Community-wide Implementation of a Smoke-Free Policy in Multi-Unit Housing in Western New York: Anticipation, Application and Adoption

Objectives: In 2013, a community in Western New York implemented smoke-free policies in its 25 Multi-Unit Housing (MUH) complexes serving primarily low-income populations. This paper presents evaluation findings on MUH managers’ and residents’ anticipated concerns prior to the adoption of the policy, implementation processes and challenges, and initial reactions as they adapted to the new ban on smoking. 

Methods: Pre and post policy implementation data included MUH resident and manager surveys examining reactions to the new policy, and environmental assessments via a PhotoVoice project. Process data consisted of the extent of policy implementation and available community resources.

Results: Residents’ anticipated and actual reactions to the policy were mixed and primarily dependent upon their smoking habits. MUH had more concerns pre-implementation than post including: losing tenants who smoke, potential tenant lawsuits, the impact on disabled and elderly tenant smokers. PhotoVoice data revealed changes in the physical environment, including differences between complexes. Data informed needed physical changes pre (e.g., potential no-smoking sign placement) and post implementation (e.g., sign visibility, evidence of smoking around signs).    

Conclusions: Smoke-free policy implementation was facilitated by multiple community agencies working together to support the MUH tenants and managers.  Early post implementation, positive attitudinal, behavioral and environmental changes were observed, challenges were identified, and recommendations proposed.  The experiences of this community-wide effort may inform implementation of smoke-free policies as more communities move towards the national objective of ensuring a smoke-free environment for all.