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.

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 prohibited lit tobacco products (cigarettes, cigars, or pipes) in all living units, indoor common areas, and administrative offices, and extended to all outdoor areas within 25 feet of housing and administrative office buildings. The rule improved indoor air quality in the housing; benefited the health of public housing residents, visitors, and PHA staff; reduced the risk of catastrophic fires; and lowered overall maintenance costs.

Since 2009, HUD had strongly encouraged PHAs to adopt smokefree policies covering living units and common areas, a policy many private housing developments already had 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. The HUD smokefree rule expanded the impact to more than 1.8 million public housing residents, including more than 500,000 units inhabited by elderly residents. Importantly, the rule protected the nearly 680,000 children living in public housing.²

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.³ Nonsmoking adults who are exposed to secondhand smoke at home or at work increase their risk of developing heart disease by 25–30%.³

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.⁷
• 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.⁸
• Improved health. The home is a major source of secondhand smoke exposure, especially for children.^5,6,7 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.⁹ 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.^4,5,6,7

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.

CDC’s Quit Smoking Resources

• CDC’s Preventing Exposure to Secondhand Smoke in the Home
• CDC’s Making the Business Case for Prevention: Smokefree Multiunit Housing
• CDC’s Tips From Former Smokers campaign. 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.
• Campaign Resources. Access resources, including social media content, videos, print ads, buttons and badges and other content tailored for specific audiences.
• Meet Jessica S. 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.

• 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
• Change is in the Air: Implementing and Enforcing Smoke-Free Housing Policies. This HUD 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.
• HUD’s Office of Lead Hazard Control & Healthy Homes – Smokefree Site

American Lung Association’s (ALA) Resources

• Medicaid Factsheet [PDF – 611KB]
• Federally Qualified Health Centers (FQHC) Factsheet [PDF – 423KB]
• General Landing Site
• 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

• 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.
• Public Health Law Center Making Affordable Housing Smoke-Free.

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].
• Interactive Map Directory of Local Health Departments, National Association of County and City Health Officials.