The Experience With Smoke-Free Policies in Affordable Multiunit Housing in North Carolina: A Statewide Survey

Am J Health Promot. 2016 May;30(5):382-9. doi: 10.1177/0890117116646346.


Purpose: Previous surveys of housing operators have identified concerns about enforcement, legal issues, and loss of market share as the main barriers to implementing smoke-free policies in multiunit housing. The purpose of this study was to examine enforcement practices as well as economic and legal outcomes in smoke-free affordable multiunit housing.

Design: Cross-sectional.

Setting: Affordable multiunit housing in North Carolina.

Subjects: Affordable multiunit housing properties (n = 1063, 57% response rate).

Measures: Property representatives completed a written survey with questions regarding the existence of smoke-free policies, smoke-free policy implementation and enforcement practices, and smoking-related costs.

Analysis: Descriptive statistics, χ(2) goodness-of-fit test, and t-test.

Results: A total of 16.5% of properties had policies that prohibited smoking in all residential units. Half (49.8%) of smoke-free properties reported no violations to their policies in the past 12 months. Legal actions to enforce policies were rarely needed and were successful when they did occur. Compared to smoking-allowed properties, smoke-free properties did not experience a loss of market share in terms of occupancy rate (t = .09; p = .93) or residents moving away (χ(2) =. 5; p = .48).

Conclusion: Housing operators' concerns about enforcement, legal issues, and loss of market share associated with smoke-free policies are largely unfounded among affordable housing properties in North Carolina. Public health professionals should use messaging strategies that refute these concerns to encourage more properties to adopt smoke-free policies.

Keywords: housing; maintenance; north carolina; organizational policy; prevention research; secondhand smoke; smoke-free policy.

Publication types

  • Observational Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Costs and Cost Analysis / statistics & numerical data
  • Cross-Sectional Studies
  • Humans
  • North Carolina
  • Public Housing / economics
  • Public Housing / legislation & jurisprudence
  • Public Housing / organization & administration*
  • Public Housing / statistics & numerical data
  • Smoke-Free Policy* / economics
  • Smoke-Free Policy* / legislation & jurisprudence
  • Surveys and Questionnaires