Tobacco & Nicotine Products
Smoke-free Home Rules (SFHRs) among African American Public Housing Residents
(School of Public Health (UMD) Behavioral and Community Health Doctoral Student)
BACKGROUND Smoking in public housing units is a pressing public health problem given the overwhelming evidence of the negative impact of second-hand smoke and the difficulty of containing such smoke in multiunit housing. This environmental tobacco exposure (ETS) in public housing is particularly troublesome because it afflicts disadvantaged and vulnerable populations, those suffering with poverty and disabling physical and mental conditions. Adopting smoke-free home rules (SFHRs) have been proven effective in restricting home smoking and curbing the ETS. This study aims to explore the predictors of adopting a SFHR in public housing with the highest incidence of African Americans in order to design public health practices for increasing the prevalence of SFHRs among this population. METHODS Data (N=62) were drawn from a survey designed to explore smoking patterns and smoking cessation behaviors among African American public housing residents in Pittsburgh, PA. Participants were considered as having a SFHR when they reported smoking was allowed in some places or at some times in their home, or where no one was allowed to smoke anywhere at any time in the home. Predictors associated with the adoption of SFHRs were analyzed in a bivariate logistic regression, controlling for socio-demographic factors. RESULTS Overall, 46.8% (N=29) of participants reported a SFHR, with 50% (N=22) of females and 38.9% (N=7) of males reporting such a rule. The results indicated that the perception of risk harming others when smoking in home (AOR: 7.44, 95% CI:1.07-51.61) was associated with a higher likelihood of adopting SFHRs; whereas, having more than four best friends smoking (AOR:0.03, 95% CI: 0.01-0.83), living with other smokers (AOR:0.1, 95% CI: 0.01-0.81), and having a higher level of religious involvement (AOR: 0.77, 95% CI: 0.60-0.99) were associated with a lower likelihood of restricting home smoking. Having children living together, marriage status, and readiness of quitting smoking were not associated with the rule adoption. CONCLUSION With the goal of increasing the adoption of SFHRs, we learned (1) increasing education about the harm of ETS is a powerful strategy; and (2) addressing family and social tensions when adopting such a rule should be promoted as a means of increasing the rules efficacy and duration. More works need to be done to understand the association of religious involvement and SFHR adoption. One possible explanation is those individuals reporting higher levels of religious involvement have deferred their health-decisions to a religious deity, indicating a lower level of competency adopting an effective method for addressing smoking related health and social issues. The data from this study support this hypothesis since the reporting of religious involvement had a strong positive association with coping (r=0.34, p<0.01). Future programs targeting this population should consider this population’s coping strategies in order to increase their adoption of SFHRs.
Importance to public health: