Supporting Smoke-Free Policy Compliance in Public Housing
- Conditions
- Smoking ReductionSmokingSmoking CessationSmoking Behaviors
- Interventions
- Behavioral: Reduction (relocation and reduction of personal smoking) and cessationBehavioral: Resident Endorsement
- Registration Number
- NCT05016505
- Lead Sponsor
- Columbia University
- Brief Summary
This project seeks to determine the effectiveness of two types of interventions to reduce exposure to secondhand smoke in residential buildings. One intervention is geared toward all building residents (resident endorsement) and the other targets smokers (smoking reduction via relocation and reduction in personal smoking/cessation) with the goal of reducing personal smoking and secondhand smoke exposure.
- Detailed Description
Smoke-free housing policies in multi-unit housing are promising and increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that improve compliance with smoke-free housing policies in low-income multi-unit housing and test corresponding solutions.
The proposed randomized controlled trial (RCT) addresses key gaps in knowledge and capitalizes on key scientific opportunities by: 1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; 2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: a) in-residence smoking cessation and b) resident endorsement, while 3) addressing population and location-specific tobacco-related disparities.
The investigators hypothesize that the relocation/cessation plus resident endorsement intervention will yield significantly larger reductions in personal smoking and secondhand smoke exposure, compared to standalone interventions and the standard approach.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 512
- NYCHA buildings in Manhattan & the Bronx (stratified evenly by borough) with more than 50 units, not undergoing major renovations.
Building
- Buildings in a borough that is not in Manhattan or the Bronx
- Buildings smaller than 50 units
- Buildings undergoing major renovations
- Buildings that are or will be part of Rental Assistance Demonstration (RAD) or Permanent Affordability Commitment Together (PACT)
- Buildings that are mixed finance
- Buildings that are exclusively for elderly
- Buildings that are privately managed
- Buildings that have other research studies ongoing
Participant Inclusion Criteria:
- Recruit NYCHA residents via door knocking and lobby intercepts until we reach our targeted number per group (4 smokers, 4 non-smokers in each building).
- Residents will be screened for smoking status. Both smokers and non-smokers to be recruited but only one participant- smoker or a non-smoker- will be recruited per apartment.
- Smoking will be defined as those that report using a cigarette or other combustible tobacco product (e.g., little cigar, cigarillo) at least 5 days in the past month. Non-smokers include never smokers and former smokers who had quit 12 months ago or earlier.
- Additional eligibility criteria include individuals above 18 years old living in the building at least 5 days/week and 9 months/year, not planning on moving in the next 2 years.
Participant Exclusion Criteria:
- Individuals with severe physical or mental medical conditions (i.e. cognitive disability) or other factors that could limit participation or ability to give informed consent in the study at baseline or during follow-ups.
- Individuals who participated in the earlier focus groups.
- Individuals who only smoke non-tobacco products (e.g., marijuana).
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Compliance through reduction (relocation and reduction of personal smoking) and cessation Reduction (relocation and reduction of personal smoking) and cessation Smokers will be referred by the survey team to peer educators from a community-based organization trained to provide peer to peer health education including tobacco cessation support. The peer educator will coordinate smoking cessation support, including serving as a liaison between participant and research team, providing information regarding the smoke-free policy and opportunities for relocation, and connecting participant to access to tobacco replacement therapy and/or physician support if deemed appropriate. Compliance through resident endorsement Resident Endorsement Buildings assigned will be targeted for a series of 2 in-residence programs that involve community forums and the creative arts to garner resident endorsements of smoke-free living environments. Premised on resident engagement, this arm seeks to impact social and physical dimensions of the residential environment to achieve compliance. The sessions will: 1) inform residents of risks associated with smoking and secondhand smoke; 2) identify reasons to have a smoke-free home, 3) ask residents to sign a pledge on paper and/or virtually; 4) display smoke-free signage on doors and/or social media pages with an original hashtag (#Smokefree\[building address\]); and 5) refer residents to the Smoke-free NYCHA website for information on the policy and existing cessation resources. Compliance through reduction/cessation plus resident endorsement (combined) Reduction (relocation and reduction of personal smoking) and cessation The combined intervention will be carried out in the buildings assigned to this RCT arm, which will provide in-residence programs based on the resident endorsement treatment and the smoking relocation/cessation treatment. Both will occur simultaneously with one geared toward all building residents (resident endorsement) and the other targeting smokers (smoking relocation/cessation) with the goal of reducing both personal smoking and secondhand smoke exposure. Compliance through reduction/cessation plus resident endorsement (combined) Resident Endorsement The combined intervention will be carried out in the buildings assigned to this RCT arm, which will provide in-residence programs based on the resident endorsement treatment and the smoking relocation/cessation treatment. Both will occur simultaneously with one geared toward all building residents (resident endorsement) and the other targeting smokers (smoking relocation/cessation) with the goal of reducing both personal smoking and secondhand smoke exposure.
- Primary Outcome Measures
Name Time Method Change in number of cigarettes smoked per day Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Self-reported average number of cigarettes smoked per day among smokers
Change in salivary cotinine At baseline and at the 12-month follow-up Salivary cotinine (saliva collected as passive drool) will be measured for 25% of the sample among smokers and non-smokers alike
Change in secondhand smoke exposure Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Self-reported secondhand smoking exposure (hours of secondhand smoke exposure in the building in the past 7 days); among smokers \& non-smokers
- Secondary Outcome Measures
Name Time Method Change in number of hours of secondhand smoke exposure Number of hours observed someone smoking indoors within the past 7 days measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Counted number of hours of exposure
Change in number of quit attempts Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Mean number of quitting attempts among smokers
Change in number of participants with secondhand smoke observations Ever observing someone smoking indoors within the past 7 days measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Binary; whether participant has observed someone smoking indoors in the building; among smokers \& non-smokers
Change in number of participants with successful quit attempts Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) Binary; whether smokers have successfully quit
Change in number of smokers At each building visit at baseline and 12 months Counted number of people observed smoking in common areas
Change in number of cigarette butts At each building visit at baseline and 12 months Counted number of cigarette butts observed in common areas
Trial Locations
- Locations (1)
Columbia University Irving Medical Center
🇺🇸New York, New York, United States