Reducing Environmental Tobacco Smoke Exposure in Public Housing

减少公共住房中的环境烟草烟雾暴露

• 批准号: 8631097
• 负责人: Douglas Levy
• 金额: $ 67.87万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8631097
• 关键词: Address; Adult; Affect; Air; Area; Asthma; Attitude; Behavior; Belief; Boston; Boston Post; Cardiovascular Diseases; Cardiovascular system; Cities; Cotinine; Country; Development; Disabled Persons; Economics; Environmental Tobacco Smoke; Exposure to; Goals; Health; Health Benefit; Household; Housing; Human; Individual; Institutes; Intervention; Knowledge; Locales; Location; Longitudinal Studies; Low income; Lung; Malignant neoplasm of lung; Measurement; Measures; Morbidity - disease rate; Nicotine; Outcome; Participant; Particulate Matter; Passive Smoking; Patient Self-Report; Policies; Policy Maker; Population; Property; Public Health; Public Housing; Public Policy; Regulation; Reporting; Research; Resort; Respiratory Tract Infections; Saliva; Salivary; Site; Smoke; Smoker; Smoking; Source; Surveys; Testing; Time; Tobacco smoke; Tobacco smoking; U.S. Department of Housing and Urban Development; Workplace; air monitoring; authority; experience; falls; follow-up; frontier; improved; longitudinal design; mortality; non-smoker; non-smoking; population health; residence; respiratory; restricting smoking; smoke-free policy; success; time use; tobacco exposure

DESCRIPTION (provided by applicant): Environmental tobacco smoke (ETS), also known as secondhand smoke or passive smoking, is a threat to non-smokers' health, causing and exacerbating asthma, as well as upper and lower respiratory infections, cardiovascular disease (CVD), and lung cancer. There is no safe level of ETS exposure. Human ETS exposure is highest among low-income groups and non-smoking households in multiunit housing (MUH), including public housing, have elevated levels of ETS. Public housing residents' vulnerability to ETS exposure is heightened because they are in housing of last resort without the means to avoid exposure by changing residences. Public policies such as workplace smoking bans have resulted in demonstrated improvements in population health, leading to lower levels of ETS exposure for non-smokers and lower rates of adverse cardiovascular and respiratory outcomes. In June of 2009, the Department of Housing and Urban Development called on local housing authorities to implement smoke-free policies. Because MUH is one of the last frontiers of smoking regulation, it is not clear whether smoke-free housing rules will be effective at reducing non-smokers' exposure to ETS, particularly in public housing, and to date there have been no comprehensive studies. In 2010, the city of Boston, MA declared that the properties of the Boston Housing Authority (BHA), including residences, will become entirely smoke-free in the fall of 2012, making Boston's the largest public housing authority in the country with such plans. Our proposed study seizes on this unique moment in time, using a quasi- experimental, longitudinal design to test the hypothesis that smoke-free policies in public housing reduce residents' exposures to ETS. The BHA is our intervention site. Our control site is the Cambridge Housing Authority (CHA) in Cambridge, MA where no smoke-free housing policy will be implemented. We will conduct difference-in-differences analyses to test whether changes in ETS levels and exposure from summer 2012 (pre-BHA smoke-free housing policy) to summer 2013 (post-BHA smoke-free policy) are greater for the intervention site (BHA) than for the control site (CHA). At least 150 randomly selected non-smoking households from each site will undergo pre and post assessments, and one resident from each household will be included in the study. ETS exposure will be assessed by measuring participants' saliva cotinine; air quality in households and common areas (airborne nicotine and particulate matter - PM2.5); and participants' self- reports. In addition, the sources of exposure to ETS will be determined by airborne nicotine, air flow, and PM2.5 measurements, as well as residents' self-report. Additionally, residents will be surveyed on their knowledge, attitudes, beliefs, and behaviors towards ETS and smoke-free policies. Understanding Boston's experience implementing the policy, and understanding the impact the policy's effect on public health will provide crucial information to policy makers and other housing authorities as these policies become more commonplace.

描述（由申请人提供）：环境烟草烟雾（ETS），也称为二手烟或被动吸烟，是对非吸烟者健康的威胁，可引起和加重哮喘，以及上呼吸道和下呼吸道感染、心血管疾病（CVD）和肺癌。ETS暴露没有安全水平。人类ETS暴露在低收入群体中最高，在多单元住房（MUH）（包括公共住房）中的非吸烟家庭ETS水平较高。公共住房居民对ETS暴露的脆弱性增加，因为他们住在最后的住房中，没有办法通过改变住所来避免暴露。公共政策，如工作场所禁烟，已导致人口健康的明显改善，导致非吸烟者的ETS暴露水平降低，心血管和呼吸系统不良后果的发生率降低。2009年6月，住房和城市发展部呼吁地方住房当局实施无烟政策。由于MUH是吸烟管制的最后前沿之一，目前尚不清楚无烟住房规则是否能有效减少非吸烟者接触ETS，特别是在公共住房中，迄今为止还没有全面的研究。2010年，马萨诸塞州波士顿市宣布，波士顿住房管理局（BHA）的财产，包括住宅，将在2012年秋季完全禁烟，使波士顿成为全国最大的公共住房管理局。我们提出的研究抓住了这一独特的时刻，使用准实验，纵向设计，以测试假设，无烟政策在公共住房减少居民暴露于ETS。BHA是我们的干预现场。我们的控制站点是位于马萨诸塞州剑桥的剑桥住房管理局（CHA），在那里将不实施无烟住房政策。我们将进行差异中差异分析，以检验从2012年夏季（BHA前无烟住房政策）到2013年夏季（BHA后无烟政策），干预地点（BHA）的ETS水平和暴露变化是否大于对照地点（CHA）。每个研究地点最少会随机抽取150个非吸烟住户进行评估，每个住户会有一名居民参与研究。ETS暴露将通过测量参与者的唾液可替宁、家庭和公共区域的空气质量（空气中的尼古丁和颗粒物-PM2. 5）以及参与者的自我报告来评估。此外，ETS的暴露来源将通过空气中尼古丁、空气流量和PM2.5测量以及居民的自我报告来确定。此外，还将调查居民对ETS和无烟政策的知识、态度、信念和行为。了解波士顿实施该政策的经验，并了解该政策对公共卫生的影响，将为政策制定者和其他住房当局提供关键信息，因为这些政策变得越来越普遍。