Reducing Environmental Tobacco Smoke Exposure in Public Housing

减少公共住房中的环境烟草烟雾暴露

基本信息

批准号：
8305271
负责人：
Douglas Levy
金额：
$ 79.02万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-03-01 至 2015-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8305271
关键词：
Address Adult Affect Air Area Asthma Attitude Behavior Belief Boston Boston Post Cardiovascular Diseases Cardiovascular system Cities Cotinine Country Development Disabled Persons Economics Environmental Tobacco Smoke Exposure to Goals Health Health Benefit Household Housing Human Individual Institutes Intervention Knowledge Locales Location Longitudinal Studies Low income Lung Malignant neoplasm of lung Measurement Measures Morbidity - disease rate Nicotine Outcome Participant Particulate Matter Passive Smoking Patient Self-Report Policies Policy Maker Population Property Public Health Public Housing Public Policy Regulation Reporting Research Resort Respiratory Tract Infections Saliva Salivary Site Smoke Smoker Smoking Source Surveys Testing Time Tobacco smoke Tobacco smoking U.S. Department of Housing and Urban Development Workplace air monitoring authority experience falls follow-up frontier improved longitudinal design mortality non-smoker non-smoking population health residence respiratory restricting smoking smoke-free policy success time use tobacco exposure

项目摘要

DESCRIPTION (provided by applicant): Environmental tobacco smoke (ETS), also known as secondhand smoke or passive smoking, is a threat to non-smokers' health, causing and exacerbating asthma, as well as upper and lower respiratory infections, cardiovascular disease (CVD), and lung cancer. There is no safe level of ETS exposure. Human ETS exposure is highest among low-income groups and non-smoking households in multiunit housing (MUH), including public housing, have elevated levels of ETS. Public housing residents' vulnerability to ETS exposure is heightened because they are in housing of last resort without the means to avoid exposure by changing residences. Public policies such as workplace smoking bans have resulted in demonstrated improvements in population health, leading to lower levels of ETS exposure for non-smokers and lower rates of adverse cardiovascular and respiratory outcomes. In June of 2009, the Department of Housing and Urban Development called on local housing authorities to implement smoke-free policies. Because MUH is one of the last frontiers of smoking regulation, it is not clear whether smoke-free housing rules will be effective at reducing non-smokers' exposure to ETS, particularly in public housing, and to date there have been no comprehensive studies. In 2010, the city of Boston, MA declared that the properties of the Boston Housing Authority (BHA), including residences, will become entirely smoke-free in the fall of 2012, making Boston's the largest public housing authority in the country with such plans. Our proposed study seizes on this unique moment in time, using a quasi- experimental, longitudinal design to test the hypothesis that smoke-free policies in public housing reduce residents' exposures to ETS. The BHA is our intervention site. Our control site is the Cambridge Housing Authority (CHA) in Cambridge, MA where no smoke-free housing policy will be implemented. We will conduct difference-in-differences analyses to test whether changes in ETS levels and exposure from summer 2012 (pre-BHA smoke-free housing policy) to summer 2013 (post-BHA smoke-free policy) are greater for the intervention site (BHA) than for the control site (CHA). At least 150 randomly selected non-smoking households from each site will undergo pre and post assessments, and one resident from each household will be included in the study. ETS exposure will be assessed by measuring participants' saliva cotinine; air quality in households and common areas (airborne nicotine and particulate matter - PM2.5); and participants' self- reports. In addition, the sources of exposure to ETS will be determined by airborne nicotine, air flow, and PM2.5 measurements, as well as residents' self-report. Additionally, residents will be surveyed on their knowledge, attitudes, beliefs, and behaviors towards ETS and smoke-free policies. Understanding Boston's experience implementing the policy, and understanding the impact the policy's effect on public health will provide crucial information to policy makers and other housing authorities as these policies become more commonplace. PUBLIC HEALTH RELEVANCE: There is no safe level of exposure to environmental tobacco smoke (ETS). Establishing policies prohibiting smoking in multiunit housing, particularly public housing, is an important new strategy for reducing involuntary exposure to tobacco smoke, with the potential to reduce the major morbidity, mortality, and economic losses associated with tobacco exposure. The goal of the proposed research is to test whether the Boston Housing Authority's smoke-free housing policy reduces non-smoking residents' exposure to ETS.

描述（由申请人提供）：环境烟草烟雾（ETS），也称为二手烟或被动吸烟，对非吸烟者的健康构成威胁，引起和加剧哮喘，以及上、下呼吸道感染、心血管疾病（ CVD）和肺癌。 ETS 暴露没有安全水平。低收入群体和多单元住房（MUH）（包括公共住房）中的非吸烟家庭的人类碳排放交易体系暴露程度最高，其碳排放交易体系水平较高。公共住房居民更容易受到碳排放交易体系的影响，因为他们住在最后的住房中，无法通过更换住所来避免接触碳排放交易。工作场所禁烟等公共政策已证明可以改善人口健康，从而降低非吸烟者接触 ETS 的水平，并降低心血管和呼吸系统不良后果的发生率。 2009年6月，住建部呼吁地方住建部门落实无烟政策。由于 MUH 是吸烟监管的最后前沿之一，目前尚不清楚无烟住房规则是否能有效减少非吸烟者接触 ETS，特别是在公共住房中，而且迄今为止还没有进行全面的研究。 2010 年，马萨诸塞州波士顿市宣布，波士顿住房管理局 (BHA) 的物业，包括住宅，将于 2012 年秋季全面禁烟，使波士顿成为全国最大的拥有此类计划的公共住房管理局。我们提出的研究抓住了这个独特的时刻，采用准实验纵向设计来检验公共住房无烟政策减少居民接触 ETS 的假设。 BHA 是我们的干预地点。我们的控制地点是位于马萨诸塞州剑桥的剑桥住房管理局 (CHA)，那里不会实施无烟住房政策。我们将进行双重差分分析，以测试干预地点从 2012 年夏季（BHA 无烟住房政策之前）到 2013 年夏季（BHA 无烟政策之后）ETS 水平和暴露的变化是否更大（ BHA) 高于对照位点 (CHA)。每个地点至少随机抽取 150 个非吸烟家庭将接受事前和事后评估，每个家庭将包括一名居民参与研究。 ETS暴露将通过测量参与者的唾液可替宁来评估；家庭和公共区域的空气质量（空气中的尼古丁和颗粒物 - PM2.5）；以及参与者的自我报告。此外，ETS的暴露来源将通过空气中的尼古丁、空气流量和PM2.5测量以及居民的自我报告来确定。此外，还将调查居民对 ETS 和无烟政策的知识、态度、信念和行为。随着这些政策变得更加普遍，了解波士顿实施该政策的经验，并了解该政策对公共卫生的影响将为政策制定者和其他住房当局提供重要信息。公共卫生相关性：环境烟草烟雾 (ETS) 的暴露没有安全水平。制定禁止在多单元住房（特别是公共住房）内吸烟的政策是减少非自愿接触烟草烟雾的一项重要新战略，有可能减少与烟草接触相关的主要发病率、死亡率和经济损失。拟议研究的目的是测试波士顿住房管理局的无烟住房政策是否减少了非吸烟居民接触 ETS 的机会。