Regulation of Smoking in Public Housing: Tools for Clinicians in Reduction of Asthma Triggers

Environmental asthma triggers contribute to the high rates of asthma of public housing residents. Numerous programs have been successful in reducing exposure to triggers such as pests, mildew and dust mites. Environmental tobacco smoke contributes to asthma and other diseases, but mandating smoke-free private indoor environments was considered beyond the reach of regulation.New federal guidelines strongly encourage Public Housing Authorities to implement nonsmoking policies in public housing units. The nexus between legal regulations and public health provide a unique opportunity for clinicians to engage residents in healthy behaviors, including smoking cessation. Clinicians may not know of evidence-based smoking cessation resources, especially those that address the economic, cultural and literacy realities of residents. Furthermore, understanding what treatments, programs and medications are covered by Medicaid will allow clinicians to expand their treatment options.Additionally, the decentralized nature of public housing from an administrative and ownership perspective creates challenges to developing and implementing smoke free policies. Clinicians, as well as housing authority representatives, need to understand the legal aspects of smoking regulation in public housing, and remedies available to protect residents from tobacco smoke. Integration of resident leaders and community health workers into smoking cessation strategies may helpful in promoting new regulations.