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Evaluating a city s smokefree policy in multi-unit housing

Institution: University of California, San Francisco
Investigator(s): Valerie Yerger, ND, MA
Award Cycle: 2011 (Cycle 20) Grant #: 20CA-0105H Award: $671,299
Subject Area: Public Health, Public Policy, and Economics
Award Type: California Research Award

Initial Award Abstract
An emerging interest in the tobacco control movement focuses on the elimination of smoking in multi-unit housing (MUH), such as apartments, condominiums, townhomes, and other attached homes. This project will evaluate a new citywide ordinance that bans smoking in MUH in Richmond, California. We will assess what community stakeholders such as MUH residents, landlords, and homeowners’ associations (HOA) know about the ordinance, and explore how the City of Richmond can implement it with cooperation from these key stakeholders.

California has made significant progress in reducing the level of tobacco smoke people are exposed to when they are in public places. However, individuals can spend as much as 90% of their time indoors, with 65% of this time inside their homes. Those who are homebound, such as the elderly and disabled, and who suffer from heart or respiratory diseases are especially vulnerable to the harmful effects of secondhand smoke if they live in MUH and have neighbors who smoke. Secondhand smoke, a by-product of cigarette smoking that can cause cancer in humans, seeps under doorways and through wall cracks. Children who live with people who smoke in the home are 44% more likely to suffer from asthma than those children who live in homes with clean air.

Effective January 1, 2011, it is illegal to smoke inside Richmond's multi-unit residences, within the private areas of those residences (including balconies, patios, and decks), and in the common areas of the MUH. Any tenant who breaks the law, or knowingly allows another person to do so, will be legally responsible to the landlord, HOA and any occupant exposed to secondhand smoke resulting from the illegal smoking. Tobacco control advocates nationwide have recognized the importance of this innovative policy; yet ironically, Richmond residents and other stakeholders appear to lack information about the city’s smokefree policy designed to benefit them.

Our project has three aims: (1) Assess knowledge of Richmond’s smokefree MUH ordinance among MUH residents, landlords, homeowners’ associations and other stakeholders, and elicit their suggestions for improving understanding and acceptance of the ordinance by the community; (2) Evaluate the levels of implementation of the policy by the City of Richmond (including promulgation, enforcement, and adjudication), with the aim of identifying specific ways in which implementation can be improved; and (3) Based on findings from Specific Aims 1 and 2, develop a community-level, user-friendly intervention that serves to inform the community about the policy and to bolster stakeholder ability to carry out each step of implementation, in order to ensure that the stated policy goals are met.

We will conduct focus groups with community stakeholders such as residents, landlords, and HOAs from Richmond. We will do one-on-one interviews with officials from Richmond and the corresponding Contra Costa County, law enforcement, local public health advocates, and representatives from community-based organizations. We will do content analysis of data collected from the focus groups and interviews. Results derived from the content analysis will help us to determine the community-level intervention. Within the time constraints of the three-year project, we will identify and document the successes and challenges of implementing the intervention. This project will also provide an opportunity to build community capacity by engaging stakeholders and building friendly partnerships.

Given that smokefree policies in MUH is a new area of interest in tobacco control, it is important to understand how community residents and other stakeholders adopt and carry out these policies. The proposed study offers an opportunity to conduct an in-depth case study of how best to implement such a policy. The overall goal of this project is to ensure that this new and innovative policy is adopted and implemented citywide. Additionally, results generated from this study could inform other communities in California and beyond as to how they can smoothly adopt and implement similar policies.