Promoting Smoke-Free Homes in Budget Hotels

Modified Project Summary/Abstract Section About one in four nonsmokers is routinely exposed to secondhand smoke (SHS), primarily at home. Involuntary exposure to SHS at home increases the risk of developing coronary heart disease, lung cancer, strokes, and sudden death for nonsmokers from 20-30 percent. Over 40,000 non-smoking adults and 400 infant deaths are attributable to SHS yearly. Although there have been significant declines in cigarette smoking since the 1960s when smoke-free policies were introduced, an estimated 58 million nonsmokers and 28 million multiunit housing residents are still at high risk for SHS in their homes. Over 80% of multiunit renters prefer smoke-free homes. Yet, low-income renters are susceptible to harm from all forms of SHS since socioeconomic barriers restrict access to better-quality homes. Low-income families rely on economy extended-stay hotels for long-term shelter. These renters may be exposed to SHS due to suboptimal smoke-free policy enforcement and adoption. Previous studies report detectable levels of SHS dosing in hotel guests even after one night. A complete smoking ban at home is an effective intervention for reducing SHS exposure. However, the effectiveness of these at-home bans for people living in hotels is unknown. We propose to (1) identify contextual facilitators and barriers to implementing smoke-free policies in hotels, (2) explore the conditions that facilitate the adaptation of a smoke-free policy intervention to align with the extended-stay hotel context, and (3) examine enforcement strategies that maintain the adoption and endorsement of a smoke-free hotel policy. A significant positive impact of this project is taking a first step in adapting an evidence-based intervention to be accessible to a population of low-income renters and refining implementation strategies that can be scaled up in urban and rural hotel settings across the country.