Public housing across the United States may go smoke-free in two years if a rule proposed by U.S. Housing and Urban Development takes effect.
The rule would require more than 3,100 public housing agencies to carry out policies prohibiting lighted tobacco products — including pipes, cigars and cigarettes — in living units, common areas, offices and outdoor areas within 25 feet of office buildings or housing.
HUD Secretary Julian Castro and Surgeon General Vivek Murthy announced the proposal earlier this year, opening a 60-day public comment period that ends this spring. “We have a responsibility to protect public housing residents from the harmful effects of secondhand smoke,” Castro stated. “This proposed rule will help improve the health of more than 760,000 children and help public housing agencies save $153 million every year in health care, repairs and preventable fires.”
Cigarette smoking kills 480,000 people each year and is the leading preventable cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.
Meanwhile, the U.S. Surgeon General has concluded there is no risk-free level of exposure to secondhand smoke and cleaning the air, ventilating buildings and separating smokers from non-smokers cannot eliminate exposure to secondhand smoke.
The only way to protect nonsmokers is to stop indoor smoking. A web of federal, state and local laws has extinguished indoor smoking in many places. Yet, 58 million Americans — including an estimated 15 million children — remain exposed to secondhand smoke, mostly at home.
HUD’s rule would impact more than 940,000 housing units, expanding on a voluntary campaign initiated by HUD in 2009. Over seven years, more than 600 public housing agencies — including at least 51 of the 123 housing authorities in Wisconsin — have adopted smoke-free policies for buildings and common areas. HUD estimates that more than 228,000 housing units already are smoke-free.
With a caution, the National Association of Community Health Centers supports the goals of the proposed rule. The association’s chief concern, said Colleen P. Meiman, director of regulatory affairs, is whether the rule would lead to increased homelessness.
“Smoking is an addiction,” Meiman said in her public comment to HUD. If the ban is implemented, she said any violations “should result in progressive action, starting with referrals to smoking cessation service” and “violations should never result in fines or eviction.”
In Wisconsin, advocates for the rule include fire chiefs, the Wisconsin Asthma Coalition in West Allis, American Lung Association in Brookfield, Westlawn Partnership for a Healthier Environment in northwest Milwaukee and the University of Wisconsin Center for Tobacco Research and Intervention.
The UW center cited a CDC study estimating that banning smoking in public and subsidized housing would save $310.48 million annually in health care costs associated with secondhand smoke, $133.77 million in costs for renovating and maintaining smoky apartments and buildings and $52.57 million in avoided fire damages.
The center encouraged HUD to expand the proposed rule to include e-cigarettes and other “electronic nicotine delivery systems,” with a reference to “growing evidence of carcinogenic and other harmful chemicals in e-cigarette liquid and vapor.
Many advocating a ban observed that secondhand smoke cannot be contained — that it travels through air leaks in ceilings, floors and walls.
The rule “has the potential to reduce health care costs, save lives and improve the quality of life for so many Americans,” according to Anne Dressel, project director for Westlawn Partnership for a Healthier Environment.
The partnership is a group of community stakeholders that has met regularly since 2008 to address health and environmental concerns at Westlawn, Wisconsin’s largest publicly subsidized housing development.
Dressel, in her comment on the proposed rule, said Milwaukee County ranks as the worst county in the state for asthma-related hospitalizations and emergency room visits. And the rate of asthma-related hospitalizations for children residing in the Westlawn community is about twice the county rate. The rate of emergency room visits for Westlawn is 1.5 times higher than the county rate.