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Community Changes Address Common Health Threat

It’s common knowledge that smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke, also referred to as secondhand smoke. Secondhand smoke contains more than 7,000 chemicals, hundreds of which are toxic, and at least 69 that can cause cancer. Adult nonsmokers who are exposed to secondhand smoke also are at increased risk for heart disease and lung cancer.1

The trend to reduce secondhand smoke exposure has grown steadily since the late 1970s. Today, hundreds of US communities have extended protections against secondhand smoke to employees, customers, and the public in restaurants, bars, workplaces, and public buildings, as well as to residents living in multiunit housing, and to children playing in community playgrounds and parks.

However, many Americans still live in communities without robust smoke-free protections. They are frequently exposed to the cancer-causing chemicals of tobacco smoke in their neighborhoods and homes. Many of those exposed are children, who are particularly vulnerable to the negative effects of secondhand smoke.1 Children’s exposure to secondhand smoke increases lung infections, triggers more frequent and severe asthma attacks; increases risk of ear infections, and sudden infant death syndrome (SIDS).1,2

The Tale of One Grandma

Many parents and grandparents live beside neighbors who smoke, wishing there was something they could do to help their family breathe easier at home. Meena Carr, affectionately known to the residents in her housing complex as “Grandma Carr,” took action after she grew concerned about her grandson’s asthma. “He started having these attacks when he would get up and he would say he could not breathe,” recalled Grandma Carr. “That really got to me.” Determined to help her grandson, she became a community leader with the intent of turning her Washington-Beech public housing complex into a smoke-free community—an improvement that a vast majority of residents in her multiunit housing complex agreed with.

Secondhand Smoke and Multiunit Housing

Secondhand smoke is inescapable at many multiunit housing complexes. Nonsmoking residents living next to neighbors who smoke can be exposed to the hazardous tobacco smoke that travels through air conditioning vents, under doors, through windows, as well as through cracks in walls and floors.

  • More than 40% of multiunit housing residents with a smoke-free home rule report secondhand smoke exposure in their units.3
  • Children live in 40% of all public housing units.4
  • According to a study, children had a 45% increase in levels of cotinine (a by-product of tobacco) when living in an apartment vs. a detached home.5

It wasn’t an easy or quick task. Grandma Carr first gathered information on secondhand smoke. Some of the information and resources came from one local organization, Community for Boston Public Housing, which presented Washington-Beech residents with results of a study. The study showed the increase in asthma among children living in the housing complex was caused by smoking in the buildings.

When Washington-Beech started plans to redevelop her housing complex, Grandma Carr stepped forward as a representative for the residents. “I said to the developers, 'When you develop, I want Washington-Beech to be a smoke-free development,' and I told them my story.”

Residents of the complex formed a smoke-free committee that began educating others about the harmful effects of secondhand smoke and the effect it was having on the children living in their multiunit housing complex.

As expected, some residents were worried about the proposed changes. Undeterred, Grandma Carr and other residents continued their education efforts, confident that the information would help address their concerns. “When I face people with opposition,” said Grandma Carr, “I say, 'Listen, [when] you have a child who wakes up in the middle of the night and says [he] cannot breathe, you will understand why I am fighting for no smoking, because it’s for my own welfare and my grandson’s welfare.'”

As a result of the efforts in Washington-Beech, the Boston Housing Authority (BHA) became the first large public housing program in the nation to make all of its properties smoke-free—a change that has benefited an estimated 23,000 residents and 900 BHA employees. In addition to BHA establishing smoke-free public housing, 7 private multiunit housing complexes implemented smoke-free homes.

The city implemented the Web site BostonSmokeFreeHomes.org to help residents find smoke-free housing; 6,600 units were listed at the site. Boston public schools have also become completely smoke-free, protecting 56,000 students and 9,000 staff from secondhand smoke exposure, and teaching a tobacco prevention program in all grades. The city of Boston also posted no-smoking signage in 135 city playgrounds.

Communities at Large Are Clearing the Air

Photo: Boy with parentsIn addition to creating smoke-free protections in multiunit housing complexes, communities across the country are also working to reduce secondhand smoke exposure in schools and other public places. With support from the Centers for Disease Control and Prevention, communities are making lasting changes that reduce secondhand smoke exposure and improve the health of their residents, even the youngest among us. For example:

  • About 400,000 Chicago public school students will have access to smoke-free playgrounds. Chicago public schools are working with the city’s health department to ensure that the places where children play are smoke-free.
  • In Maryland, approximately 1.5 million residents living in 19 counties have increased access to tobacco-free or smoke-free environments. Parents and their children can take comfort in knowing that the Maryland Stadium Authority (responsible for Oriole Park at Camden Yards and M&T Bank Stadium, home field for the Baltimore Ravens), the University System of Maryland, and county governments have all implemented changes to reduce residents’ exposure to secondhand smoke and increase the number of areas providing a smoke-free environment.
  • In Los Angeles County, California, the Santa Monica Pier—a place many families visit—became smoke-free. Approximately 4 million people who visit the pier each year are now protected from the dangers of secondhand smoke exposure.

More Information

To learn more about the dangers of secondhand smoke and what can be done to limit exposure, access the following Web resources:

1 Centers for Disease Control and Prevention. Secondhand Smoke Facts Web site. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm.
Accessed September 5, 2013.

2 US Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: a Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services; 2006. http://www.surgeongeneral.gov/library/secondhandsmoke/report Accessed September 19, 2013.

3 Centers for Disease Control and Prevention. Healthy Homes Manual: Smoke-Free Policies in Multiunit Housing. Atlanta: US Department of Health and Human Services HHS; 2011. http://www.cdc.gov/healthyhomes/healthy_homes_manual_web.pdf [PDF - 6.99MB]. Accessed September 19, 2013.

4 HUD. Resident Characteristics Report. In press.

5 Wilson KM, Klein JD, Blumkin AK, Gottlieb M, Winickoff JP. Tobacco-smoke exposure in children who live in multiunit housing. Pediatrics. 2011;127(1):85-92.

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