Cessation programs for public housing / low SES populations – 3/25/11

Q: Nashville’s public housing is going smoke-free, and the public health department is working to develop a cessation program for that audience. We are in the process of lining up counseling and pharmacotherapy for the residents, free-of-charge and on-site. We know it helps to get the residents involved and that it helps to augment tobacco cessation classes with an overall wellness approach (walking groups have already been formed, weekly physical activity groups are ongoing, healthy cooking classes are happening). But what else?
 
Knowing that over 230 other public housing agencies nationwide have gone smoke-free, is there a specific cessation program that has been successful for low SES/public housing folks? What were the success rates or other outcomes? What challenges did you encounter with implementation?

A:

1. Oregon: The National Smoke-free Housing Listserv would be an excellent place to post this question. All the leaders in smokefree housing are on it, and the discussions are active and pertinent. An excellent source of resources for everybody, from beginning to advanced. To subscribe, contact Jim Bergman, moderator, at jbergman@tcsg.org.
    
2. Wisconsin: In general:
    
   • Provide barrier free treatment (medications and counseling),
   • Allow multiple quit attempts and ample time to accomplish quitting before negative consequences for continued smoking accrue,
   • Hire residents to help each other (share their quit experience and tips, help refer people to services, etc).

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Partner Response:

American Lung Association - Oregon: The American Lung Association has a smoking cessation program called “Freedom From Smoking.” It is available in four different formats—group clinics, online, over the phone, and self-help guides.

Our success rates for the group clinic are as follows:

• 25% of participants report being smokefree one year after completing the 7-week program
• When used in conjunction with smoking cessation medications, clinics have experienced quit rates as high as 60%.

Two years ago, the Lung Association in Oregon trained two Resident Services staff members at the Housing Authority of Portland to become Freedom From Smoking facilitators, so they could bring the program back to their residents. The clinics had mixed results. In a setting where everyone knows each other, there can be concerns about a person’s privacy. They may be reluctant to share their personal struggles with their neighbors (vs. a community-wide clinic, where you are with a group of strangers).

In a public housing setting, self-help options or 1-on-1 counseling may be more appropriate. Freedom From Smoking offers a self-help print guide, as well as smoking cessation assistance through our Lung HelpLine: 1-800-LUNG-USA.

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Related Resources:

• Public Health Law and Policy is a California-based organization, so the materials are based on California law, but many resources can be adapted to other states: a model ordinance, various regulatory and enforcement options, and implementation guides. Click here to see the available resources on smoke-free housing.
   
• American for Nonsmokers’ Rights (ANR) has a library of resources on smoke-free housing policies and implementation, available here.
   
• Memos from HUD re: smoke-free housing rationale/ implementation:
   
• http://www.hud.gov/offices/pih/publications/notices/09/pih2009-21.pdf
• http://www.tcsg.org/sfelp/HUD-SFHsgImplemt091510.pdf

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