Commentary: Smoke-Free Housing Should be Safe and Secure

Smoking has been aggressively and fraudulently marketed to the American public by an industry that has lied and misrepresented key information about its deadly product for years, including the severely addictive nature of tobacco as well as the deadly health consequences of smoking and secondhand smoke exposure (SHS). Adding insult to injury, tobacco companies have specifically marketed to minorities and those of lower socio-economic status. Research shows that smoking rates are highest among adults with incomes below the poverty level and among those with a GED diploma or less.

As smoke-free housing policies gain momentum nationwide, we should ensure populations that are disproportionately impacted by tobacco use – including low SES groups and minorities – are not subject to the draconian consequences of these otherwise well-intended policies. A December 2012 report from the Centers for Disease Control and Prevention finds up to 29 million residents of multi-unit housing are exposed to secondhand smoke, despite having smoke-free home rules. The study, released in the journal Nicotine & Tobacco Research, is the first to report national and state estimates of the number of multi-unit housing residents who are exposed to secondhand smoke that entered their homes from somewhere else in or around their buildings.

Secondhand tobacco smoke causes heart disease and lung cancer in nonsmoking adults and is a known cause of sudden infant death syndrome or SIDS, respiratory problems, ear infections and asthma attacks in infants and children. Even brief exposure to secondhand smoke can trigger acute cardiac events such as heart attack; and SHS is responsible for an estimated 50,000 deaths each year.

Legacy agrees that the best way to prevent SHS exposure, especially to children, is not allowing smoking in multi-housing units in general. Through our grants and awards initiatives, we have support groups that have successfully worked toward making multi-unit housing smoke free. Legacy also believes that the enforcement of smoke-free policies, whether in public housing units or even private, must be reasonable and fair.

In June 2012, the U.S. Department of Housing and Urban Development (HUD), Health and Human Services (HHS) and other public health groups released “how-to” guides to assist and encourage private owners of federally assisted multi-unit housing and public housing authorities to adopt smoke-free policies to protect residents from the dangers of SHS exposure and to reduce maintenance costs.

As HUD and HHS develop enforcement mechanisms for smoke-free housing, they should avoid using termination of lease agreements or eviction as an end. Safe and secure housing – a key direction of the National Prevention Strategy – should not be put at risk because someone is not able to overcome the powerful addiction to nicotine. Instead, smokers might benefit more from other tactics, such as paying the costs associated with tobacco use or performing community service hours. In addition, tobacco users and all residents should be notified in advance of any imminent smoke-free policies and should be given smoking cessation information.

While smoke-free housing would promote health, putting the security of housing for smokers at risk due to cigarette addiction is not the answer to creating healthy homes. As we know, nearly 70 percent of adult smokers want to quit, but only 6 percent succeed; smokers need as much information about quitting, including tobacco quitline numbers, local services or even web-based services, as possible. HUD and HHS should also coordinate with Medicare and Medicaid, local health departments, community health centers and other health providers. This will ensure that smokers have access to proven tobacco cessation interventions that will save lives, money and contribute to safe and healthy homes.

David Dobbins
Chief Operating Officer
Legacy