AAFP Backs HUD Proposal to Make Public Housing Smoke-free

November 18, 2015 09:49 am Chris Crawford

According to the Feb. 6 issue(www.cdc.gov) of the CDC's Morbidity and Mortality Weekly Report, two in five children overall in the United States are exposed to secondhand smoke. The numbers are even worse in black children, with about seven in 10 exposed to secondhand smoke.

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The report also noted that despite a significant reduction in exposure to secondhand smoke among people who rent their homes in the past decade (46 percent reduction from 1999-2000 to 2011-2012), renters were still almost twice as likely to be exposed to secondhand smoke compared with those who own their homes (about 37 percent versus 19 percent).

So it came as welcome news when on Nov. 12, the U.S. Department of Housing and Urban Development (HUD) issued a proposed rule(www.gpo.gov) to make public housing properties smoke-free.

Not only would this reduce the prevalence of exposure to secondhand smoke, but the CDC also estimated annual savings in health care and housing-related costs would total $497 million if all government-subsidized housing was made smoke-free.

"Do not underestimate what this proposed rule could do for public health," said AAFP Board Chair Robert Wergin, M.D., in a prepared statement. "This is a huge step in the right direction.

"Everyone has the right to live in a smoke-free environment. We need action. We need more smoke-free environments, and that's why the American Academy of Family Physicians fully supports the proposed rule to make public housing properties smoke-free.”

Proposed Rule Basics

HUD's proposed rule would require all public housing agencies (PHAs) to establish -- within 18 months after publication of the final rule -- a policy prohibiting the use of lit tobacco products in all indoor areas of public housing.

The rule explains that this policy is expected to improve indoor air quality, benefit the health of public housing residents and PHA staff, reduce the risk of catastrophic fires, and lower overall maintenance costs. Residents would learn of this smoke-free policy when they sign their leases and in public meetings.

HUD notes the benefits of the smoke-free policies could affect residents in more than 700,000 public housing units, including more than 500,000 inhabited by the elderly and those who are disabled.

AAFP Calls for Policy Change

In a March 27 letter(2 page PDF) to HUD Secretary Julián Castro, J.D., the AAFP joined more than 20 health organizations in calling for the agency to make all government-subsidized housing smoke-free. The letter explained that secondhand smoke contains many poisons, and exposure to these toxins poses health risks for all individuals, particularly children and pregnant women.

In their letter, the groups noted that the 2006 U.S. Surgeon General's Report(www.ncbi.nlm.nih.gov) detailed how exposure to even small amounts of secondhand smoke can have serious health consequences, including sudden infant death syndrome, lung cancer, heart disease and respiratory infections.

The letter also stated that asthma is disproportionately prevalent among residents of federally assisted public housing, so eliminating smoking in public housing would be an important step in preventing asthma attacks and protecting individuals with asthma from the harmful effects of tobacco smoke exposure.

Jennifer Frost, M.D., medical director for the AAFP Health of the Public and Science Division, told AAFP News that people exposed to secondhand smoke are exposed to the same toxic substances as smokers.

"Individuals who smoke are increasing their family members' risk of poor health, including lung disease and cancer," she said.

The AAFP is now reviewing the proposed rule and will provide comments on it by HUD's Jan. 19 submission deadline.

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