Cost Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing
Introduction
Exposure to secondhand smoke (SHS) from burning tobacco products causes disease and premature death among nonsmokers.1 With the increasing number of U.S. states prohibiting tobacco smoking in indoor public places, private settings are becoming relatively larger contributors to total SHS burden.1, 2 This may be particularly true for residents of multiunit housing, where SHS can infiltrate smokefree living units from units that permit smoking and shared areas.3, 4, 5, 6 In addition to SHS-related healthcare costs, smoking in multiunit housing can lead to excess expenses from property renovation and smoking-attributable fires.7, 8
Approximately 7.1 million Americans lived in subsidized housing during 2009–2010.9 Among these individuals, 2.1 million lived in public housing, which is housing either owned or operated by a Housing Authority.9 In 2009, approximately 32.7% of adult subsidized-housing residents were current cigarette smokers,10 compared with 20.6% of U.S. adults.11 This high smoking prevalence is a concern, considering that a large proportion of subsidized housing is occupied by individuals who are particularly sensitive to SHS, including children, the elderly, and the disabled.1, 9 The current study calculated the costs associated with SHS-related health care, renovation of units where smoking is permitted, and smoking-attributable fires that could be averted by prohibiting smoking in U.S. subsidized housing.
Section snippets
Healthcare Costs Related to Secondhand Smoke
Expenditures for health care related to secondhand smoke were calculated using previously published cost estimates among all nonsmoking Minnesota residents that were derived using claims data from the state’s largest health insurer.12 Because Minnesota’s smoking prevalence (16.8%) is approximately half that of subsidized housing residents (32.7%),10, 11 the annual per capita savings reported for Minnesota ($44.00) was adjusted to $85.00 (32.7/16.8 multiplied by $44). To account for differences
Results
The estimated cost savings from prohibiting smoking in all U.S. subsidized housing would be $521 million (range: $270–$892) per year, including $341 million (range: $169–$611) in SHS-related health care; $108 million (range: $61–$169) in renovation expenses; and $72 million (range: $41–$113) in smoking-attributable fire losses (Table 1). The estimated cost savings from prohibiting smoking in U.S. public housing alone would be $154 million (range: $80–$265) per year, including $101 million
Discussion
Smokefree policies are favored by a majority of tenants and legally permissible in subsidized and market-rate housing.19, 20, 21, 22 The U.S. Department of Housing and Urban Development has encouraged Public Housing Authorities, and owners and managers of multifamily housing rental assistance programs such as Section 8, to implement smokefree policies in their properties.23, 24 As of January 2012, more than 250 Public Housing Authorities across the U.S. have instituted such policies, including
Acknowledgements
There were no sources of funding, direct or indirect, for the reported research. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
No financial disclosures were reported by the authors of this paper.
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Cited by (16)
The impact of a smoke-free policy on environmental tobacco smoke exposure in public housing developments
2016, Science of the Total EnvironmentCitation Excerpt :A number of studies have examined the impact of smoke-free policies on SHS exposure through its indicators (e.g. nicotine) and biomarkers (e.g. cotinine) in public indoor areas (e.g. restaurants, bars, hospitals) and have consistently found significant reduction in exposure to SHS following prohibitions (Jensen et al., 2010; Wilson et al., 2012). Beneficial effects of smoking prohibitions on health outcomes as well as cost savings have also been established (Jacobs et al., 2013; King et al., 2013; King et al., 2014b; Wilson et al., 2010). But very little is known about the impact of smoke-free policies on SHS exposure in the nation's 1.2 million households in public multi-unit housing developments.
Navigating local smoke-free multi-unit housing policy adoption
2013, Journal of Drug EducationNot Just Public Housing: An Ethical Analysis of Expanding Smoke-free Housing Policies in the United States
2023, Public Health ReportsThe impact of energy retrofits on pediatric asthma exacerbation in a Boston multi-family housing complex: a systems science approach
2021, Environmental Health: A Global Access Science SourceDeveloping smoke-free policies in public housing: Perspectives from early adopters in 2 Southern States
2018, Preventing Chronic Disease