), there was a 66% reduction in mean PM₂.₅ concentrations across the four prisons sampled, from 39 to 13 µg/m³ (difference 26 µg/m³, 95% CI 25 to 26 µg/m³).ConclusionPrison smoke-free policies achieve significant improvements in indoor air quality. A national smoke-free policy would therefore be an effective means of protecting prisoners and staff from harm due to SHS exposure in the prison environment.
| S-EPMC6575713 | biostudies-literature
Project description:A 2018 rule requiring federally-subsidized public housing authorities (PHAs) in the United States to adopt smoke-free policies (SFPs) has sparked interest in how housing agencies can best implement SFPs. However, to date, there is little quantitative data on the implementation of SFPs in public housing. Massachusetts PHAs were among the pioneers of SFPs in public housing, and many had instituted SFPs voluntarily prior to the federal rule. The aim of this study was to examine the adoption, implementation, and outcomes of SFPs instituted in Massachusetts PHAs prior to 2018 using a survey conducted that year. The survey asked if PHAs had SFPs and, if so, what activities were used to implement them: providing information sessions, offering treatment or referral for smoking cessation, soliciting resident input, training staff, partnering with outside groups, using a toolkit, and/or providing outdoor smoking areas. We used multivariable regression to investigate associations between implementation activities and respondent-reported policy outcomes (resident support, complaints about neighbors' smoking, and the number of violations reported per year). Of 238 Massachusetts PHAs, 218 (91%) completed the survey and 161 had an SFP prior to 2018. Common implementation activities were offering smoking cessation treatment/referral (89%) and information sessions for residents (85%). Information sessions for residents were associated with higher resident support (adjusted odds ratio [AOR] 4.3; 95%CI 1.2-15.3). Training staff (AOR 6.3, 95%CI 1.2-31.8) and engaging in ≥5 implementation activities (AOR 4.1, 95%CI 1.2-14.1) were associated with fewer smoking-related complaints. Utilization of multiple implementation activities, especially ones that informed residents and trained PHA staff, was associated with more favorable policy outcomes. We identified five groups of PHAs that shared distinct patterns of SFP implementation activities. Our findings, documenting implementation activities and their associations with SFP outcomes among the early adopters of SPFs in Massachusetts public housing, can help inform best practices for the future implementation of SFPs in multiunit housing.
| S-EPMC9819479 | biostudies-literature
Project description:BackgroundDental technologies have increasingly been implemented in orthodontic practice to offer better experiences for orthodontists and patients, however, there is no scientific evidence yet whether which technologies should be implemented into the postgraduate programs.ObjectivesTo investigate perceptions of orthodontic residents toward the confidence and importance of dental technologies, as well as to determine their necessity in postgraduate programs.Materials and methodsThe online questionnaire was designed to collect data from residents from all accredited orthodontic postgraduate programs in Thailand. The questionnaire consisted of four sections, which were (1) demographic data, (2) self-perceived importance of orthodontic technologies, (3) self-perceived confidence toward orthodontic technologies, and (4) the necessity of orthodontic technologies in postgraduate programs. The data were analyzed using descriptive statistics, Spearman correlation, and a chi-square test.ResultsIntraoral scanner was found to be an orthodontic technology with the highest scores for both self-perceived importance (4.37 ± 0.59) and confidence (4.23 ± 0.75), followed by cone-beam computed tomography, digital treatment planning software, and lab-produced aligners. These orthodontic technologies were also considered as mandatory in orthodontic postgraduate programs. CAD/CAM technologies appeared to be least important, and their training may be arranged as short course training. There was no significant influence of training locations on the necessity of all orthodontic technologies (P > 0.05), except CBCT. Self-perceived importance and confidence in all technologies were found to have significant positive correlations (P < 0.05), except teledentistry and in-office aligners.ConclusionOrthodontic technologies were perceived as important in clinical workflow. Intraoral Scanners, CBCT, digital treatment planning software, lab-produced aligners, and digital modeling software appeared to be necessary for clinical practice and should be considered for orthodontic postgraduate programs, while other technologies may be arranged as short course training. Further research should investigate how to arrange and organize training sessions in orthodontic postgraduate programs.
| S-EPMC10474673 | biostudies-literature
Project description:Exposure to wildfire smoke (WFS) is associated with detrimental physical and mental health. Periods of sustained WFS are predicted to increase with climate change, affecting populations globally. Using a retrospective cross-sectional study, we assessed perceptions of and responses to WFS in a cohort of New York State (NYS) residents in Summer 2023. Data were collected using an online survey from October to November 2023. Descriptive statistics summarized respondent experiences, while exploratory analyses identified high-risk populations using chi-square and t-tests. Our sample consisted of 609 primarily healthy, white, and well-educated individuals who spent most of their time in NYS during Summer 2023. Of the 99% that reported experiencing WFS, 92% received and 91% sought out WFS-related air quality information. While only 25% reported a WFS-related illness, 87% experienced at least one symptom with WFS, frequently citing watery eyes (63%), irritated throat (50%), and headaches (49%), with women reporting symptoms more frequently than men (89.1% vs. 81.6%; p = 0.034). A majority (93%) reported taking mitigation actions, including avoiding outdoor activities (75%) and wearing masks (54%). Our results highlight widespread impacts of wildfires in NYS during Summer 2023, with nearly all respondents reporting sustained periods of WFS. Most reported at least one adverse health symptom despite taking preventative measures, indicating that current protective strategies may be insufficient and more effective interventions are needed.
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Project description:INTRODUCTION:Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM2.5) in hospitality venues in Ghana. METHODS:This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana. RESULTS:Smoking was observed in a third of the venues visited. The median indoor PM2.5 concentration was 14.6 ?g/m3 (range: 5.2-349). PM2.5 concentrations were higher in venues where smoking was observed (28.3 ?g/m3) compared to venues where smoking was not observed (12.3 ?g/m3) (p<0.001). Hospitality locations in Accra, Ghana's capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale. CONCLUSIONS:The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.
| S-EPMC7252429 | biostudies-literature
Project description:ObjectivesSmoke-free legislation was implemented in Guangzhou on 1 September 2010. However, the smoke-free policy did not cover all indoor areas and smoking rooms can be set in some public places. This study aimed to assess changes in self-reported second-hand smoke (SHS) exposure in different types of venues and in homes, in order to evaluate the effectiveness of smoke-free legislation.Methods/designA repeated cross-sectional survey of representative participants was conducted in Guangzhou before and after the smoke-free legislation. Logistic regression models were used to examine the effectiveness of smoke-free legislation.Main outcome measuresSelf-reported exposure to SHS,antitobacco advertisements and tobacco advertisements.ParticipantsA total of 4900 participants before the ban and 5135 participants after the ban were selected using a multistage stratified design.ResultsIn full smoking ban places, overall self-reported SHS exposure has declined significantly from 58.8% to 50.3% (p<0.05) with greater drops in cultural venues, government offices and commercial venues. The smoke-free policy did not alter SHS exposure in smokers' homes (39.6% in 2009 vs 40.0% in 2011; p=0.454). Although a slight decrease in SHS exposure was observed in smoking rooms in hotels, workplaces, restaurants, cafes/bars/nightclubs and amusement parks, SHS continued to be high in those areas. The implementation of smoke-free legislation was accompanied by an increase in antitobacco advertisements.ConclusionsSHS exposure declines more significantly in full smoking ban places than in partial smoking ban places. The smoke-free policy in public places does not lead to more SHS exposure in homes. Therefore, it is recommended that Guangzhou should implement a 100% smoke-free policy in all public places and workplaces in the future.
| S-EPMC3927996 | biostudies-literature
Project description:ImportanceSecondhand smoke (SHS) exposure is associated with many health conditions in children and adults. Millions of individuals in the US are currently exposed to SHS in their homes.ObjectiveTo investigate whether a federal ban on smoking in public housing settings was associated with a decrease in indoor SHS levels in New York City public housing developments 12 months after the policy's implementation.Design, setting, and participantsThis cohort study tracked indoor air quality longitudinally from April 2018 to September 2019 and used difference-in-differences analysis to examine SHS exposure before vs after implementation of the 2018 federal smoke-free housing (SFH) policy in 10 New York City Housing Authority (NYCHA) buildings vs 11 matched low-income buildings not subject to the SFH policy (ie, Section 8 buildings).ExposuresFederal SFH policy implementation, beginning July 30, 2018.Main outcomes and measuresComparison of nicotine concentration levels from passive, bisulfate-coated filters before vs 12 months after implementation of the federal SFH policy. Secondary outcomes included changes in particulate matter less than 2.5 μm in diameter, measured with low-cost particle monitors, and counts of cigarette butts in common areas.ResultsAir quality was measured repeatedly in a total of 153 NYCHA and 110 Section 8 nonsmoking households as well as in 91 stairwells and hallways. Before the SFH policy implementation, air nicotine was detectable in 19 of 20 stairwells (95.0%) in NYCHA buildings and 15 of 19 stairwells (78.9%) in Section 8 buildings (P = .19) and in 17 of 19 hallways (89.5%) in NYCHA buildings and 14 of 23 hallways (60.9%) in Section 8 buildings (P = .004). Nicotine was detected less frequently inside nonsmoking apartments overall (26 of 263 [9.9%]) but more frequently in NYCHA apartments (20 of 153 [13.1%]) than in Section 8 apartments (6 of 110 [5.5%]) (P = .04). One year after policy implementation, there was no differential change over time in nicotine concentrations measured in stairwells (DID, 0.03 μg/m3; 95% CI, -0.99 to 1.06 μg/m3) or inside nonsmoking households (DID, -0.04 μg/m3; 95% CI, -0.24 to 0.15 μg/m3). Larger decreases in nicotine concentration were found in NYCHA hallways than in Section 8 hallways (DID, -0.43 μg/m3; 95% CI, -1.26 to 0.40 μg/m3).Conclusions and relevanceThe findings suggest that there was no differential change in SHS in NYCHA buildings 12 months after SFH policy implementation. Additional support may be needed to ensure adherence to SFH policies.
| S-EPMC7645700 | biostudies-literature
Project description:BackgroundTo support appropriate prescribing hospital-wide, the 'Check of Medication Appropriateness' (CMA) service was implemented at the University Hospitals Leuven. The CMA concerns a clinical rule based and pharmacist-led medication review service. The aim of this study was to explore both physicians' and pharmacists' feedback on the optimised CMA service to further improve the service.MethodsAn anonymous e-questionnaire was sent to all physicians active in the University Hospitals Leuven (n = 1631) and to all clinical pharmacists performing the CMA service (n = 16). Feedback was collected using multiple choice questions. During a 5-month period, physicians were also contacted in case of non-acceptance of recommendations to investigate barriers affecting implementation. Thematic analysis was performed and additional acceptance after telephone contact within 24 h was registered.ResultsA total of 119 physicians (7.3%) and 16 pharmacists (100%) completed the e-questionnaire. The overall service was assessed as clinically relevant to highly relevant by 77.7% of physicians. The main reasons for non-acceptance of recommendations were related to workload, work environment and time constraints. About two thirds (66.3%) of initially not-accepted recommendations were accepted after phone contact. A nearly full consensus was reached among pharmacists (15/16) on the centralised CMA being complementary to current clinical pharmacy activities. Two major barriers were reported by pharmacists: (1) too limited time allocation and (2) a large number of irrelevant alerts.ConclusionsThe CMA was perceived as clinically relevant by the majority of end-users. Acceptance rate of pharmaceutical recommendations was further increased by calling the physician. Increasing the specificity of clinical rules in the future is imperative.
| S-EPMC9258110 | biostudies-literature