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Attitudes and experiences with secondhand smoke and smoke-free policies among subsidised and market-rate multiunit housing residents living in six diverse communities in the USA
  1. Andrea S Gentzke1,2,
  2. Andrew Hyland1,
  3. Marc Kiviniemi3,
  4. Mark J Travers1
  1. 1 Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
  2. 2 Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA
  3. 3 Department of Community Health and Health Behavior, State University of New York at Buffalo, Buffalo, New York, USA
  1. Correspondence to Dr Andrea S Gentzke, Department of Health Behavior, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, USA ; aslicht01{at}


Background Given that higher smoking rates persist among lower socioeconomic populations, multiunit housing (MUH) environments may result in higher secondhand smoke (SHS) exposures among subsidised MUH residents. This cross-sectional assessment compares experiences with SHS and smoke-free policies among subsidised and market-rate MUH residents living in six US communities.

Methods MUH residents (n=1565) were surveyed regarding their smoke-free rules (home and building), SHS exposures and preferences towards smoke-free policies. Binary logistic regression identified predictors of each outcome, focusing on differences by subsidised housing status (subsidised vs market rate).

Results Among residents enforcing smoke-free home rules (76%, overall), 50% reported SHS incursions into their unit. Only 23% reported living in a smoke-free building; 56% of those living in smoking-allowable buildings reported preferences towards smoke-free building policies. Among market-rate housing residents, smoke-free home (OR=4.18) and building (OR=2.26) rules were significantly higher when children were present. Smoke-free building rules reduced the odds of SHS incursions among market-rate housing residents (OR=0.50), but no association was observed among subsidised housing residents. Non-smoking subsidised housing residents exhibited stronger preferences for smoke-free policies compared with those in market-rate housing.

Discussion Smoke-free home rules may not protect MUH residents from SHS exposures, particularly in subsidised MUH. Although strong preferences towards smoke-free policies were present overall, subsidised MUH residents may have fewer alternative smoke-free housing options available. Therefore, all publicly funded housing should be smoke free to protect these vulnerable populations. However, continued efforts to encourage privately owned MUH operators to adopt smoke-free policies are also necessary.

  • Secondhand Smoke
  • Multiunit Housing
  • Policy
  • Smoke-free

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  • Contributors All authors were involved in the conceptualisation of this manuscript. ASG conducted the statistical analyses and completed the initial draft of the manuscript. All authors contributed to the interpretation of results and approved the final submitted and revised versions of this manuscript.

  • Funding This project was funded by R01CA151953 (NCI; Travers, Roswell Park Cancer Institute) and R25CA113951 (NCI; Freudenheim, State University of New York at Buffalo).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.