Drifting Tobacco Smoke Exposure among Young Adults in Multiunit Housing

Systems and policies to reduce secondhand smoke in multiunit housing in Singapore: a qualitative study

BACKGROUND

Multiunit housing residents are often exposed to neighbours' secondhand smoke (SHS). Little is known on the current systems available to protect residents in places not covered by a residential smoking ban, or what constitutes an appropriate policy approach. This study explores relevant systems and policies in Singapore, a densely populated city-state where the vast majority live in multiunit housing and discussions on regulating smoking in homes are ongoing.

METHODS

In-depth interviews with 18 key informants involved in thought leadership, advocacy, policy or handling SHS complaints, and 14 smokers and 16 non-smokers exposed to SHS at home.

RESULTS

The current system to address neighbours' SHS comprises three steps: moral suasion, mediation and legal dispute. Moral suasion and mediation are often ineffective as they depend on smokers to willingly restrict their smoking habits. Legal dispute can yield a court order to stop smoking inside the home, but the process places a high evidence burden on complainants. While setting up designated smoking points or running social responsibility campaigns may help to create no-smoking norms, more intractable cases will likely require regulation, a polarising approach which raises concerns about privacy.

CONCLUSIONS

Without regulations to limit SHS in multiunit housing, current systems are limited in their enforceability as they treat SHS as a neighbourly nuisance rather than a public health threat.

Residential secondhand smoke in a densely populated urban setting: a qualitative exploration of psychosocial impacts, views and experiences

Background

People remain exposed to secondhand smoke, a serious health hazard, inside their home as households face challenges in setting no-smoking rules or are exposed to secondhand smoke drifting in from neighbouring homes. This study explores the psychosocial impacts, views, and experiences with residential secondhand smoke in a densely populated urban setting. 

Methods

In-depth online or face to face interviews with 18 key informants who had been involved in public discourse, policy, advocacy or handling complaints related to residential secondhand smoke, 14 smokers, and 16 non-smokers exposed to secondhand smoke inside their home. All participants were residents of Singapore, a densely populated, multi-ethnic city-state. Interview transcripts were coded in NVivo using a deductive and inductive coding process.

Findings

Secondhand smoke has wide-reaching impacts on physical and psychosocial wellbeing, even if smokers tried to minimise secondhand smoke. Feelings of anxiety and stress are generally tied to feeling discomfort in one’s personal space, a perceived lack of control over the situation, resentment towards smokers, and concerns over the health effects. Family, community, and cultural dynamics add complexities to tackling the issue, especially in patriarchal households. Secondhand smoke exposure from neighbours is considered a widespread issue, exacerbated by structural factors such as building layout and the COVID-19 pandemic. Resolving the issue amicably is considered challenging due to the absence of regulations and a reluctance to stir up conflict with neighbours. While smokers took measures to reduce secondhand smoke, these were described as ineffective by other participants. Smokers appeared to have contrasting views from other participants on what it means to smoke in a socially responsible manner.

Conclusion

Given the wide-reaching psychosocial impacts of residential secondhand smoke, there is a case for stronger interventions, especially in densely populated urban settings where it is more difficult to avoid.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13561-7.

Willingness to Pay for Healthy Housing During the COVID-19 Pandemic in China: Evidence From Eye-Tracking Experiment

Healthy housing can set its occupants completely in good physical, mental and social conditions, but there is a lack of research in China on the public's willingness to pay (WTP) for healthy housing. From the perspective of cognitive psychology, this study constructs an analytical framework based on the model of "theory of planned behavior" (TPB), the theory of selective information exposure, and the model of "emotions as social information," while exploring the effect mechanism of the online reviews on the public's WTP for healthy housing during COVID-19 pandemic. In combination with eye-tracking experiments and subjective reports, physiological, psychological and behavioral multimodal data on WTP of 65 participants for healthy housing are collected. Partial least squares structural equation modeling (PLS-SEM) is adopted to analyze the formation effect mechanism of the public's WTP for healthy housing. This study acquires the following results: (i) Information attentiveness to online reviews on different valence information of healthy housing as obtained in eye tracking experiments delivers significant effect on attitude, subjective norm (SN) and perceived behavioral control (PBC), but has no direct effect on the public's WTP for healthy housing; (ii) Hypotheses from TPB model are verified. attitude, PBC and SN can all make significant effect on WTP for healthy housing, with attitude showcasing the most prominent effect; and (iii) In terms of the mediating effect, information attentiveness can deliver significant indirect effect on WTP through attitude.

Piloting a spatial mixed method for understanding neighborhood tobacco use disparities

The tobacco retail environment is where most advertising dollars are spent. However, most research on the retail environment has not methodologically situated tobacco retailers as part of a larger community, and few studies have incorporated community member perspectives of their own tobacco use in relation to their local environments. The purpose of this study is to describe and evaluate a multilevel, multimodal, mixed methods approach for understanding tobacco use in context. We combine quantitative data collected from tobacco retailer audits and geographically-explicit interviews with neighborhood residents to tell a more complete story of tobacco use behavior among adults in San Francisco's Marina district, and the Oakland Coliseum neighborhood in Alameda County, California. We find that while area-level and retail data provide a broad snapshot of two distinct communities with respect to sociodemographic characteristics and tobacco availability, interviews with community residents who use tobacco add important perspectives regarding how tobacco retailers are viewed and how residents interact with their neighborhood landscapes on a daily basis. The method we describe and critique has the potential to be scaled to incorporate a broader set of geographies, or tailored to address a multitude of health-related questions. Our approach further demonstrates the utility of including geolocated participant narratives as a means of understanding where researcher interpretations of urban environments diverge from those of community residents.

Policy Support for Smoke-Free and E-Cigarette Free Multiunit Housing

PURPOSE

Estimate public support for prohibiting multiunit housing (MUH) e-cigarette and cigarette use.

DESIGN

Cross-sectional study.

SETTING

Data from an online panel survey.

SAMPLE

A Fall 2018 nationally representative sample of 3,415 (99.3% response rate) United States (US) adults 18-64 years old.

MEASURES

Policy support for prohibiting MUH smoking and e-cigarette use, sociodemographics, and tobacco perceptions and behaviors.

ANALYSIS

Weighted multivariate logistic regression examined predictors of support for prohibiting 1) cigarette use and 2) e-cigarette use in MUH.

RESULTS

Most respondents expressed support for prohibiting smoking (76.9%) and e-cigarette use (74.0%) in MUH. About 17% (n = 588) of the sample lived in MUH, and living in MUH was not predictive of support for either policy. For both cigarette and e-cigarette policies, current smokers (n = 630; OR = 0.44, p < 0.001; OR = 0.59, p < 0.01) and current e-cigarette users (n = 305; OR = 0.42, p < 0.001; OR = 0.22, p < 0.001) had lower odds of support. Notably, while most smokers supported prohibiting cigarette (51.4%) and e-cigarette use in MUH (51.1%), there was less support among current e-cigarette users for prohibiting cigarette (48.1%) and e-cigarette use in MUH (34.5%).

CONCLUSION

Majority support for prohibiting smoking and e-cigarette use in MUH is promising for policy adoption; however, lower support of both policies among e-cigarette users needs to be examined, as increasing use of e-cigarettes may be shifting social norms away from support for smoke free housing policies.

Local variation in cannabis use patterns among young adults in the San Francisco Bay Area

This study evaluated whether neighborhood-level disorder, social cohesion, and perceived safety, were associated with days of cannabis use in the prior month in a representative sample of young adults in Alameda and San Francisco Counties in California (N = 1272). We used multiscale geographically weighted regression, modeled by county, to measure associations between cannabis use days and neighborhood attributes, adjusting for sociodemographic characteristics and self-rated health. Positive associations were found between number of cannabis use days and neighborhood disorder, and greater perceived safety. Higher levels of social cohesion predicted fewer cannabis use days. Racial/ethnic, sex and, socioeconomic compositions of participants residing in areas with significant neighborhood-level associations varied substantially, suggesting that risk factors for young adult cannabis use may be highly localized. Public health efforts in cannabis education and intervention should be tailored to fit the culture and composition of local neighborhoods.

Housing Conditions, Neighborhood Physical Environment, and Secondhand Smoke Exposure at Home: Evidence from Chinese Rural-to-Urban Migrant Workers

Over the past two decades, health-related issues among rural-to-urban migrant workers in China have been widely discussed and documented by public health scholars. However, little, if any, scholarly attention has been paid to migrant workers’ secondhand smoke (SHS) exposure at home. This study aims to explore the contours of SHS exposure at home and investigate the effects of inadequate housing conditions and poor neighborhood physical environments on such in-home exposure among Chinese migrant workers. A respondent-driven sampling method was employed to interview 1854 rural-to-urban migrant workers from the period June 2017 to June 2018 in Chengdu, China. The results indicate that Chinese migrant workers are at high risk of SHS exposure at home. Migrant workers who live in homes with inadequate conditions, such as substandard housing and crowdedness, are especially at high risk of SHS exposure at home. Moreover, poor neighborhood physical environments are significantly and positively associated with SHS exposure at home. These findings suggest that strategies that can help improve housing conditions and neighborhood physical environments should be developed and promoted to protect rural-to-urban migrant workers from SHS exposure at home.