'If I pay rent, I'm gonna smoke': Insights on the social contract of smokefree housing policy in affordable housing settings

Abstract

Smoke-free housing policy in multi-unit housing has emerged as a promising tobacco control initiative, yet full compliance remains elusive and is a critical impediment to policy effectiveness. There is a gap in existing research on potential factors preventing optimal smoke-free policy adoption and corresponding solutions. Using qualitative and quantitative data from resident surveys (N = 115) as well as key informant interviews, a focus group, and observational fieldwork, this study 1) assesses smoking behaviors and experience with secondhand smoke in buildings after adoption of a smoke-free policy; 2) examines resident and property management perceptions of the policy; and 3) identifies socioecological factors that influence the policy's effectiveness in affordable housing settings in New York City. Findings indicate that residents view smoking regulations within the context of broader relationships with the housing provider and other residents. We argue that these "social contracts" strongly influence the effectiveness of smoke-free housing policies and must be acknowledged to maximize compliance.

Keywords: Affordable housing; Smoke-free housing; Social determinants; Tobacco control; Urban health.

Conflict of interest statement

Declarations of interest

None.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Figures

Fig. 1.

Building playground – gap between the mats are littered with trash and cigarette butts.

Fig. 2.

Hallway window littered with cigarette butts.

Fig. 3.

Staircases with cigarette filter and packet.

Fig. 4.

Padlocked terrace gate, closed due to vandalism and marijuana smoking. Tenants identified it as a potential designated smoking area.

Fig. 5.

The social contract of smoke-free housing and levers to promote policy effectiveness.