Effects of policy change on smoking status for Boston public housing residents

The Tobacco Treatment Advocates in Public Housing Research Project, is a group-randomized smoking cessation trial designed to test whether public housing residents trained as Tobacco Treatment Advocates (TTAs) can increase (1) utilization of smoking cessation resources, and (2) smoking cessation rates among smokers in Boston public housing (BPH). In September 2012, the Boston Housing Authority (BHA) implemented a policy that bans smoking in BHA owned properties, including residents' apartments. To gain a better understanding of participants' general understanding of the policy and its potential impact on their motivation to quit smoking, we added a set of questions on the smoking restriction policy to the study's baseline and follow-up questionnaires. Topics covered included knowledge of different components of the policy, attitude toward the policy, and a self-assessment of the policies impact on readiness to quit. All subjects (n=571) received the questionnaire, 103 with pre- and post-implementation responses and 468 with post-implementation administration only. Additionally, audiotapes of counseling sessions with subjects in the intervention arm were analyzed to further illustrate the impact of policy change on readiness, motivation and confidence to quit smoking. As many municipalities across the country move towards considering similar smoke-free policies, lessons learned in Boston provide an important framework for future efforts and may also have relevance for other areas of health policy.