“We have a responsibility to protect public housing residents from the harmful effects of secondhand smoke, especially the elderly and children who suffer from asthma and other respiratory diseases,” HUD Secretary Julián Castro said in a statement announcing the measure. “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 healthcare, repairs and preventable fires.”
Though HUD will not design a final rule until after it hears public comments over the next two months, there seems little doubt that the government is headed toward the smoking ban, since the Obama administration is already moving in that direction. Since HUD strongly encouraged public housing agencies to design anti-smoking policies in 2009, more than 600 have done so. That means that more than 228,000 of the nation’s public housing units are already smoke-free.
The latest move escalates even further the anti-smoking crackdown that has unfolded in the five decades since the U.S. surgeon general first linked cigarette smoking to deadly diseases such as lung cancer and heart disease. The campaign has seen some successes: cigarette smoking among adults has been cut more than in half from its 42 percent rate in 1965, and the United States now has more former smokers than current ones.
But cigarette smoking still kills 480,000 Americans each year, making it the leading preventable cause of death in the United States, according to the Center for Disease Control and Prevention (CDC). Officials primarily cited that health data in justifying the proposed public housing smoking ban, noting especially the risks to children and the elderly people who live in more than 500,000 public housing units.
“Everyone – no matter where they live – deserves a chance to grow up in a healthy, smoke-free home,” said U.S. Surgeon General Vivek H. Murthy. “There is no safe level of secondhand smoke. So, when 58 million Americans – including 15 million children – are exposed to secondhand smoke, we have an obligation to act.”
Anti-smoking and health groups on Thursday hailed the proposal. “Secretary Castro has taken an important step to improve public health by eliminating exposure to secondhand smoke and creating an environment that discourages smoking in public housing units,” said Chris Hansen, president of the American Cancer Society Cancer Action Network.
American Heart Association CEO Nancy Brown said the move would “clear the air in public housing where children and the elderly are especially vulnerable to tobacco smoke exposure. No level of secondhand smoke is safe, and tobacco in any form is a major risk factor for cardiovascular disease.’’
But housing authority officials and lawyers, while generally supporting the government’s move, raised a series of concerns, including whether some residents will resist the smoking ban and how it will be enforced. “Obviously, there is a clear public health issue,’’ said Amy M. Glassman, who is of counsel at Ballard Spahr in Washington and represents public housing authorities. “But especially when you’re talking about banning smoking within their housing unit, folks take that as an issue of personal space and freedom, ‘You’re telling me what to do within the confines of my own home.’ That’s the main pushback issue.’’
In New York City, home to the country’s largest population of public housing tenants, Housing Authority Chairwoman Shola Olatoye said, “The dangers of second-hand smoke have been clearly documented.” The authority bans smoking in public areas, but not in private apartments. The success of the new ban will depend on “peer support and accountability,” she said.
A 2012 survey of public housing residents showed a smoking rate of 14 percent, in line with the 13.9 percent rate in the city as a whole.
Olatoye said it was unclear how the ban would be enforced, in part because “we’re at our lowest staffing levels in many years.” She said it likely the housing authority will designate an area where residents can smoke, although officials have not decided whether it would be inside or outside.
“Reasonable accommodations [for smokers] are going to have to be made,” she said.
Timothy Kaiser, executive director of the Public Housing Authorities Directors Association, which represents 1,900 housing authorities, said the smoking ban “addresses an important health issue.” But he said local housing authorities have higher-priority concerns, like a shrinking budget for operating expenses and massive cuts to capital spending that’s resulted in a loss of 10,000 apartments a year to decaying conditions.
“Your average executive director is trying to figure out how to keep the light on and the doors open and operating in the next three to five years,” Kaiser said in an interview.
He said housing officials also are concerned that the smoking ban will create hardships for elderly and disabled tenants, many of whom light up in their apartments. “We have elderly residents who are addicted to nicotine,” he said. “They will have a very difficult time. They may not be all that ambulatory. They’ll need adjustments to the new rules.”
The surgeon general’s office, which famously first called attention to smoking’s health dangers in 1964, has continued that campaign into the digital era. In a report release last year, then-Acting Surgeon General Boris D. Lushniak added liver cancer and colorectal cancer to the list of health problems associated with tobacco use.
And in March, the Centers for Disease Control and Prevention targeted e-cigarettes in its anti-smoking ads for the first time.
In addition to the health benefits of the smoking ban, the government cited economic gains: officials said it would also help reduce damage and maintenance costs associated with smoking. HUD cited estimates that smoking causes more than 100,000 fires each year, resulting in more than half a billion dollars in property damage, and is the leading cause of fire-related deaths in multifamily buildings.
The agency also cited a study last year by the CDC that estimated that banning smoking in public housing would save $153 million annually, including $94 million in secondhand smoke-related health care and $43 million in renovation of units where smoking is now permitted.
Lisa Rein contributed to this post.