Making no-smoking rules WORK in Affordable Housing

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

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

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

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

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.

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

“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

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

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.

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

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

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.

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-2009-21(HA) HUD Notice H-2010-21

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

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

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

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.

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.

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.

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

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

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

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

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

Understanding TOBACCO Addiction

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.

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

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

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

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

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

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

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

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

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.”

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

Oregon Smokefree Housing Project For more information and tools, go to www.smokefreehousinginfo.com Oregon Smokefree Housing Project diane.laughter@ 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