Effect of the Housing and Urban Development’s Smokefree Public Housing Rule on Air Quality and Health in the District of Columbia

摘要 这项研究的目的是提供一个全面的评估美国住房和城市发展的 （HUD）无烟公共住房规则，2018年8月3日生效，在哥伦比亚特区住房管理局。 该规定禁止在所有生活单位，公共区域，行政办公室使用点燃的烟草产品和水烟 在所有公共住房设施中，建筑物和室外面积不超过25英尺。该规则的主要目标是创建 为公屋家庭提供更健康的居所。禁止在公共场所吸烟的烟草使用控制法 这些地方帮助减少了40%的吸烟率， 71%。尽管一般人口的这些指标有所下降，但仍取得了相当大的进展。 低收入、种族和少数民族因吸烟而受到不成比例的伤害， 二手烟暴露。家庭仍然是SHSe的重要来源，部分原因是 成人和儿童在家中度过的时间。SHSe在多单元住房中特别成问题， 二手烟可透过通风系统及其他途径进入非吸烟单位。而 一些研究表明，无烟公共住房对室内空气质量、SHSe和吸烟有积极影响 停止，存在限制。也就是说，有一个以上干预后评估的纵向研究， 评估对短期和长期健康结果的影响的研究，以及包括目标 需要对二手烟暴露进行测量。本研究解决了方法的局限性， 是目前评价研究的热点，是专门针对HUD规则的效果进行评价的。了质的 将采用这种方法记录规则的执行过程。定量方法将是 用于评估该规则对成人和儿童SHSe和健康结果的影响。评价 将包括三个队列：一个队列的住宅，以评估影响HUD政策对SHSe，一个队列的 吸烟成年人评估规则对吸烟行为的影响，以及一组患有哮喘的青年人评估 该规则对儿童呼吸系统健康的影响。基线数据收集将在2018年8月之前进行， 拟议研究的资金将用于四项实施后评估（最长24个月） 规则）。该规则的不同影响将在家庭和老年人/残疾人社区进行审查。 评估这一规则至关重要，因为超过200万公共住房居民将受到影响， 这一规则有可能减少与烟草有关的健康差距。在目前情况下有效的程序 这项研究有可能在未来加速烟草控制政策的实施。

Abstract The goal of this study is to provide a comprehensive evaluation of the U.S. Housing and Urban Development's (HUDs) smoke-free public housing rule, effective August 3, 2018, in the District of Columbia Housing Authority. The rule prohibits lit tobacco products and hookah use in all living units, common areas, administrative office buildings, and outdoor areas up to 25 feet in all public housing facilities. A primary goal of the rule is to create healthier homes for families living in public housing. Tobacco use control laws that prohibit smoking in public places have helped reduce smoking prevalence by 40% and exposure of nonsmokers to secondhand smoke by 71%. Even with declines in these indicators for the general population, progress has been considerably slower for low-income, racial and ethnic minorities who experience disproportionate harm from smoking and secondhand smoke exposure. Homes remain a significant source of SHSe due, in part, to the substantial amount of time adults and children spend in the home. SHSe is particularly problematic in multiunit housing, where secondhand smoke can enter non-smoking units through ventilation systems and other means. While a few studies suggest positive effects of smoke-free public housing on indoor air quality, SHSe, and smoking cessation, limitations exist. Namely, longitudinal studies with more than one post-intervention assessment, studies evaluating the effect on short- and long-term health outcomes, and studies that include objective measures of secondhand smoke exposure are needed. This study addresses the methodological limitations of current evaluation studies and is designed to evaluate the effect of HUDs rule specifically. A qualitative approach will be used to document the implementation process of the rule. A quantitative approach will be used to evaluate the effects of the rule on SHSe and health outcomes of adults and children. The evaluation will include three cohorts: a cohort of residences to assess the effect of HUDs policy on SHSe, a cohort of smoking adults to assess effects of the rule on smoking behavior, and a cohort of youth with asthma to assess effects of the rule on children's respiratory health. Baseline data collection will occur prior to August 2018, and funding from the proposed study will be used for four post-implementation assessments (up to 24-months post rule). Differential effects of the rule will be examined across family and senior/disabled communities. Evaluating this rule is critical, given that over 2 million public housing residents will be effected and the potential for this rule to reduce tobacco-related health disparities. Processes found to be effective in the current study have the potential to accelerate the implementation of tobacco control policies in the future.