Organizations Serving Public Housing Residents

The Centers for Disease Control and Prevention (CDC) is supporting the U.S. Department of Housing and Urban Development (HUD) in its effort to protect residents and staff working and living in federally owned and operated public housing units from the dangers of secondhand smoke exposure.

HUD’s Smokefree Rule: What You Need to Know

On December 5, 2016, HUD published its final rule ¹ in the Federal Register requiring each Public Housing Agency (PHA) administering low-income, conventional public housing to initiate a smokefree policy. The rule, which became effective on February 3, 2017, provided an 18-month implementation period after which all PHAs must have a smokefree policy in place, by no later than July 31, 2018. This smokefree policy prohibits lit tobacco products (cigarettes, cigars or pipes) in all living units, indoor common areas, and administrative offices and extends to all outdoor areas within 25 feet of housing and administrative office buildings. The rule improves indoor air quality in the housing; benefits the health of public housing residents, visitors, and PHA staff; reduces the risk of catastrophic fires; and lowers overall maintenance costs.

Since 2009, HUD has strongly encouraged PHAs to adopt smokefree policies covering living units and common areas, a policy many private housing developments already have in place, and more than 600 PHAs and Tribally Designated Housing Entities (TDHEs) adopted at least partial smokefree policies. Through this voluntary effort and local initiatives, more than 228,000 public housing units became smokefree. Once fully implemented, the HUD smokefree rule will expand the impact to more than 1.8 million public housing residents, including more than 500,000 units inhabited by elderly residents. Importantly, the rule will protect the nearly 680,000 children living in public housing.²

What is Secondhand Smoke and How is it Harmful?

Secondhand smoke is smoke from burning tobacco products or smoke that has been exhaled by a person smoking.³ Tobacco smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer. Exposure to secondhand smoke causes disease and premature death among nonsmokers.³ There is no risk-free level of secondhand smoke. The U.S. Surgeon General has warned that breathing secondhand smoke for even a short time is dangerous.⁴

Secondhand smoke has been shown to travel between units in multiunit housing, such as apartment buildings.^4,5 Persons who live in rental housing are especially likely to be exposed to secondhand smoke. Other populations that are present in large numbers in public housing, including children, African Americans, and persons living below the poverty level, are also more likely to be exposed to secondhand smoke. African American children are especially likely to be exposed to secondhand smoke.⁶

Secondhand smoke causes numerous health problems in infants and children, including sudden infant death syndrome (SIDS), more frequent and severe asthma attacks, respiratory infections, and ear infections.

In nonsmoking adults, secondhand smoke causes coronary heart disease, stroke, and lung cancer.⁷ Nonsmoking adults who are exposed to secondhand smoke at home or at work increase their risk of developing heart disease by 25–30%.⁷

How Does Smokefree Housing Benefit Housing Managers and Protect Residents?

There are proven benefits of smokefree housing for landlords, managers and their residents. These benefits include:

• Improved safety. Smokefree housing reduces fires caused by smoking. It is estimated that smoking causes more than 100,000 fires each year nationwide, resulting in more than 500 deaths and nearly a half a billion dollars in direct property damage.⁸
• Cost Savings. HUD’s smokefree rule will reduce damage and maintenance costs associated with smoking. According to CDC, HUD’s national smokefree policy will save public housing agencies $153 million every year, including $43 million in renovation of smoking-permitted units, $16 million in smoking-related fire losses, and $94 million in secondhand smoke-related health care expenditures.⁹
• Improved health. The home is a major source of secondhand smoke exposure, especially for children.^5,6,8 Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from exposure to secondhand smoke in these settings.^5,6 More than four in five U.S. households have adopted smokefree home rules.¹⁰ However, even when they adopt such a rule, residents of multiunit housing can still be exposed to secondhand smoke that seeps into their units from other units and common areas.^4,5,6,8

Free CDC Smokefree Resources

CDC and its partners have secondhand smoke information and quit smoking resources, including some specific to smokefree housing. The following resources can help you as you implement your smokefree policies.

Secondhand Smoke Resources

• Share this CDC Infographic.
  
• Order these posters to display in your office—CDC Secondhand Smoke Posters (available through the CDC Publications Catalog).
  
• CDC Booklets Secondhand Smoke: What It Means to You [PDF – 11MB] (SGR2006 consumer booklet). This booklet is available through the publications catalogue. How We Can Protect Our Children from Secondhand Smoke brochure (English, Spanish, Native American, African American versions). These are available through CDC Publications Catalog, though not all versions are currently in stock.

Quit Smoking Resources

• Print and post this flyer in the common areas of your properties. It can also be shared as a handout at meetings, as an insert in newsletters, or included in other communications you have with residents and staff. The flyer is designed to be printed on 8 ½ x 11 inch paper, either in color or in black and white. It is available in English and Spanish.
  • Smokefree Quit Flyer [PDF – 2MB]
  • Smokefree Quit Flyer – Spanish version [PDF – 866kb]
• Resources to help residents quit smoking. There are many free resources available to help your residents quit smoking, including quitlines, educational materials, websites, apps, and support groups. For a list of free quitting tools, visit CDC.gov/quit.
• Meet Jessica. Jessica, age 28, lives in New York and has never smoked. Her son, Aden, was diagnosed with asthma at age 3, and experienced asthma attacks that were triggered by exposure to secondhand smoke.
• Visit the Tips From Former Smokers® (Tips®) Campaign Download Center—HUD tab—to download and print free materials (materials available in English and Spanish).

Free HUD Smokefree Housing Resources

• HUD Guidebook: Implementing HUD’s Smoke-Free Policy in Public Housing (2017) [PDF -1.49MB]
• HUD Public Housing Smoke-Free Fact Sheets
• Public Housing Agency (PHA) contact information: map of local housing authorities, regional districts
• Watch this video: Change is in the Air: Implementing and Enforcing Smoke-Free Housing Policies. The video includes links to materials including customizable educational materials (e.g., presentations, brochures, fact sheets); sample resident surveys; archived webinars on smokefree public housing, etc.
• Learn more from HUD’s Office of Lead Hazard Control & Healthy Homes – Smokefree Site

Additional Smokefree Housing Resources

Smokefree Housing Videos

• Watch this Informative Video: Making the Business Case for Prevention: Smokefree Multiunit Housing
• Listen to resident’s stories captured as part of the American Lung Association’s (ALA) “Expanding Smokefree Communities” project video series on smokefree multi-unit housing: A Mother’s Asthma-friendly Housing Story, Breathing Easier at Home: A Tenant’s Story, and A Fireman’s Perspective.

Policy Related Resources

• American Lung Association and The University of Texas MD Anderson Cancer Center Smokefree Multi-Unit Housing and Tobacco Cessation Toolkit: features materials aimed at helping state and local officials and public health advocates increase coverage and access to evidence-based tobacco cessation treatments for Medicaid enrollees.
• Americans for Nonsmokers’ Rights’ Smokefree Public Housing resources, including model policy, infographics, and other materials to support communications with public housing authority staff and residents.
• Tobacco Control Legal Consortium’s Public and Subsidized Housing.

Healthcare Related Resources

• National Behavioral Health Network’s Building Healthier Housing: How Behavioral Health Providers Can Support Smoke-Free Public Housing.
• National Center for Health in Public Housing’s Public Housing is Going Smokefree [PDF – 752kb].
• Extinguish Tool. Georgia Tech. A geospatial mapping tool, with data on public housing, Medicaid, and nearby health centers, services and facilities.
• Interactive Map Directory of Local Health Departments, National Association of County and City Health Officials.

Citations:

1. U.S. Department of Housing and Urban Development. Final Rule: Instituting SmokeFree Public Housing [PDF – 488KB]. Washington, DC: Office of the Assistant Secretary for Public and Indian Housing, HUD, 2016.
2. HUD.gov. PIC Resident Characteristics Report as of August 31, 2018. Washington, DC: U.S. Department of Housing and Urban Development (cited 2018 Sep 11).
3. CDC. Secondhand Smoke Fact Sheet. Atlanta: Centers for Disease Control and Prevention, Office on Smoking and Health, 2016.
4. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
5. King BA, Travers MJ, Cummings KM, et al. Secondhand Smoke Transfer in Multiunit Housing. Nicotine Tob Res 2010;12:1133–41.
6. CDC. Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999–2012. Morbidity and Mortality Weekly Report 2015;64(4):103–8.
7. CDC. Health Effects of Secondhand Smoke Fact Sheet. Atlanta: Centers for Disease Control and Prevention, Office on Smoking and Health, 2016.
8. U.S. Department of Housing and Urban Development. Smokefree Housing: A Toolkit for Owners/Management Agents of Federally Assisted Public and Multi-Family Housing [PDF – 6MB]. Washington, DC: U.S. Department of Housing and Urban Development, Office of Healthy Homes and Lead Hazard Control, 2016.
9. King BA, Peck RM, Babb SD. National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States. Preventing Chronic Disease Journal 2014;11:140222. DOI: http://dx.doi.org/.
10. CDC. Prevalence of Smokefree Home Rules—United States, 1992–1993 and 2010–2011. Morbidity and Mortality Weekly Report 2014;63(35):765-9.