1. Making no-smoking rules WORK in Affordable Housing

2. Today we’ll talk about Trends
Why safe & healthy housing should not be a luxury
Steps and tools to implement a no-smoking policy
Understanding tobacco addiction

3. Smoking: The world has changed
In 1965, 1/2 of adult men and 1/3 of women in the US smoked and they did it:
At work
On airplanes
During college classes
In hotels and theatres
In restaurants, bars and taverns
In their homes and
In their beds

4. Present Day Most workplaces are smokefree
85% of homes in Oregon and 87% in Washington have a no-smoking rule
People expect smoke-free air where they work and where they live

5. What we know about SECONDHAND SMOKE
There is no safe level of exposure to SHS:
“The scientific evidence is now indisputable:
secondhand smoke is not a mere annoyance.
It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults.”
U.S. Surgeon General, 2006

6. Children living in buildings where smoking is allowed…
Have higher levels of nicotine markers in their blood.
SHS can seep into apartments where no one smokes through shared walls, ventilation systems and ductwork.
SHS is absorbed into furniture, carpets, curtains, clothing, toys, etc that children come into contact with and put in their mouths.

7. Secondhand smoke cannot be controlled
“At present the only means of
effectively eliminating the health risks
associated with indoor exposure is
to ban smoking activity.”
American Society of Heating, Refrigerating &
Air-Conditioning Engineers

8. “Treatments” can make it worse
Separating smokers from non-smokers, using air cleaning technologies, or ventilating buildings does not eliminate SHS exposure
Heating, ventilation and air conditioning systems can actually distribute SHS throughout a building

9. What we know about RENTERS
77% of Metro renters, regardless of smoking status, prefer to live in smokefree housing
46% would feel uncomfortable living next door to a smoker
74% say it’s OK for landlords to ban smoking
Results were similar across all income groups
Portland-Vancouver metro renter survey conducted 2009 by Campbell DeLong Resources, Inc

10. What we know about RENTERS and SMOKING
How many renters do you think smoke?
Survey of Metro renters said: 23% (16% daily, 7% some days)
How many renter households allow smoking inside?
82% do not allow smoking anywhere inside + 6% where smoking occurs rarely or never
Most tenants don’t smoke,
and over half of those who do already go outside.

11. Oregon and Washington Smokefree Laws
Almost every workplace and public place is smokefree in Oregon and Washington
This includes public and common areas and anywhere an employee must pass through in the course of their duties
Also no-smoking within 10 feet (OR) and 25 feet (WA) of any entrance, window or intake unit
Since 12/ 2005 for Washington and 1/2009

12. Prohibiting smoking is legal…
Smokers are not a protected class.
Nonsmokers may be eligible for protection from SHS under Fair Housing laws.
“Property owners and managers have every right to restrict smoking in and on their property.”
Fair Housing Council of Oregon

13. New Oregon law for landlords
As of 1/1/10 landlords must disclose, as part of their rental agreement, whether or not smoking is:
Prohibited on the premises
Allowed on the entire premises
Allowed in limited areas on the premises
If smoking is allowed, the disclosure must state where it is allowed.

14. HUD Weighs In HUD strongly encourages public housing authorities and
multifamily housing rental assistance programs to implement Non-Smoking policies
for some or all of the units they own or manage.
HUD Notice PIH (HA)
HUD Notice H

15. National trends in public housing
Please note: though some cities and municipalities throughout the country have pursued legislative approaches to no-smoking policies, the Washington State Department of Health support voluntary policies and works with landlords and owners who are interested in learning more about no-smoking policies.
*This represents an increase of over 1,000% over the last 68 months. 15

16. Safe and healthy housing should not be a luxury for those who can afford it

17. Portland Tribune photos
Look familiar?
Clean-up after a smoker; nicotine coats everything
Portland Tribune photos

18. Safe & Healthy Housing for ALL
Safe & healthy housing is key to a person’s physical safety and well-being.
Homes should not pose a serious health hazard to the people who live there.

19. Safe & Healthy Housing for ALL
Residents in affordable housing have the least amount of choice and ability to move.
With long waits to get in, they are not likely to move out if they experience unwanted SHS at home.

20. Safe & Healthy Housing for ALL
People with low-incomes already have higher rates of chronic disease and disability.
Exposure to SHS and tobacco use make this worse.

21. How YOU can provide Safe & Healthy Housing
A no-smoking policy is an easy and affordable way to:
Improve the indoor air quality of a building
Improve resident health

22. No-Smoking policy might include:
All buildings
Inside the units
Porches,patios and balconies
Outside areas (such as playgrounds & pools)
Parking areas

23. Communicating your policy
Make sure to use the words “non-smoking” or “smokefree” in your rental ads
Put the rule in writing - where smoking is and is not allowed - that it applies to guests too
Post adequate signage

25. A no-smoking rule doesn’t mean “no smokers” It just means NO-SMOKING

26. Enforcing your no-smoking rule
Just like any other rule:
Residents can be your best allies
If a resident complains, document the facts and resolve the matter
Prompt consistent action will send a clear message
Lack of enforcement with one resident will make it difficult to enforce with others

27. Understanding TOBACCO Addiction

28. 3 out of 4 Who is Ready to Quit? Oregon smokers say they want to quit
Prochaska’s Readiness to Change Model. This can be used for any type of behavior change.
Have them write down a behavior and place themselves on this scale. Why do they think this is where they are on the scale. What would make them move up the scale?
Example of the Ambivalence Box.

29. Why Don’t They Just Quit?
Chain of Addiction:
Biologically Addictive
Psychologically Addictive
Culturally Addictive
Talking Points:
Three different types of addiction make quitting even harder for tobacco users to quit.
Biologically Addictive:
Nicotine has been reported as more addictive than heroine or cocaine.
Nicotine triggers chemicals in the brain that increase pleasure and reduce anxiety.
Nicotine exposure produces lasting changes in the brain.
Psychologically Addictive:
Can be used as self-medication.
Can be used as coping mechanism.
Behaviors and rituals make quitting even harder.
Culturally Addictive:
Promoted as part of social activities and norms.
Linked to group membership.
Tobacco companies spend over $15 Billion on marketing annually.
Adapted from materials produced by the Tobacco Cessation Resource Center, Washington State Department of Health

30. Biological addiction to nicotine
Feeling of pleasure, decrease in anxiety
Lasting chemical changes in brain
Quitting produces withdrawal symptoms
Adapted from materials produced by the Tobacco Cessation Resource Center, Washington State Department of Health

31. Psychological addiction to smoking
Triggered by other behaviors
Having drinks or coffee, driving, etc
Self-medication
Adapted from materials produced by the Tobacco Cessation Resource Center, Washington State Department of Health

32. Cultural/Environmental link to nicotine addiction
Friends who smoke
Activities that involve smoking
Advertising
Movies
Places that still allow smoking
Adapted from materials produced by the Tobacco Cessation Resource Center, Washington State Department of Health

33. What’s in a Cigarette? 4000 chemicals, 50 carcinogens

34. Benefits of Quitting 20 Minutes 2 Weeks-3 Months 8 Hours 48 Hours
Blood Pressure 
Body temp in feet/hands 
2 Weeks-3 Months
Circulation improves
Lung function increases
8 Hours
C02 Level decreases to normal
Oxygen level increases to normal
1 year - Risk of coronary heart disease decreases by 50%
5 years - Stroke risk is reduced to that of never-smokers
48 Hours
Taste/Smell improves
Nerve endings begin regrowth
10 Years
Lung cancer death rate
decreases by 50%
Risk of Heart Disease almost same as a non-smoker
Source: The American Lung Association

35. The average person makes 2-3 serious quit attempts before finally quitting
Prochaska’s Readiness to Change Model. This can be used for any type of behavior change.
Have them write down a behavior and place themselves on this scale. Why do they think this is where they are on the scale. What would make them move up the scale?
Example of the Ambivalence Box.
Adapted from materials produced by the Tobacco Cessation Resource Center, Washington State Department of Health

36. No-smoking rule supports cessation
Cessation supports no-smoking rule
Moves people along quitting continuum
Prevents relapse
Creates supportive environment to stay quit
Makes rule easier to enforce
Creates supportive environment for no-smoking policy

37. One last thought
A disgruntled resident from Housing Authority of Portland said (in a March 2009 Tribune article)
“If you can’t afford to buy a condo
or your own house,
it’s going to be very difficult to smoke
in your own home.”

38. Think of it this way You shouldn’t have to buy your own home
to be protected from secondhand smoke.

39. Oregon Smokefree Housing Project
For more information and tools, go to
Oregon Smokefree Housing Project
comcast.net
Developed by Diane Laughter, MPH, of Health In Sight LLC
This work is funded by the Tobacco Prevention & Education Program, Oregon Health Authority