Ban Smoking in Public Housing

By Jonathan P. Winickoff | NEWSWEEK

Published Jun 27, 2009

From the magazine issue dated Jul 13, 2009

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Ten years ago, I was the doctor for an 18-year-old with cystic fibrosis whose mother was a heavy smoker. The patient told me how she coughed, wheezed, and choked when she was at home. I became close with her; it seemed she was always in the hospital, and I couldn't help but think it was because she wanted to escape a toxic environment. Three years later, at 21, she died—more than 14 years before a person with cystic fibrosis could be expected to live at that time.

She is not the only young patient of mine to feel the effects of secondhand smoke. More must be done to address this suffering. President Obama's Family Smoking Prevention and Tobacco Control Act is a great step toward accomplishing this goal: it gives the FDA authority to regulate tobacco, especially as it pertains to minors. But change can't come fast enough for children from lower income levels, where rates of exposure to secondhand smoke are especially high—not surprising, given that poor adults smoke at higher rates. Children in densely populated public housing suffer the worst.

That's ironic, since these smoke-filled environments are subsidized by the same government that spends billions of dollars on secondhand-smoke-related disease. Public-housing programs receive federal taxpayer funding from the U.S. Department of Housing and Urban Development. HUD does not prohibit local public-housing authorities from making their buildings smoke-free, but it does not require it either. It should.

Across America, landlords of privately owned multiple housing units are implementing popular smoke-free policies; taxpayers funding public accommodations should demand the same. A smoke-free designation means higher property values, and lower fire risk, insurance, and clean-up costs. But most important, it means a healthier life for children.

Some people argue that smoke-free regulation weighs against our longstanding cultural values surrounding privacy and protecting the sanctity of our homes. These values are important. But when considering them against the health of a child who has never smoked but is suffering from tobacco exposure in his own building, the choice is clear to me.

Winickoff is a pediatrician at Mass General Hospital for Children and Chair of the American Academy of Pediatrics Tobacco Consortium.

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Posted By: smoke-screen.org @ 08/22/2009 4:52:12 PM

Couldn't agree with you more! I invite you to please take a few moments
to take a look and share it with those you love and care about and help them quit the nasty ugly habit.

http://www.smoke-screen.org

Thank you
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Posted By: Michael J. McFadden @ 07/14/2009 11:11:00 AM

Mr. Repace, anyone who reads my post carefully will find that I most certainly did NOT set up a straw man argument: my model actually bends over backward to avoid it. I assumed a full third of the restaurant population to be heavy active smokers, smoking twice an hour during their 16 waking hours, and I also assumed they would smoke at this heavy rate all through their "three hour nice restaurant meal." Additionally, my ventilation rate of 6 changes per hour is less than half the standard rate prescribed for such settings by ASHRAE.

If I had used a *realistic* model, the ultimate exposure would have been less than a quarter of that "100 ug/m3" (which, in any event, is very specifically defined as "unhealthy" only for 24 hour continuous exposures in OUTDOOR air with the fundamental assumption that indoor exposures during air pollution episodes will be even worse.)

Even the much higher exposures have never been defined as a health problem for bar/restaurant workers by OSHA despite the fact that OSHA spent years examining the question. Your description of this as a "festering problem" shows the fundamental bias you are operating under and which so strongly pervades all your work. Extending this sort of nonsense to the far lower exposures experienced in multi-unit dwellings simply moves the field from nonsense into outright insanity.

Michael J. McFadden,
Author of "Dissecting Antismokers' Brains"
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Posted By: James Repace @ 07/11/2009 9:22:34 AM

Reply to Mc Fadden:

Mr. Mc Fadden, a fixture on ???smokers??? rights??? websites, sets up a straw man argument. For the case he describes, restaurant volume 400 cubic meters, 6 air changes per hour, and 10 smokers, the expected respirable particulate (RSP) concentration would be 90 micrograms per cubic meter above background. Assuming a typical outdoor background of 10 micrograms per cubic meter (ug/m3), The federal air quality index, which uses a 3-hour running average, about the duration of a nice restaurant meal, describes an RSP concentration of 100 ug/m3 as ???unhealthy air.??? Not something you???d want your family exposed to. Secondly, very few restaurants would have ventilation rates that generous ??? 1 or 2 air changes per hour would be more likely, increasing the exposure by factors of 3 to 6-fold, well into the ???hazardous??? air pollution range, a major occupational health problem for restaurant workers in many states without comprehensive smoke-free laws. Thirdly, secondhand smoke in multifamily dwellings is at best a major nuisance, and at worst puts nonsmoking neighbors with respiratory disease in the hospital. Unfortunately, Departments of Public Health in cities and states have long ignored this festering problem. Finally, it is well known in the indoor air research community that it is impossible to keep tobacco smoke from penetrating into neighboring apartments. Dr. Winnickoff is dead right ??? it is long past time to end smoking in multi-family dwellings.

James Repace
Visiting Asst. Professor, Tufts University School of Medicine
and Repace Associates, Inc.