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Cost Savings Associated with Prohibiting Smoking in U.S. Subsidized Housing

      Background

      Tobacco smoking in multiunit housing can lead to secondhand-smoke (SHS) exposure among nonsmokers, increased maintenance costs for units where smoking is permitted, and fire risks. During 2009–2010, approximately 7.1 million individuals lived in subsidized housing in the U.S., a large proportion of which were children, elderly, or disabled.

      Purpose

      This study calculated the annual economic costs to society that could be averted by prohibiting smoking in all U.S. subsidized housing.

      Methods

      Estimated annual cost savings associated with SHS-related health care, renovation of units that permit smoking, and smoking-attributable fires in U.S. subsidized housing were calculated using residency estimates from the U.S. Department of Housing and Urban Development and previously reported national and state cost estimates for these indicators. When state estimates were used, a price deflator was applied to account for differential costs of living or pricing across states. Estimates were calculated overall and by cost type for all U.S. subsidized housing, as well as for public housing only. Data were obtained and analyzed between January and March 2011.

      Results

      Prohibiting smoking in all U.S. subsidized housing would yield cost savings of approximately $521 million per year, including $341 million in SHS-related healthcare expenditures, $108 million in renovation expenses, and $72 million in smoking-attributable fire losses. Prohibiting smoking in U.S. public housing alone would yield cost savings of approximately $154 million per year.

      Conclusions

      Efforts to prohibit smoking in all U.S. subsidized housing would protect health and generate substantial cost savings to society.
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      References

        • DHHS
        The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General.
        DHHS, CDC, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention & Health Promotion, Office on Smoking and Health, Atlanta GA2006
        • CDC
        State smoke-free laws for worksites, restaurants, and bars—U.S., 2000-2010.
        Morb Mortal Wkly Rep. 2011; 60: 472-475
        • Kraev T.A.
        • Adamkiewicz G.
        • Hammond S.K.
        • Spengler J.D.
        Indoor concentrations of nicotine in low-income, multi-unit housing: associations with smoking behaviors and housing characteristics.
        Tob Control. 2009; 18: 438-444
        • King B.A.
        • Travers M.J.
        • Cummings K.M.
        • Mahoney M.C.
        • Hyland A.J.
        Secondhand smoke transfer in multiunit housing.
        Nicotine Tob Res. 2010; 12: 1133-1141
        • Levy D.E.
        • Rigotti N.A.
        • Winickoff J.P.
        Tobacco smoke exposure in a sample of Boston public housing residents.
        Am J Prev Med. 2013; 44: 63-66
        • Hewett M.J.
        • Ortland W.H.
        • Brock B.E.
        • Heim C.J.
        Secondhand smoke and smokefree policies in owner-occupied multi-unit housing.
        Am J Prev Med. 2013; 43: S187-S196
      1. Markowitz S. Where there’s smoking, there’s fire: the effects of smoking policies on the incidence of fires in the U.S. Working Paper 16625. National Bureau of Economic Research. 2010. www.nber.org/papers/w16625.

        • Ong M.K.
        • Diamant A.L.
        • Zhou Q.
        • Park H.Y.
        • Kaplan R.M.
        Estimates of smoking-related property costs in California multiunit housing.
        Am J Public Health. 2012; 102: 490-493
      2. U.S. Department of Housing and Urban Development. Resident characteristic report as of March 31, 2012. https://pic.hud.gov/pic/RCRPublic/rcrmain.asp.

      3. CDC. National Health Interview Survey. 2009 data release. www.cdc.gov/nchs/nhis/nhis_2009_data_release.htm.

        • CDC
        Vital signs: current cigarette smoking among adults aged≥18 years—U.S., 2009.
        Morb Mortal Wkly Rep. 2010; 59: 1135-1140
        • Waters H.R.
        • Foldes S.S.
        • Alesci N.L.
        • Samet J.
        The economic impact of exposure to secondhand smoke in Minnesota.
        Am J Public Health. 2009; 99: 754-759
      4. Top 50 States. Cost of living by state. www.top50states.com/cost-of-living-by-state.html.

        • Klepeis N.E.
        • Nelson W.C.
        • Ott W.R.
        • et al.
        The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.
        J Expo Anal Environ Epidemiol. 2001; 11: 231-252
      5. National Cancer Institute. 2006–2007 tobacco use supplement to the current population survey. www.riskfactor.cancer.gov/studies/tus-cps.

      6. Smoke-Free Housing Coalition of Maine. How much does secondhand smoke cost a landlord? www.smokefreeforme.org/presentation/maintenance_cost.pdf.

        • Hall J.R.
        The total cost of fire in the United States.
        National Fire Protection Association, Fire Analysis and Research Division, Quincy MA2010
        • Ahrens M.
        Home structure fires.
        National Fire Protection Association, Fire Analysis and Research Division, Quincy MA2010
        • Licht A.S.
        • King B.A.
        • Travers M.J.
        • Rivard C.
        • Hyland A.J.
        Attitudes, experiences, and acceptance of smoke-free policies among U.S. multiunit housing residents.
        Am J Public Health. 2012; 102: 1868-1871
        • Drach L.L.
        • Pizacani B.A.
        • Rohde K.L.
        • Schubert S.
        The acceptability of comprehensive smoke-free policies to low-income tenants in subsidized housing.
        Prev Chronic Dis. 2010; 7: 1-3
      7. Schoenmarklin S. Infiltration of secondhand smoke into condominiums, apartments and other multi-unit dwellings: 2009. Tobacco Control Legal Consortium, October 2009. publichealthlawcenter.org/sites/default/files/resources/tclc-syn-condos-2009_0.pdf.

        • Winickoff J.P.
        • Gottlieb M.
        • Mello M.M.
        Regulation of smoking in public housing.
        N Engl J Med. 2012; 362: 2319-2325
      8. U.S. Department of Housing and Urban Development. Non-smoking policies in public housing. 2009. www.hud.gov/offices/pih/publications/notices/09/pih2009-21.pdfhttp.

      9. U.S. Department of Housing and Urban Development. Optional smoke-free housing policy information. 2010. portal.hud.gov/hudportal/documents/huddoc?id=10-21hsgn.pdf.

      10. Smoke-Free Housing Coalition of Maine. Government subsidized housing.2012.www.smokefreeforme.org/landlord.php?page=Government+Subsidized+Housing.

        • King B.A.
        • Cummings K.M.
        • Mahoney M.C.
        • Hyland A.J.
        Intervention to promote smoke-free policies among multiunit housing operators.
        J Public Health Manag Pract. 2011; 17: E1-E8
        • Hewett M.J.
        • Sandell S.D.
        • Anderson J.
        • Niebuhr M.
        Secondhand smoke in apartment buildings: renter and owner or manager perspectives.
        Nicotine Tob Res. 2007; 9: S39-S47
        • Cramer M.E.
        • Roberts S.
        • Stevens E.
        Landlord attitudes and behaviors regarding smoke-free policies: implications for policy change.
        Public Health Nurs. 2011; 28: 3-12
        • Pizacani B.A.
        • Maher J.E.
        • Rohde K.
        • Drach L.
        • Stark M.J.
        Implementation of a smoke-free policy in subsidized multiunit housing: effects on smoking cessation and secondhand smoke exposure.
        Nicotine Tob Res. 2012; 14: 1027-1034
        • Farrelly M.C.
        • Nonnemaker J.M.
        • Watson K.A.
        The consequences of high cigarette excise taxes for low-income smokers.
        PLoS One. 2012; 7: e43838
        • Behan D.F.
        • Eriksen M.P.
        • Lin Y.
        Economic effects of environmental tobacco smoke report.
        Society of Actuaries, Schaumburg IL2005
        • Hovell M.F.
        • Robusto K.M.
        • Matt G.E.
        When is it appropriate to scream fire in a crowded theater or public housing?.
        Am J Prev Med. 2013; 44: 93-95