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.