Community Engagement Approach to Smoke-Free Public Housing for Seniors

Background: Private residences are among the last frontiers for clean indoor air policies; residents in multi-dwelling units are often exposed to secondhand smoke from neighbors. In 2009, HUD encouraged (not required) Public Housing Authorities to go smoke-free. Before implementing a smoke-free policy in a senior complex, a housing authority agency initiated a community engagement process to assess residents' perceptions about imposing a smoke-free policy.

Methods: Housing authority residents were engaged in the development and implementation of the study. Seventy-five (60%) of residents in a senior citizen complex were surveyed regarding their perception of smoking, secondhand smoke, and the proposed policy. Two separate focus groups of smokers and nonsmokers provided additional insight about survey findings.

Results: Thirty-seven percent of the residents were current smokers. The majority of smokers (75%) were aware of the dangers of second hand smoke and the majority of both groups (80% of non-smokers vs. 82% of smokers) agreed this was a violation of non-smokers' rights.

Conclusions: Low income residents remain the most exposed to secondhand smoke. Because the elderly in public housing have so many tobacco-related health issues, and spend the majority of their time in their homes, they especially need protection. Before implementing a smoke-free policy, the majority in both groups indicated the housing authority should: make policy clear, give ample notice, educate residents, and find resources to help smokers who wanted to quit.

Learning Objectives: Describe how to use a community engagement approach to develop and implement a smoke-free policy for seniors in public housing.