Smoke-Free Housing Benefits and Challenges: Expert Insights

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Experts discuss the benefits of smoke-free housing, such as promoting health equity, protecting investments, and reducing legal liability. Challenges include enforcement issues and policy implementation beyond public housing. Presenters from different organizations share their perspectives in a comprehensive discussion.


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  1. F FIRST SMOKE S SUCCESSES NEXT IRSTANNIVERSARY SMOKE- -FREE UCCESSES, , CHALLENGES NEXTSTEPS STEPS ANNIVERSARYOF FREEHOUSING CHALLENGES, , AND OFTHE RULE: : THE HUD HUD HOUSINGRULE AND 9/12/2024 2

  2. PRESENTERS PRESENTERS Rachel Callanan, Public Health Law Center Kara Skahen, ANSR-MN Deborah Thrope, National Housing Law Project Mike Freiberg, Public Health Law Center 9/12/2024 3

  3. AGENDA AGENDA The benefits of smoke-free housing (Kara Skahen) Overview of the HUD smoke-free housing rule (Mike Freiberg) Effective and Equitable Smoke-Free Public Housing (Deborah Thrope) Enforcement Challenges (Deborah Thrope and Mike Freiberg) Smoke-free housing policies beyond public housing Thanks to our funder: (Mike Freiberg) Resources (Rachel Callanan) Q & A 9/12/2024 4

  4. THE PUBLIC HEALTH LAW CENTER THE PUBLIC HEALTH LAW CENTER 9/12/2024 5

  5. LEGAL TECHNICAL ASSISTANCE LEGAL TECHNICAL ASSISTANCE Legal Research Policy Development, Implementation, Defense Publications Trainings Direct Representation Lobby 9/12/2024 6

  6. Image credit: Sam Bradd https://drawingchange.com/gathering-wisdom-visuals-for-a-healthy-future/ 9/12/2024 7

  7. POLLING QUESTIONS 1 & 2 POLLING QUESTIONS 1 & 2 1) Who is on the call today? a) Public housing administrator or manager b) Attorney c) Public health professional d) Resident service provider e) Resident 2) In which part of the country do you reside? a) NE b) SE c) Midwest d) NW e) SW 9/12/2024 8

  8. The Benefits of Smoke-Free Housing Kara Skahen

  9. Why smoke-free housing? Promote health equity Protected investments Increase cost savings Protect vulnerable populations Reduced legal liability Reduced fire risk Help obtain funding to build affordable or green housing Potential insurance savings Everyone deserves a safe, clean, healthy, affordable place to live.

  10. Support is growing nationally Voluntary policy adoption has been steadily increasing nationwide for the past decade, especially in market rate housing To address growing health disparities, in 2016 HUD announced a rule that all public housing must be smoke free Cities and counties are now adopting smoke-free air incentives and ordinances

  11. SMOKE-FREE PUBLIC HOUSING HAS Saved an estimated $521 million per year Protected over one million households from the harms of second and third- hand smoke, including children and the elderly Helped residents quit smoking Given a voice to residents suffering due to SHS exposure Increased awareness of cessation resources available Promoted broad discussion of healthy housing issues

  12. LESSONS LEARNED Partnering with residents is key to success and promoting compliance Success takes time and commitment Seek out mentors and community resources Remember: goal is to promote clean, healthy air for everyone, but this should be done fairly. Access CAFA s Compliance and Enforcement toolkit here: www.smokefreepublichousingproject.org

  13. Resources available Compliance and Enforcement Toolkit Foundations for a Successful Smoke-Free Policy Bi-monthly manager and resident service provider/resident Connect Calls Upcoming in-person trainings: NAHRO Conference in San Antonio in 8/26 NCTOH Ancillary Session: One Year Later- Lessons Learned from Smoke-Free Public Housing October www.smokefreepublichousingproject.org

  14. CONNECT WITH US info@smokefreepublichousingproject.org 651-646-3005 x301 www.smokefreepublichousingproject.org

  15. HUD RULE OVERVIEW HUD RULE OVERVIEW 9/12/2024 16

  16. HUD RULE HUD RULE WHAT? WHAT? Public housing Except mixed-finance Scattered sites & single- family properties Prohibited tobacco products Combustibles (cigarettes, cigars, pipes, etc.) Waterpipes (hookahs) Does NOT include e-cigs 9/12/2024 17

  17. HUD RULE HUD RULE WHERE? WHERE? All indoor areas Living units Interior areas (hallways, rental & administrative offices, community centers, day care centers, laundry rooms, etc.) All outdoor areas within 25 ft. of buildings (or to the property boundary where 25 ft. is not feasible) Entrances & windows Decks, patios, balconies No grandfathering 9/12/2024 18

  18. HUD RULE HUD RULE WHERE? WHERE? No grandfathering PHAs can add requirements to make their smoke-free policies more comprehensive than the HUD rule 9/12/2024 19

  19. HUD RULE HUD RULE HOW? HOW? Amend PHA plans Significant amendment? Check PHA plan criteria. Likely yes. 5 year plan / Annual plan Amend all tenant leases or house rules Model smoke-free lease / lease addendum Model smoke-free house rules Resident engagement (e.g., public meetings) Board approval 9/12/2024 20

  20. LOCAL DISCRETION LOCAL DISCRETION In addition to HUD rule requirements, PHAs may Restrict use of e-cigarettes Make property 100% smoke-free Increase building setbacks past 25 ft. Add additional outdoor restrictions (playgrounds & picnic tables) Include designated smoking areas At least 25 ft. from buildings 9/12/2024 21

  21. POLLING QUESTION 3 POLLING QUESTION 3 3) What is a concern you have heard about the HUD smoke-free housing policy? a) It is not being enforced b) It is being enforced unfairly c) There is confusion about policy details d) There is no resident engagement e) There is a lack of staff capacity to maintain the policy f) Other (type in chat box) 9/12/2024 22

  22. Effective and Equitable Smoke-Free Public Housing Public Health Law Center Webinar July 23, 2019 Deborah Thrope dthrope@nhlp.org

  23. Effective Smoke-Free Policies Ability of PHA to regulate smoking on its property Leads to improved public health due to a reduction in second-hand smoke, cost- savings, and other positive outcomes 2 4

  24. Equitable Smoke-Free Policies Ability of PHA to work with residents and support compliance with smoke-free rules Avoids eviction and other negative outcomes for tenants Recognizes that both smoking and non- smoking families deserve a safe and stable home 2 5

  25. Equitable Implementation Collaborate with residents and other stakeholders Provide information to tenants about cessation services and access to free/low- cost health care clinics Consider including in a smoke-free policy: Designated smoking areas A reasonable accommodation policy specific to smoking 2 6

  26. Equitable Enforcement HUD required housing authorities to amend public housing leases to include smoking in prohibited areas as a lease violation Housing authorities should also consider Evictions as a last resort Graduated enforcement No fines and fees Reset the clock after positive performance 2 7

  27. POLLING QUESTIONS 4 & 5 POLLING QUESTIONS 4 & 5 4) Have you seen improvement in air quality since the policy has gone into effect? a) Yes, less smoke is present and air quality is improving b) No change c) Unsure 5) How is the policy going so far? a) It s going well b) No opinion c) Needs improvement 9/12/2024 28

  28. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 1: How is the rule enforced? Do you have examples of best practices? 9/12/2024 29

  29. Equitable Enforcement: Best Practices 3 0

  30. ENFORCEMENT PLAN ENFORCEMENT PLAN - - EXAMPLE EXAMPLE 1st Violation: Verbal warning & cessation materials 2nd Violation: Verbal warning, cessation materials, Resident Service Referral 3rd Violation: Written warning, cessation materials, Resident Service Referral 4th Violation: Notice to Vacate with Option to Remedy, cessation materials, Resident Service Referral 5th Violation: 10-day Notice to Vacate without the option to remedy 9/12/2024 31

  31. ENFORCEMENT PLAN ENFORCEMENT PLAN EXAMPLE 2 EXAMPLE 2 1st Violation: Written warning 2nd Violation: Written warning 3rd Violation: Letter of eviction 9/12/2024 32

  32. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 2: What penalties can be applied? Are fines or evictions allowed? 9/12/2024 33

  33. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 3: What evidence can and will be used for enforcement of the rule? 9/12/2024 34

  34. COMPLIANCE & ENFORCEMENT COMPLIANCE & ENFORCEMENT ISSUES ISSUES 9/12/2024 35

  35. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 4: How does the reasonable accommodation requirement for persons with disabilities interact with the rule? 9/12/2024 36

  36. Reasonable Accommodations A reasonable accommodation is a change in a rule, policy, practice or service that may be necessary to allow a person with a disability the equal opportunity to use and enjoy their home. Smoking is not a disability as defined by fair housing and civil rights laws although residents can request an accommodation based on an underlying disability that frustrates the tenant s ability to comply with smoke-free rules. 3 7

  37. ACCOMMODATION OPTIONS ACCOMMODATION OPTIONS Move resident to a first floor unit or closer to an elevator or door to get outside. Have a social worker place signs in the home reminding the resident to go outside. Partner with local public health or community-based organizations to help the resident understand the policy, manage cravings, and provide available quitting resources if interested. 9/12/2024 38

  38. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 5: What rights and protections do residents that smoke have? 9/12/2024 39

  39. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 6: What is the role of the housing authority to assist with helping residents quit or reduce tobacco use? Do you have examples of best practices? 9/12/2024 40

  40. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES http://www.lungusa2.org/cessation2/ 9/12/2024 41

  41. 9/12/2024 42 http://www.lungusa2.org/cessation2/statedetail.php?stateId=39

  42. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES CESSATION CESSATION Cessation support should be a component in implementing the smoke free policy Electronic cigarettes are not FDA-approved cessation products FDA-approved cessation products do not pose the same risks of second or third-hand exposure There is insufficient evidence from randomized controlled trials about the effectiveness of e- cigarettes as cessation aids compared with no treatment or to Food and Drug Administration approved smoking cessation treatments. (National Academies of Sciences, Engineering, and Medicine, 2018) 9/12/2024 43

  43. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 7: How do you handle RAD converted properties? 9/12/2024 44

  44. What about RAD properties? The Rental Assistance Demonstration Program converts public housing to housing with other forms of federal assistance. Over 400,000 units of public housing are eligible for RAD. Smoke-free rules and other policies can carry over into the new development, even with new property manager and/or owner. 4 5

  45. ENFORCEMENT CHALLENGES ENFORCEMENT CHALLENGES Question Number 8: Are smoking monitors an effective approach to monitoring compliance? 9/12/2024 46

  46. COMPLIANCE COMPLIANCE AND ENFORCEMENT ISSUES: AND ENFORCEMENT ISSUES: EVIDENCE EVIDENCE 47 10/25/2018

  47. SMOKE SMOKE- -FREE OPTIONS BEYOND FREE OPTIONS BEYOND PUBLIC HOUSING PUBLIC HOUSING Other Subsidized Housing Privately Owned Market Rate Housing Policies Local Ordinances Know your authority and state law! 9/12/2024 48

  48. RESOURCES RESOURCES https://www.nhlp.org/our- initiatives/implementing- a-smoke-free-policy-in- public-housing/ www.smokefreepublic housingproject.org 9/12/2024 49

  49. RESOURCES RESOURCES https://www.nhlp.org/wp- content/uploads/Cessation -Resources-for-Legal- Services-Lawyers.pdf 9/12/2024 50

  50. WWW.PUBLICHEALTHLAWCENTER.ORG WWW.PUBLICHEALTHLAWCENTER.ORG https://www.publichealthlawcenter.org/topics/tobacco-control/smoke-free-tobacco-free-places/housing/public-subsidized-housing 9/12/2024 51

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