Smoke-Free Public Housing: The Debate Continues

5/31/2013

In July 2009, HUD issued a notice encouraging housing authorities to implement smoke-free policies in public housing units. PIH Notice 2009-21 outlined the health effects of breathing secondhand smoke and argued that housing authorities should adopt smoke-free policies to protect non-smoking residents’ health and to decrease property maintenance costs (this notice was extended by PIH Notice 2012-25). The number of housing authorities with some version of a smoke-free policy has tripled since the issuance of this notice to approximately 350, according to an estimate by the Center for Disease Control (CDC). The growth of smoke-free policies in subsidized housing has caught the attention of major news outlets, including the New York Times, and of the public health community. A recently published CDC study on the cost-savings of smoke-free policies in subsidized housing is likely to generate even more interest by policymakers, researchers, and practitioners.

The CDC study, “Cost-Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing,” estimated the economic costs that could be averted by prohibiting smoking in subsidized housing. For all subsidized housing, the CDC estimates that the implementation of smoke-free policies would produce aggregate cost-savings of $521 million ($341 million in smoke-related health care, $108 million in renovations related to smoke damage, and $72 million in fires caused by smoking). For public housing alone, the CDC estimates aggregate cost-savings of $154 million ($101 million in smoke-related health care, $32 million in renovations related to smoke damage, and $21 million in fires caused by smoking). It should be noted that the CDC’s estimates are particularly rough because of limited data: the CDC’s analysis suggests that the total cost-savings associated with smoke-free subsidized housing may be as low as $270 million and as high as $892 million; for public housing alone, the smoke-free cost-savings could range from $80 to $265 million.

Within the study, the CDC justifies a smoke-free policy in subsidized housing by the fact that many localities have prohibited smoking in indoor public places, leaving private settings as the main contributor to secondhand smoke exposure. The CDC suggests that smoke-free policies are appropriate for subsidized housing because multifamily housing is more likely to allow for secondhand smoke exposure due to smoke infiltration between units. Moreover, the CDC also suggests that smoke-free policies are appropriate because they increase the likelihood that residents who smoke will quit or reduce their consumption, thus improving their health and reducing their expenses. This argument highlights the cause of the controversy over smoke-free subsidized housing: to what extent should the government intervene into citizens’ private lives—particularly those of the poor—in the name of improving their lives?

Thus, some CLPHA members have objected to imposing the smoke-free policy in public housing as a form of social engineering that targets the poor and which disregards that these units are residents’ homes. On the other hand, there are some CLPHA members who argue that the role of a housing authority is to improve the life outcomes of residents and do not see smoke-free policies as more intrusive than other efforts to improve residents’ health. These members point out residents are able to smoke outside, which is a minor inconvenience when compared to the benefits created for all residents. Other members have adopted-smoke free policies for reasons that might appeal to any property manager, such as reducing smoke and fire damage to units and increasing resident satisfaction, and have made their decision outside of a public health context.

There are additional reasons that housing authorities may choose to forgo a smoke-free policy. Some CLPHA members have experienced implementation challenges surrounding smoke-free policies, including policy enforcement, additional costs for promoting the policy and providing smoking cessation support, and slower lease-up of units. Other members have found that such policies may be poorly received at the outset by both residents and the general public. However, members also report that smoke-free policies become more popular over time, causing residents to request more smoking restrictions (e.g., additional floors or buildings). The limited research on implementing smoke-free policies in multifamily housing has found that the costs of implementation are minimal, but it may be that further research supports the experience of members that faced implementation challenges.

Both Rochester Housing Authority and the Alaska Housing Finance Agency have proposals for smoke-free pilots pending (policies must be incorporated into annual plans for public review and board approval). At last count, 19 CLPHA members have some form of a smoke-free policy. CLPHA last surveyed its members on this topic in 2009 and has since updated the survey results informally.

CLPHA Members with Smoke-Free Policies:

Albany Housing AuthoritySan Antonio Housing Authority
Akron Housing AuthoritySan Bernardino Housing Authority
Boston Housing AuthoritySan Buenaventura Housing Authority
Chester Housing AuthoritySan Diego Housing Commission
Denver Housing AuthoritySan Francisco Housing Authority
Fresno City and County Housing AuthoritySanta Clara Housing Authority
Home Forward Seattle Housing Authority
Kansas City Housing AuthorityTacoma Housing Authority
King County Housing AuthorityVancouver Housing Authority
Minneapolis Public Housing Authority


If your housing authority has a smoke-free policy and is not listed above, please update us. Questions and comments on smoke-free public housing can be directed to Research and Policy Analyst Carmen Brick.



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