Self-Reported Exposure to Secondhand Smoke and Support for Complete Smoking Bans in Multiunit Housing Among Smokers in the United States, Canada, and the United Kingdom

Introduction Involuntary exposure to secondhand smoke most frequently occurs at home, which is problematic for residents of multiunit housing (MUH). The primary objective of this study was to estimate the extent of secondhand smoke incursions into the homes of MUH smokers who banned smoking in their homes but lived in buildings where smoking is allowed. Methods We used data from Wave 9 of the International Tobacco Control Four Country Survey. We estimated 1) the prevalence of complete smoking bans among smokers living in single-family homes vs MUH in the United States (n = 3,208), Canada (n = 1,592), and the United Kingdom (n = 1,403) from 2013 to 2015; 2) the extent of secondhand smoke incursions into the homes of MUH smokers who banned smoking in their units but lived in buildings that allow smoking; and 3) MUH smokers' preferences for complete smoking bans in MUH. Weighted multivariable logistic regression estimated the country-specific adjusted prevalence of all outcomes. Results Overall, 53.0% of smokers living in single-family homes completely banned smoking in their homes, compared with 44.8% of smokers in MUH. Across all 3 countries, only 27.8% of MUH smokers reported that smoking was completely prohibited in their building. A similar percentage of MUH smokers who banned smoking in their home but lived in buildings allowing smoking reported a secondhand smoke incursion into their home in the United States (29.9%; 95% CI, 20.4%-41.5%), Canada (38.4%; 95% CI, 26.7%-51.6%), and the United Kingdom (24.7%; 95% CI, 15.7%-36.7%). Across all 3 countries, 36.1% (95% CI, 33.4%-38.9%) of smokers in MUH reported they preferred a complete smoking ban in all building areas. Conclusion A need remains to educate MUH operators and residents about the benefits of comprehensive smoke-free policies.