The Southern Nevada Health District (SNHD) located in Las Vegas, Nevada is the public health authority serving Clark County. The SNHD is one of the largest local public health departments in the U.S. and serves the public health needs of over 2 million people, (75% of Nevada's population).
The SNHD's Office of Chronic Disease Prevention and Health Promotion (OCDPHP) has taken a lead role in promoting tobacco-free environments including developing a robust smoke-free housing program. Nevada has the fourth-lowest homeownership rate in the country, which means that many families live in multi-unit housing (MUH). Currently, 65% of housing units in Clark County are contained in multi-unit structures. In 2019, 34.5% of Clark County residents lived in a MUH community.
Secondhand smoke (SHS) is the third leading cause of preventable death in the U.S. According to the US Surgeon General, there is no risk-free level of secondhand smoke exposure. Secondhand smoke from neighbors who smoke in or around the building can travel into neighboring units, exposing others to the secondhand smoke.
The goal of the initiative is to increase access to smoke-free living. To reach this goal, our objective is to increase the number of MUH properties that adopt new or expand existing smoke-free policies. This is achieved through a multi-faceted program that includes providing technical assistance, maintaining and promoting an online smoke-free housing directory available in English and Spanish, community outreach/media, and offering cessation services to MUH residents.
Activities implemented to support the practice included developing a smoke-free MUH toolkit for MUH managers and owners, the development of marketing and cessation materials, an online smoke-free housing directory, and a marketing campaign. Toolkits were distributed to MUH properties in ZIP codes with 20% or more of the population living in poverty where a majority of the population identified as Hispanic or African American/Black. The toolkit includes information on electronic vaping products, policy development, marijuana smoke, legal information, and other local resources. The toolkit addresses common misconceptions and provides implementation guidelines to facilitate smoke-free policy adoption. Resources including marketing materials, Spanish-language resident materials and smoke-free signs for leasing offices were also developed. Free cessation resources were offered to MUH residents and staff. An online smoke-free housing directory was developed. The directory is available in English and Spanish and is available on the program websites and contains all of the identified smoke-free MUH properties in Clark County sorted by location, price, and housing type. SNHD developed a robust media campaign in English and Spanish to promote the smoke-free housing directory to MUH residents and attract new properties to join the directory and adopt a smoke-free policy.
Project period: September 30th, 2019 to September 29th, 2021.
Objectives:
-Increase the number of smoke-free MUH units and buildings in Southern Nevada: The number of total smoke-free units increased by 6,098 contained in 58 buildings.
-Increase the number of smoke-free MUH units and buildings located in ZIP codes with high African American and Hispanic populations by 1,000 units in 16 buildings: The number of smoke-free MUH units located in these ZIP codes increased by 2,494 contained in 1,244 buildings.
Activities:
-Update and distribute toolkit to MUH properties in zip codes with 20% of the population living in poverty: Over 280 toolkits were distributed to multi-unit housing properties.
-Participate in 24 outreach events to promote the smoke-free housing directory: SNHD staff and project partners participated in a total of 69 community events.
-Develop culturally appropriate communications/media to support an increase in smoke-free MUH: More than 26 million ad impressions resulted from paid and earned media.
The online smoke-free housing directory includes a total of 52,492 units that are designated as smoke-free.The overall program goal was to increase the availability of smoke-free MUH in southern Nevada over a two-year period. The number of total smoke-free units increased by 6,098 contained in 58 buildings during the project period greatly exceeding the goal. Our results indicate that our program activities were effective.
The comprehensive nature of the project largely contributed to its success including the development and distribution of a comprehensive smoke-free MUH toolkit for property managers. Free resources were offered to MUH property managers and residents and included marketing materials, smoke-free signage, and cessation resources. Individualized technical assistance was provided through in-person meetings when requested. This personalized service fostered buy-in from MUH staff to advocate for the development of new and expansion of existing policy.
Smoke-free properties were promoted through a robust media campaign and posted in the online directory. The directory contains all of the identified smoke-free MUH properties in Clark County and is sorted by location, price, and housing type (affordable, senior, luxury, etc.). SNHD developed a robust media campaign in English and Spanish to promote the smoke-free housing directory to MUH residents and attract new MUH communities to join the directory and adopt smoke-free policy.
Project interventions were strategically focused in priority zip codes where 20% or more of the population live in poverty. Specific activities were conducted to ensure community engagement and to support health equity. Community engagement activities included participation in resident meetings at MUH properties, participation in outreach events within priority zip codes, and focus groups with MUH property managers and residents. Input from community outreach activities was used to further inform and provide areas for quality improvement. To further guide activities, an adult tobacco survey was conducted and findings from a community needs assessment were also used. Data on health inequities and social determinants of health was presented to MUH stakeholders and decision makers. Activities to reduce health inequities and support health equity included providing in-person and telephonic cessation options to MUH residents Project staff and community partners reflected the composition of the community. Project partner, Nevada Minority Health and Equity Coalition assisted with community outreach to assure interactions were conducted in culturally competent manner.
The SNHD's smoke-free housing directory and other resources can be accessed on the gethealthyclarkcounty.org (English) and vivasaludable.org (Spanish) sites:
https://gethealthyclarkcounty.org/live-tobacco-free/smoke-free-housing/ (English) and https://www.vivasaludable.org/live-tobacco-free/smoke-free-housing/ (Spanish)