Smoking, Smoking Behaviors, Smoking Cessation, Smoking Reduction
Conditions
Keywords
smoking, secondhand smoke
Brief summary
This project seeks to determine the effectiveness of two types of interventions to reduce exposure to secondhand smoke in residential buildings. One intervention is geared toward all building residents (resident endorsement) and the other targets smokers (smoking reduction via relocation and reduction in personal smoking/cessation) with the goal of reducing personal smoking and secondhand smoke exposure.
Detailed description
Smoke-free housing policies in multi-unit housing are promising and increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that improve compliance with smoke-free housing policies in low-income multi-unit housing and test corresponding solutions. The proposed randomized controlled trial (RCT) addresses key gaps in knowledge and capitalizes on key scientific opportunities by: 1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; 2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: a) in-residence smoking cessation and b) resident endorsement, while 3) addressing population and location-specific tobacco-related disparities. The investigators hypothesize that the relocation/cessation plus resident endorsement intervention will yield significantly larger reductions in personal smoking and secondhand smoke exposure, compared to standalone interventions and the standard approach.
Interventions
BEHAVIORALReduction (relocation and reduction of personal smoking) and cessation
Individual-level. Peer educator to provide reduction/cessation and/or relocation support.
BEHAVIORALResident Endorsement
Building-level. Peer educator to conduct building-level sessions.
Sponsors
National Cancer Institute (NCI)
Columbia University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
The proposed design will be a borough-stratified, four-arm, factorial-design, cluster RCT that will target 64 randomly selected buildings (16 buildings per arm) in separate New York City Housing Authority (NYCHA) developments. The investigators will recruit and follow 8 randomly selected residents stratified by smoking status- 4 smokers and 4 non-smokers- per building (n=512 residents) into four arms: (1) reduction (relocation and reduction in personal smoking)/cessation, (2) resident endorsement, (3) reduction (relocation and reduction in personal smoking)/cessation plus resident endorsement and (4) the standard approach (128 participants per arm).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Building Inclusion Criteria: * NYCHA buildings in Manhattan & the Bronx (stratified evenly by borough) with more than 50 units, not undergoing major renovations. Building
Exclusion criteria
* Buildings in a borough that is not in Manhattan or the Bronx * Buildings smaller than 50 units * Buildings undergoing major renovations * Buildings that are or will be part of Rental Assistance Demonstration (RAD) or Permanent Affordability Commitment Together (PACT) * Buildings that are mixed finance * Buildings that are exclusively for elderly * Buildings that are privately managed * Buildings that have other research studies ongoing Participant Inclusion Criteria: * Recruit NYCHA residents via door knocking and lobby intercepts until we reach our targeted number per group (4 smokers, 4 non-smokers in each building). * Residents will be screened for smoking status. Both smokers and non-smokers to be recruited but only one participant- smoker or a non-smoker- will be recruited per apartment. * Smoking will be defined as those that report using a cigarette or other combustible tobacco product (e.g., little cigar, cigarillo) at least 5 days in the past month. Non-smokers include never smokers and former smokers who had quit 12 months ago or earlier. * Additional eligibility criteria include individuals above 18 years old living in the building at least 5 days/week and 9 months/year, not planning on moving in the next 2 years. Participant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in secondhand smoke exposure | Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Self-reported secondhand smoking exposure (hours of secondhand smoke exposure in the building in the past 7 days); among smokers & non-smokers |
| Change in number of cigarettes smoked per day | Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Self-reported average number of cigarettes smoked per day among smokers |
| Change in salivary cotinine | At baseline and at the 12-month follow-up | Salivary cotinine (saliva collected as passive drool) will be measured for 25% of the sample among smokers and non-smokers alike |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in number of hours of secondhand smoke exposure | Number of hours observed someone smoking indoors within the past 7 days measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Counted number of hours of exposure |
| Change in number of participants with successful quit attempts | Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Binary; whether smokers have successfully quit |
| Change in number of cigarette butts | At each building visit at baseline and 12 months | Counted number of cigarette butts observed in common areas |
| Change in number of smokers | At each building visit at baseline and 12 months | Counted number of people observed smoking in common areas |
| Change in number of quit attempts | Measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Mean number of quitting attempts among smokers |
| Change in number of participants with secondhand smoke observations | Ever observing someone smoking indoors within the past 7 days measured at baseline (in person interview), 3 months (phone interview) and 12 months (in person interview) | Binary; whether participant has observed someone smoking indoors in the building; among smokers & non-smokers |
Countries
United States
Outcome results
None listed