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

摘要 这项研究的目标是对美国住房和城市发展局的 (HUDS)哥伦比亚特区住房管理局无烟公共住房规定，2018年8月3日生效。 该规定禁止在所有居住单位、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，建筑物和户外面积可达25英尺。该规则的主要目标是创建 为居住在公共住房的家庭提供更健康的住房。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%的吸烟率和非吸烟者对二手烟的暴露。 增加了71%。即使普通人口的这些指标有所下降，但进展仍然相当可观。 对于低收入、种族和少数民族来说，吸烟和吸烟造成的伤害不成比例 接触二手烟。住房仍然是SHSE的一个重要来源，部分原因是 成人和儿童在家中度过的时间。SHSE在多单元住房中尤其成问题， 二手烟可以通过通风系统和其他方式进入无烟单元。当一个 很少有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，限制存在。即，具有一项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 二手烟暴露的措施是必要的。这项研究解决了方法学上的局限性。 目前的评估研究旨在具体评估HUDS规则的效果。一种定性的 将使用一种方法来记录该规则的实施过程。量化的方法将是 用于评估该规则对成人和儿童的SHSE和健康结果的影响。评估 将包括三个队列：评估HUDS政策对SHSE的影响的住宅队列， 吸烟成年人评估该规则对吸烟行为的影响，并对一组患有哮喘的青年进行评估 该规则对儿童呼吸道健康的影响。基准数据收集将在2018年8月之前进行，以及 拟议研究的资金将用于四项实施后评估(最多24个月员额 规则)。将审查这项规定在家庭和老年人/残疾人社区的不同影响。 评估这项规定至关重要，因为超过200万公屋居民将受到影响，而 这项规则有可能减少与烟草有关的健康差距。被发现在当前有效的过程 这项研究有可能在未来加快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.