US department of housing and urban development's smoke-free housing initiative: An overview of best practices and lessons learned to date

In the US, we have made significant progress in banning smoking from most workplaces and in indoor public spaces; however smoking is still allowed in most multiunit housing. This is true even though the US Surgeon General has concluded that there is no safe level of exposure to secondhand tobacco smoke (SHS) and research has clearly demonstrated that SHS migrates between apartments in multiunit buildings. Subpopulations that are particularly susceptible to adverse health effects from SHS exposure include children, seniors, and those with chronic disease conditions (e.g., asthma, cardiovascular disease). Smoking is also the leading cause of fatal residential fires and increases maintenance costs for property owners at unit turnover. This issue is especially salient for low income housing because low SES populations have a smoking prevalence of approximately 30% compared to a 20% prevalence in the general US population. To mitigate the adverse consequences of tobacco use and to help achieve HUD's strategic goal to “utilize HUD assistance to improve health outcomes” the Department implemented an initiative to promote smoke-free the adoption of (SF) multiunit housing policies. HUD's SF housing initiative is also a priority action in the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. Major elements of the initiative include publication of official program notices encouraging adoption of SF policies in federally assisted multiunit housing, the creation and distribution of SF housing toolkits, and the public solicitation of information on best practices and key obstacles in the implementation of SF housing policies. This presentation will summarize the elements of HUD's initiative and its impact in creating SF housing for low-income households. Best practices for initiating and implementing SF multiunit policies will also be discussed as well as estimates of the monetary benefits from implementing SF policies in federally assisted housing.