1. CPHA: Public Health 2014 Toronto, Ontario May 26-29, 2014 The Impact of Smoke-free Policies in Affordable Housing on Perspectives, Experiences and Behaviours of Tenants Pamela Kaufman, Pamela Kaufman, Julie Kang, Roberta Ferrence, Ryan David Kennedy, Pippa Beck

2. To determine how non-smoking policies impact perspectives, experiences and smoking behaviours of tenants Affordable Housing Case Study 1 New leases smoke-free (balconies, patios included) Existing leases exempted/grandfathered 5m buffer around buildings Emphasis: health (SHS) and fire damage 32 tenant interviews (14 s; 18 ns) 2 focus groups (10 front-line staff; 8 administrative housing staff (operations, facilities, finance) Affordable Housing Case Study 2 All leases non-smoking (balconies, patios not included) 7 month grace period 5m buffer around shared entrances Emphasis on fire/ damage; little focus on health 26 tenants interview (12 s; 13 ns) 1 focus group with housing staff

3. 1. Cutting Back and Quitting Preparing for non-smoking lease Social smoking Inconvenience “...I started thinking you know I don’t think I’ve been smoking as much since I moved here… I would go up and down, up and down...” (Tenant)

4. 2. Compliance Indoor non-compliance Weather Stress, immobility and health issues Accommodating visitors Outdoor non-compliance Lack of clarity regarding non-smoking rules

5. Lease Exemption or ‘Grandfathering’ Monitoring compliance is challenging New tenants smoking in GF units “...everybody goes to that grandfathered unit to hang out and smoke on their back patio…or in their unit…I guess they could be building friendships…but it’s also causing social problems.” (Staff)

6. 3. Complaints Hesitant to complain Long involved complaints process Don’t think it will help “... some people don’t want to complain, they don’t want to squeal on their neighbour...they might casually mention it, but they’ll never put it in writing.” (Staff)

7. Conclusions Some tenants attributed quitting and reduced smoking to the S-F policy Lease exemption/grandfathering was related to challenges with compliance and enforcement Clear communication of rules is required Address issues with complaints processes Emphasis on staff enforcement vs. complaints

8. Thanks! Pippa Beck, SHAF Ryan David Kennedy, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health Roberta Ferrence, OTRU Julie Kang Waterloo Region Housing Staff & Tenants Yukon Housing Corporation Staff & Tenants WRH Policy Evaluation Committee Funding: Canadian Institutes of Health Research (CIHR)