Grant Number:	5R01CA220591-05 Interpret this number
Primary Investigator:	Thorpe, Lorna
Organization:	New York University School Of Medicine
Project Title:	Evaluation of Smoke-Free Housing Policy Impacts on Tobacco Smoke Exposure and Health Outcomes
Fiscal Year:	2022

ABSTRACT. Tobacco use remains the leading cause of preventable death in the U.S., responsible for more than 440,000 deaths annually, of which 41,000 are attributable to environmental tobacco smoke (ETS). The federal Department of Housing and Urban Development (HUD) recently passed a rule that will require all public housing agencies (PHAs) to implement smoke free policies in their developments. There is a strong rationale for the new housing policy. Compared to the general public, residents in public housing are at excess risk for ETS exposure for two reasons: (1) Despite overall declines in smoking over time, major disparities persist by income level, education and race/ethnicity. Thus smoking rates among residents living in public housing, a predominantly minority, lower income population, tend to be higher than in the general population. (2) Most public housing residents live in multiunit housing (MUH), an environment that places all residents at elevated risk for involuntary ETS exposure due to smoke accumulation compared to residents living in detached housing. While prohibition of smoking in homes has promising implications for improving health, initiatives to mandate smoke-free housing are still nascent. No empirical studies have objectively evaluated the impact on health outcomes among residents. Estimated health consequences of such policies are currently based on mathematical models, and only a few studies have measured change in resident ETS exposure before and after implementation of housing-wide bans. These studies have mostly been small, with short follow-up periods, and they have given only limited attention to studying the implementation process. To fill this gap, we propose a large-scale natural experiment to examine the impact of the HUD policy on reducing ETS exposure and improving health outcomes. The New York City Housing Authority (NYCHA) is the largest housing authority in the United States, with more than 400,000 residents. Using a quasi-experimental longitudinal design, we plan to monitor ETS before and after policy implementation (tracking every 6 months for 2.5 years post-policy) in 200 apartments of non-smokers and common areas of 10 select high-rise NYCHA buildings, and compare to ETS changes in 200 apartments in 10 demographically matched high-rise buildings in another housing program, not subject to the smoke-free policy. Using geocoded administrative data, citywide NYCHA resident health outcomes will be compared to residents in matched low-income census blocks. Finally we will use survey data, qualitative interviews and focus groups to explore multilevel factors that influence the implementation process and outcomes. This study leverages a strong, ongoing partnership of academic and municipal government investigators, including experts at New York University School of Medicine, senior staff at NYCHA, and leaders from the NYC Department of Health and Mental Hygiene. Findings will be used to develop guidance for implementing SFH policies in public or private MUH settings nationally.




Patterns and drivers of disparities in pediatric asthma outcomes among Medicaid-enrolled children living in subsidized housing in NYC.
Authors: Titus A.R. , Terlizzi K. , Conderino S. , Ðoàn L.N. , Kim B. , Thorpe L.E. .
Source: Preventive Medicine, 2024 Aug; 185, p. 108023.
EPub date: 2024-06-20 00:00:00.0.
PMID: 38908569
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Variability in self-reported and biomarker-derived tobacco smoke exposure patterns among individuals who do not smoke by poverty income ratio in the USA.
Authors: Titus A.R. , Shelley D. , Thorpe L.E. .
Source: Tobacco Control, 2024-07-14 00:00:00.0; , .
EPub date: 2024-07-14 00:00:00.0.
PMID: 39004510
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Portable Air Cleaners and Home Systolic Blood Pressure in Adults With Hypertension Living in New York City Public Housing.
Authors: Wittkopp S. , Anastasiou E. , Hu J. , Liu M. , Langford A.T. , Brook R.D. , Gordon T. , Thorpe L.E. , Newman J.D. .
Source: Journal Of The American Heart Association, 2023-07-04 00:00:00.0; 12(13), p. e029697.
EPub date: 2023-06-29 00:00:00.0.
PMID: 37382099
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A Matched Analysis of the Association Between Federally Mandated Smoke-Free Housing Policies and Health Outcomes Among Medicaid-Enrolled Children in Subsidized Housing, New York City, 2015-2019.
Authors: Titus A.R. , Mijanovich T.N. , Terlizzi K. , Ellen I.G. , Anastasiou E. , Shelley D. , Wyka K. , Elbel B. , Thorpe L.E. .
Source: American Journal Of Epidemiology, 2023-01-06 00:00:00.0; 192(1), p. 25-33.
PMID: 35551590
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Titus et al. Respond to "Guiding Comprehensive and Equitable Policy".
Authors: Titus A.R. , Anastasiou E. , Shelley D. , Elbel B. , Thorpe L.E. .
Source: American Journal Of Epidemiology, 2023-01-06 00:00:00.0; 192(1), p. 39-40.
PMID: 36269016
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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.
Authors: Anastasiou E. , Gordon T. , Wyka K. , Tovar A. , Gill E. , Rule A.M. , Elbel B. , Kaplan J.D.S. , Shelley D. , Thorpe L.E. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2023-01-01 00:00:00.0; 25(1), p. 164-169.
PMID: 36041039
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Attitudes, perceptions, and preferences towards SARS CoV-2 testing and vaccination among African American and Hispanic public housing residents, New York City: 2020-2021.
Authors: Izeogu C. , Gill E. , Van Allen K. , Williams N. , Thorpe L.E. , Shelley D. .
Source: Plos One, 2023; 18(1), p. e0280460.
EPub date: 2023-01-19 00:00:00.0.
PMID: 36656814
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Rapid Community Engagement in Response to SARS-CoV-2 Funding Opportunities: New York City, 2020‒2021.
Authors: Williams N.J. , Gill E. , Punter M.A. , Reiss J. , Goodman M. , Shelley D. , Thorpe L.E. .
Source: American Journal Of Public Health, 2022 Nov; 112(S9), p. S904-S908.
PMID: 36446061
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Feasibility of low-cost particle sensor types in long-term indoor air pollution health studies after repeated calibration, 2019-2021.
Authors: Anastasiou E. , Vilcassim M.J.R. , Adragna J. , Gill E. , Tovar A. , Thorpe L.E. , Gordon T. .
Source: Scientific Reports, 2022-08-26 00:00:00.0; 12(1), p. 14571.
EPub date: 2022-08-26 00:00:00.0.
PMID: 36028517
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Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Authors: Kim B. , Mulready-Ward C. , Thorpe L.E. , Titus A.R. .
Source: Preventive Medicine, 2022 08; 161, p. 107147.
EPub date: 2022-07-06 00:00:00.0.
PMID: 35803352
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The Effect of Floor Height on Secondhand Smoke Transfer in Multiunit Housing.
Authors: Gill E. , Anastasiou E. , Tovar A. , Shelley D. , Rule A. , Chen R. , Thorpe L.E. , Gordon T. .
Source: International Journal Of Environmental Research And Public Health, 2022-03-23 00:00:00.0; 19(7), .
EPub date: 2022-03-23 00:00:00.0.
PMID: 35409478
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Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact.
Authors: Jiang N. , Gill E. , Thorpe L.E. , Rogers E.S. , de Leon C. , Anastasiou E. , Kaplan S.A. , Shelley D. .
Source: International Journal Of Environmental Research And Public Health, 2021-11-29 00:00:00.0; 18(23), .
EPub date: 2021-11-29 00:00:00.0.
PMID: 34886292
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Evaluation of Secondhand Smoke Exposure in New York City Public Housing After Implementation of the 2018 Federal Smoke-Free Housing Policy.
Authors: Thorpe L.E. , Anastasiou E. , Wyka K. , Tovar A. , Gill E. , Rule A. , Elbel B. , Kaplan S.A. , Jiang N. , Gordon T. , et al. .
Source: Jama Network Open, 2020-11-02 00:00:00.0; 3(11), p. e2024385.
EPub date: 2020-11-02 00:00:00.0.
PMID: 33151318
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Secondhand smoke exposure in public and private high-rise multiunit housing serving low-income residents in New York City prior to federal smoking ban in public housing, 2018.
Authors: Anastasiou E. , Feinberg A. , Tovar A. , Gill E. , Ruzmyn Vilcassim M.J. , Wyka K. , Gordon T. , Rule A.M. , Kaplan S. , Elbel B. , et al. .
Source: The Science Of The Total Environment, 2020-02-20 00:00:00.0; 704, p. 135322.
EPub date: 2019-11-21 00:00:00.0.
PMID: 31787288
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Self-reported Secondhand Marijuana Smoke (SHMS) Exposure in Two New York City (NYC) Subsidized Housing Settings, 2018: NYC Housing Authority and Lower-Income Private Sector Buildings.
Authors: Anastasiou E. , Chennareddy S. , Wyka K. , Shelley D. , Thorpe L.E. .
Source: Journal Of Community Health, 2019-12-05 00:00:00.0; , .
EPub date: 2019-12-05 00:00:00.0.
PMID: 31807996
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A protocol for measuring the impact of a smoke-free housing policy on indoor tobacco smoke exposure.
Authors: Cardozo R.A. , Feinberg A. , Tovar A. , Vilcassim M.J.R. , Shelley D. , Elbel B. , Kaplan S. , Wyka K. , Rule A.M. , Gordon T. , et al. .
Source: Bmc Public Health, 2019-05-30 00:00:00.0; 19(1), p. 666.
EPub date: 2019-05-30 00:00:00.0.
PMID: 31146711
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Perceptions about the Federally Mandated Smoke-Free Housing Policy among Residents Living in Public Housing in New York City.
Authors: Jiang N. , Thorpe L. , Kaplan S. , Shelley D. .
Source: International Journal Of Environmental Research And Public Health, 2018-09-20 00:00:00.0; 15(10), .
EPub date: 2018-09-20 00:00:00.0.
PMID: 30241291
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Time to Track Health Outcomes of Smoke-Free Multiunit Housing.
Authors: Thorpe L.E. , Feinberg A.M. , Elbel B. , Gordon T. , Kaplan S.A. , Wyka K. , Athens J. , Shelley D. .
Source: American Journal Of Preventive Medicine, 2018 Feb; 54(2), p. 320-322.
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