search for



KCI

Crossref

Cross mark

Cited-by

Fundref

TDM

View (76) Download (30) CrossRef (1)
Introduction of the Smoke-Free Public Housing Policy in the United States and its Implications for Korea
J Korean Soc Res Nicotine Tob 2024; 15(4): 117-125
Published online December 30, 2024
© 2024 The Korean Society for Research on Nicotine and Tobacco.

Boram Lee1*, Eon Sook Lee2, Douglas E. Levy3,4,5

1Department of Public Health and Health Sciences, Northeastern University, Boston, MA, USA, 2Inje University, College of Medicine, Ilsanpaik Hospital, Goyang, Korea, 3Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA, 4Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, 5Harvard Medical School, Boston, MA, USA
Correspondence to: *이보람
미국 노스이스턴대학 박사후연구원
E-mail: bo.lee@northeastern.edu
Received September 26, 2024; Revised December 24, 2024; Accepted December 25, 2024.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Secondhand smoke exposure in multiunit housing poses a significant health risk. In Korea, the current smoke-free policy for multiunit housing allows residents to designate shared areas of apartment complexes (i.e., hallways, stairs, elevators, and parking lots) as non-smoking areas. However, this policy does not extend to private spaces, including residential units and balconies, leaving gaps in protection. This paper examines the smoke-free policy for public (i.e., government-subsidized) housing in the United States (US), which prohibits smoking in all indoor areas, including residents’ units, and outdoor areas within 25 feet of the building entrance. We review the US policy’s history, scientific rationale, and evaluation, and discuss the implications of the policy to the smoke-free housing policy in Korea. The US experience highlights the importance of extending non-smoking areas throughout indoor areas of apartment complexes and provides strategic lessons for successful implementation (e.g., resident engagement, effective communication, smoking cessation support, designating appropriate smoking areas, establishing realistic enforcement methods, and partnering with external organizations). This paper calls for further research and policy discussions to promote a more comprehensive smoke-free housing policy in Korea.
Keywords : Smoke-free policy; Smoke-free home; Secondhand smoke; Tobacco control policy in the United States
References
  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014.
  2. Kraev TA, Adamkiewicz G, Hammond SK, Spengler JD. Indoor concentrations of nicotine in low-income, multi-unit housing: associations with smoking behaviours and housing characteristics. Tob Control. 2009; 18(6): 438-44.
    Pubmed KoreaMed CrossRef
  3. Russo ET, Hulse TE, Adamkiewicz G, Levy DE, Bethune L, Kane J, et al. Comparison of indoor air quality in smoke-permitted and smoke-free multiunit housing: findings from the Boston Housing Authority. Nicotine Tob Res. 2015; 17(3): 316-22.
    Pubmed KoreaMed CrossRef
  4. Snyder K, Vick JH, King BA. Smoke-free multiunit housing: a review of the scientific literature. Tob Control. 2016; 25(1): 9-20.
  5. Korea Statistical Information Service. Housing census. Housing units by type of housing units. 2023;
  6. National Health Promotion Act, Act No. 14777. Article 9(5).
  7. National Health Promotion Act, Act No. 14777. Article 34(3).
  8. 공공데이터포털. 한국건강증진개발원 국가금연지원서비스 실적(금 연구역지도점검). 2024.10.08 https://www.data.go.kr/data/15092413/fileData.do#tab-layer-file (Accessed on November 26, 2024).
  9. Kim HS. Achievements and emerging challenges of smoking ban policy in Korea. J Korean Soc Res Nicotine Tob. 2022; 13(4): 116-29.
    CrossRef
  10. Hwang J, Park E, Cho S il. A Qualitative study of smoke-free areas in apartment buildings: Current situation and a way forward. Health Soc Welf Rev. 2019; 39(3): 602-32.
    CrossRef
  11. Federal Register. Instituting Smoke-Free Public Housing; FR 87430: 87430-87444; U.S. Department of Housing and Urban Development: Washington, DC, USA, 2016; Volume 81. 2016 Dec 5;
  12. Kegler MC, Lea J, Lebow-Skelley E, Lefevre AM, Diggs P, Haardorfer R. Implementation and enforcement of smoke-free policies in public housing. Health Educ Res. 2019; 34(2): 234-46.
    Pubmed KoreaMed CrossRef
  13. Hernández D, Swope CB, Azuogu C, Siegel E, Giovenco DP. ‘If I pay rent, I’m gonna smoke‘: insights on the social contract of smokefree housing policy in affordable housing settings. Health Place. 2019; 56: 106-17.
    Pubmed KoreaMed CrossRef
  14. Fargen J. Fargen, J. Grandma breathes easier in smoke-free housing. Boston Herald. November 18, 2018. Accessed November 11, 2024.
  15. McCabe K. HRiA welcomes news that all public housing in U.S. will be smoke-free in 18 months. Health Resources in Action. December 1, 2016. Available at https://hria.org/2016/12/01/hria-welcomes-newspublic-housing-u-s-will-smoke-free-18-months/ (Accessed on November 11, 2024).
  16. Boston Housing Authority. Smoke-Free Housing at BHA. https://www.bostonhousing.org/en/SmokeFreeBHA.aspx (Accessed on November 11, 2024).
  17. American Nonsmokers’ Rights Foundation. U.S. Public Housing Authority Policies Restricting or Prohibiting Smoking.
  18. United States Department of Housing and Urban Development (HUD). HUD Archives: HUD secretary Castro announces public housing to be smoke-free. November 30, 2016. [Internet].
  19. Akter S, Islam MdR, Rahman MdM, Rouyard T, Nsashiyi RS, Hossain F, et al. Evaluation of population-level tobacco control interventions and health outcomes: A systematic review and meta-analysis. JAMA Netw Open. 2023; 6(7): e2322341.
    Pubmed KoreaMed CrossRef
  20. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services. Atlanta, GA: Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2006.
  21. Alpert HR, Behm I, Connolly GN, Kabir Z. Smoke-free households with children and decreasing rates of pediatric clinical encounters for otitis media in the United States. Tob Control. 2011; 20(3): 207-11.
    Pubmed CrossRef
  22. McFarlane A, Djoko Y, Woodward A. Instituting smoke-free public housing: An economic analysis. Cityscape. 2017; 19(3): 435-48.
  23. King BA, Peck RM, Babb SD. National and state cost savings associated with prohibiting smoking in subsidized and public housing in the United States. Prev Chronic Dis. 2014; 11: E171.
    Pubmed KoreaMed CrossRef
  24. Horn K, Dearfield CT, Beth Johnson S, Krost K, Rincon Gallardo Patino S, Gray T, et al. Smoking cessation intentions and attempts one year after the federally mandated smoke-free housing rule. Prev Med Rep. 2021; 24: 101600.
    Pubmed KoreaMed CrossRef
  25. Rokicki S, Adamkiewicz G, Fang SC, Rigotti NA, Winickoff JP, Levy DE. Assessment of residents’ attitudes and satisfaction before and after implementation of a smoke-free policy in Boston multiunit housing. Nicotine Tob Res. 2016; 18(5): 1282-9.
    Pubmed KoreaMed CrossRef
  26. Galiatsatos P, Koehl R, Caufield-Noll C, Brigham E, Leone FT, Eakin M, et al. Proposal for smoke-free public housing: a systematic review of attitudes and preferences from residents of multi-unit housing. J Public Health Policy. 2020; 41(4): 496-514.
    Pubmed CrossRef
  27. Jiang N, Gill E, Thorpe LE, Rogers ES, de Leon C, Anastasiou E, et al. Implementing the federal smoke-free public housing policy in New York City: Understanding challenges and opportunities for improving policy impact. Int J Environ Res Public Health. 2021; 18(23): 12565.
    Pubmed KoreaMed CrossRef
  28. Cheng D, Fung V, Shah R, Goldberg S, Lee B, Song G, et al. Smoke-free policies and resident turnover: An evaluation in Massachusetts public housing from 2009‒2018. Am J Prev Med. 2023; 64(4): 503-11.
    Pubmed KoreaMed CrossRef
  29. Anastasiou E, Gordon T, Wyka K, Tovar A, Gill E, Rule AM, et al. Long-Term trends in secondhand smoke exposure in high-rise housing serving low-income residents in New York city: three-year evaluation of a federal smoking ban in public housing, 2018-2021. Nicotine Tob Res. 2023; 25(1): 164-9.
    Pubmed KoreaMed CrossRef
  30. Curry LE, Feld AL, Rogers T, Coats EM, Nonnemaker J, Anker E, et al. Changes in reported secondhand smoke incursions and smoking behavior after implementation of a federal smoke-free rule in New York state federally subsidized public housing. Int J Environ Res Public Health. 2022; 19(6): 3513.
    Pubmed KoreaMed CrossRef
  31. MacNaughton P, Adamkiewicz G, Arku RE, Vallarino J, Levy DE. The impact of a smoke-free policy on environmental tobacco smoke exposure in public housing developments. Sci Total Environ. 2016; 557-558: 676-80.
    Pubmed KoreaMed CrossRef
  32. Kingsbury JH, Reckinger D. Clearing the air: smoke-free housing policies, smoking, and secondhand smoke exposure among affordable housing residents in Minnesota, 2014-2015. Prev Chronic Dis. 2016; 13: E111.
    Pubmed KoreaMed CrossRef
  33. Lathen LS, Plears ML, Shartle EL, Conner KL, Fiore MC, Christiansen BA. The HUD smoke-free rule: Perceptions of residents postimplementation. Prev Med Rep. 2020; 19: 101159.
    Pubmed KoreaMed CrossRef
  34. Levy DE, Adamkiewicz G, Rigotti NA, Fang SC, Winickoff JP. Changes in tobacco smoke exposure following the institution of a smoke-free policy in the Boston housing authority. PloS One. 2015; 10(9): e0137740.
    Pubmed KoreaMed CrossRef
  35. Plunk AD, Rees VW, Jeng A, Wray JA, Grucza RA. Increases in secondhand smoke after going smoke-free: an assessment of the impact of a mandated smoke-free housing policy. Nicotine Tob Res Off J Soc Res Nicotine Tob. 2020; 22(12): 2254-6.
    Pubmed KoreaMed CrossRef
  36. Young W, Karp S, Bialick P, Liverance C, Seder A, Berg E, et al. Health, Secondhand Smoke Exposure, and Smoking Behavior Impacts of No-Smoking Policies in Public Housing, Colorado, 2014-2015. Prev Chronic Dis. 2016; 13: E148.
    Pubmed KoreaMed CrossRef
  37. Titus AR, Mijanovich TN, Terlizzi K, Ellen IG, Anastasiou E, Shelley D, et al. A matched analysis of the association between federally mandated smoke-free housing policies and health outcomes among Medicaidenrolled children in subsidized housing, New York City, 2015-2019. Am J Epidemiol. 2023; 192(1): 25-33.
    Pubmed KoreaMed CrossRef
  38. Lee B, Fung V, Cheng D, Winickoff JP, Rigotti NA, Shah R, et al. Implementation activities in smoke-free public housing: the Massachusetts experience. Int J Environ Res Public Health. 2023; 20(1): 78.
    Pubmed KoreaMed CrossRef
  39. Anthony J, Goldman R, Rees VW, Frounfelker RL, Davine J, Keske RR, et al. Qualitative assessment of smoke-free policy implementation in low-income housing: Enhancing resident compliance. Am J Health Promot. 2019; 33(1): 107-17.
    Pubmed KoreaMed CrossRef
  40. Levy DE, Adams IF, Adamkiewicz G. Delivering on the promise of smoke-free public housing. Am J Public Health. 2017; 107(3): 380-3.
    Pubmed KoreaMed CrossRef
  41. Dearfield CT, Ulfers M, Horn K, Bernat DH. Resident support for the federally mandated smoke-free rule in public housing: 2018-2022. Int J Environ Res Public Health. 2024; 21(1): 102.
    Pubmed KoreaMed CrossRef
  42. Satterlund TD, Treiber J, Kipke R, Cassady D. A qualitative evaluation of 40 voluntary, smoke-free, multiunit, housing policy campaigns in California. Tob Control. 2014; 23(6): 491-5.
    Pubmed KoreaMed CrossRef
  43. Childs E, Geller AC, Brooks DR, Davine J, Kane J, Keske R, et al. Assessing smoke-free housing implementation approaches to inform best practices: A national survey of early-adopting public housing authorities. Int J Environ Res Public Health. 2022; 19(7): 3854.
    Pubmed KoreaMed CrossRef
  44. Patel M, Donovan EM, Liu M, Solomon-Maynard M, Schillo BS. Policy support for smoke-free and e-cigarette free multiunit housing. Am J Health Promot AJHP. 2022; 36(1): 106-16.
    Pubmed CrossRef
  45. Lindson N, Butler AR, McRobbie H, Bullen C, Hajek P, Begh R, et al. Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews 2024(1). Art. No.: CD010216. doi: 10.1002/14651858.CD010216.pub8.
    Pubmed KoreaMed CrossRef