A study released by the Centers for Disease Control and Prevention last week examines costs associated with smoking in subsidized housing, finding that adopting smoke-free policies in all such units nationwide would save nearly $500 million annually. The report also includes the first published data assessing health and other cost savings at the state level.
The findings come at a time when a growing number of public housing agencies are considering smoking bans, with more than 500 adopting varying types of smoking prohibitions, according to recent HUD estimates.
“There’s been a shift in social norms to implement such practices in private settings, like in multiunit housing,” said Brian King, a senior adviser in CDC's Office of Smoking and Health who co-authored the study.
Researchers considered health care expenses related to secondhand smoke exposure, building renovations and fires caused by smoking to estimate total cost savings. New York would save more than any other state -- an estimated $125 million annually -- because a high proportion of subsidized housing residents live there. King said that total cost savings would actually be higher because the study couldn’t account for factors such as long-term health costs and work productivity losses.
Secondhand smoke-related health expenditures make up the bulk of the cost savings. Even though residents may only smoke inside their rooms, secondhand smoke has been found to drift in between units, into hallways and stairwells. Residents of subsidized housing units, the study notes, are particularly vulnerable to secondhand smoke. About 41 percent are elderly and 45 percent are children, according to HUD data.
Public agencies also must spend more to renovate units with carpets, walls and fixtures worn by smoking. And if a cigarette sparks a fire, losses could be huge. Three fires attributable to cigarette smoking occurred in properties managed by the Allegheny County (Pa.) Housing Authority, which subsequently banned smoking at five facilities.
For any smoking ban to be successful, though, residents must comply. While it’s true that smoking is slightly more prevalent in public housing complexes, King said a majority of residents still don’t smoke and support smoke-free policies.
The Kansas City Housing Authority began contemplating a smoking ban in the summer of 2012 after a fire started in a high rise designated for seniors and the disabled. Its board later passed a smoking ban that became effective in July for all properties managed by the housing authority.
Edwin Lowndes, the agency’s executive director, said that while overall reaction to the ban has been positive, smokers expressed concerns over how they’ll quit. To help ease the transition, the authority granted an extension until the start of next year for smokers who requested it, most of whom did. They’ve also worked with community groups to offer smoking cessation classes.
Those caught breaking the rules receive a written violation and consultation after the first two incidents. The third time, they could be evicted, depending on the circumstances.
“We know we’re going to have to continually monitor this,” Lowndes said. “We may have to tweak some of the implementation and look at our enforcement.”
The authority expects the policy to yield considerable health benefits and cost savings. Renovating a room that smoker vacates costs about $3,500, for example, compared to $750 for a non-smoker, Lowndes said.
HUD does not mandate smoke-free policies, but the agency encourages public housing agencies to adopt rules prohibiting smoking and has published a toolkit outlining how to do so.
Many municipalities in California have taken laws a step further, prohibiting smoking in all privately-owned multi-unit housing. Fifteen localities there enacted smoking bans that apply to all private market-rate multi-unit housing, according to the American Nonsmokers’ Rights Foundation (ANRF). One of the newer laws enacted in Berkeley this spring prohibits smoking inside units, common areas and balconies.
Another 22 California municipalities passed more limited laws prohibiting smoking in only newly-occupied units or select types of units in existing buildings, according to ANRF.
While local laws are far more common, a few state legislatures also have taken up the issue. Thirteen states passed smoke-free laws for lobby and common areas in government multi-unit housing, but only Hawaii and Oklahoma ban smoking in living areas.
There’s also movement, the CDC’s King said, among private landlords to voluntarily implement their own smoking bans.
Smoking Ban Cost Savings Data
The CDC study estimated annual cost savings associated with prohibiting smoking in all government-subsidized housing. Ranges are shown in parenthesis. Totals may not equal due to rounding.| State | Total Savings | Health Care | Renovation | Fires |
|---|---|---|---|---|
| Alabama | $12.39 ($6.57-$20.67) | $6.09 ($3.02-$10.84) | $5.03 ($2.83-$7.86) | $1.27 ($0.71-$1.98) |
| Alaska | Unavailable | Unavailable | Unavailable | Unavailable |
| Arizona | $4.90 ($2.52-$8.43) | $3.54 ($1.76-$6.30) | $0.76 ($0.43-$1.18) | $0.61 ($0.34-$0.95) |
| Arkansas | $6.80 ($3.63-$11.27) | $2.96 ($1.47-$5.26) | $3.25 ($1.83-$5.08) | $0.59 ($0.33-$0.92) |
| California | $72.36 ($36.67-$126.28) | $61.08 ($30.32-$108.66) | $5.86 ($3.30-$9.16) | $5.42 ($3.05-$8.46) |
| Colorado | $4.53 ($2.40-$7.55) | $2.20 ($1.09-$3.91) | $1.62 ($0.91-$2.53) | $0.72 ($0.40-$1.12) |
| Connecticut | $10.69 ($5.49-$18.41) | $7.88 ($3.91-$14.02) | $1.99 ($1.12-$3.10) | $0.82 ($0.46-$1.29) |
| Delaware | $1.30 ($0.67-$2.24) | $0.95 ($0.47-$1.68) | $0.25 ($0.14-$0.39) | $0.11 ($0.06-$0.17) |
| District of Columbia | Unavailable | Unavailable | Unavailable | Unavailable |
| Florida | $23.24 ($12.03-$39.75) | $15.84 ($7.86-$28.17) | $4.79 ($2.69-$7.48) | $2.62 ($1.47-$4.10) |
| Georgia | $11.64 ($6.11-$19.64) | $6.69 ($3.32-$11.91) | $3.26 ($1.84-$5.10) | $1.69 ($0.95-$2.64) |
| Hawaii | $3.76 ($1.93-$6.47) | $2.78 ($1.38-$4.95) | $0.66 ($0.37-$1.02) | $0.32 ($0.18-$0.50) |
| Idaho | $0.82 ($0.43-$1.38) | $0.45 ($0.22-$0.80) | $0.23 ($0.13-$0.36) | $0.14 ($0.08-$0.21) |
| Illinois | $13.25 ($6.97-$22.30) | $7.37 ($3.66-$13.12) | $4.53 ($2.55-$7.07) | $1.35 ($0.76-$2.11) |
| Indiana | $8.32 ($4.43-$13.81) | $3.73 ($1.85-$6.64) | $3.68 ($2.07-$5.75) | $0.91 ($0.51-$1.42) |
| Iowa | $3.75 ($2.00-$6.23) | $1.66 ($0.82-$2.95) | $1.71 ($0.96-$2.68) | $0.38 ($0.21-$0.60) |
| Kansas | $2.85 ($1.54-$4.67) | $1.02 ($0.50-$1.81) | $1.54 ($0.87-$2.40) | $0.29 ($0.17-$0.46) |
| Kentucky | $7.13 ($3.83-$11.72) | $2.68 ($1.33-$4.77) | $3.82 ($2.15-$5.96) | $0.63 ($0.36-$0.99) |
| Louisiana | $14.43 ($7.50-$24.55) | $9.27 ($4.60-$16.48) | $3.83 ($2.16-$5.99) | $1.33 ($0.75-$2.08) |
| Maine | $4.23 ($2.17-$7.27) | $3.07 ($1.53-$5.47) | $0.89 ($0.50-$1.38) | $0.27 ($0.15-$0.42) |
| Maryland | $6.95 ($3.61-$11.85) | $4.57 ($2.27-$8.14) | $1.66 ($0.94-$2.60) | $0.71 ($0.40-$1.11) |
| Massachusetts | $24.02 ($12.31-$41.47) | $18.20 ($9.03-$32.37) | $4.31 ($2.42-$6.73) | $1.51 ($0.85-$2.37) |
| Michigan | $12.77 ($6.71-$21.48) | $7.07 ($3.51-$12.58) | $4.37 ($2.46-$6.83) | $1.32 ($0.74-$2.06) |
| Minnesota | $7.13 ($3.74-$12.03) | $4.14 ($2.05-$7.36) | $2.24 ($1.26-$3.50) | $0.75 ($0.42-$1.17) |
| Mississippi | $7.16 ($3.73-$12.15) | $4.46 ($2.21-$7.93) | $1.95 ($1.10-$3.04) | $0.75 ($0.42-$1.17) |
| Missouri | $9.42 ($5.01-$15.66) | $4.36 ($2.17-$7.76) | $4.03 ($2.26-$6.29) | $1.03 ($0.58-$1.62) |
| Montana | $1.04 ($0.55-$1.72) | $0.44 ($0.22-$0.79) | $0.47 ($0.26-$0.73) | $0.13 ($0.07-$0.20) |
| Nebraska | $2.14 ($1.14-$3.55) | $0.97 ($0.48-$1.73) | $0.91 ($0.51-$1.42) | $0.26 ($0.14-$0.40) |
| Nevada | $1.94 ($1.02-$3.27) | $1.07 ($0.53-$1.90) | $0.52 ($0.29-$0.81) | $0.36 ($0.20-$0.56 |
| New Hampshire | $1.87 ($0.99-$3.14) | $0.99 ($0.49-$1.77) | $0.68 ($0.38-$1.06) | $0.20 ($0.11-$0.31) |
| New Jersey | $15.75 ($8.25-$26.6) | $9.19 ($4.56-$16.34) | $4.71 ($2.65-$7.37) | $1.85 ($1.04-$2.89) |
| New Mexico | $2.95 ($1.52-$5.06) | $2.08 ($1.03-$3.70) | $0.58 ($0.32-$0.90) | $0.29 ($0.16-$0.46) |
| New York | $124.68 ($63.45-$216.71) | $101.15 ($50.22-$179.9) | $15.70 ($8.83-$24.53) | $7.84 ($4.41-$12.24) |
| North Carolina | $13.94 ($7.38-$23.29) | $6.98 ($3.47-$12.42) | $5.42 ($3.05-$8.47) | $1.54 ($0.86-$2.40) |
| North Dakota | $1.18 ($0.63-$1.93) | $0.45 ($0.22-$0.80) | $0.60 ($0.34-$0.94) | $0.12 ($0.07-$0.19) |
| Ohio | $21.73 ($11.48-$36.41) | $11.34 ($5.63-$20.18) | $7.98 ($4.49-$12.47) | $2.41 ($1.36-$3.77) |
| Oklahoma | $6.78 ($3.61-$1.93) | $3.10 ($1.54-$5.51) | $3.07 ($1.73-$4.80) | $0.61 ($0.35-$0.96) |
| Oregon | $4.28 ($2.23-$7.28) | $2.70 ($1.34-$4.80) | $1.07 ($0.60-$1.68) | $0.51 ($0.29-$0.79) |
| Pennsylvania | $17.71 ($9.35-$29.68) | $9.26 ($4.60-$16.48) | $6.82 ($3.84-$10.66) | $1.63 ($0.91-$2.54) |
| Rhode Island | $4.00 ($2.08-$6.82) | $2.63 ($1.31-$4.68) | $1.06 ($0.60-$1.66) | $0.31 ($0.17-$0.48) |
| South Carolina | $7.02 ($3.72-$11.71) | $3.45 ($1.71-$6.13) | $2.82 ($1.58-$4.40) | $0.75 ($0.42-$1.18) |
| South Dakota | $1.11 ($0.59-$1.84) | $0.50 ($0.28-$0.89) | $0.50 ($0.28-$0.78) | $0.11 ($0.06-$0.18) |
| Tennessee | $12.94 ($6.86-$21.59) | $6.35 ($3.15-$11.29) | $5.34 ($3.00-$8.34) | $1.26 ($0.71-$1.96) |
| Texas | $28.26 ($14.85-$47.59) | $15.87 ($7.88-$28.22) | $8.69 ($4.89-$13.57) | $3.71 ($2.09-$5.79) |
| Utah | $1.35 ($0.72-$2.26) | $0.68 ($0.34-$1.21) | $0.42 ($0.24-$0.66) | $0.25 ($0.14-$0.38) |
| Vermont | $1.92 ($0.98-$3.31) | $1.46 ($0.73-$2.60) | $0.33 ($0.18-$0.51) | $0.13 ($0.07-$0.20) |
| Virginia | $7.76 ($4.10-$12.99) | $4.02 ($1.99-$7.15) | $2.51 ($1.41-$3.93) | $1.23 ($0.69-$1.92) |
| Washington | $5.02 ($2.60-$8.58) | $3.39 ($1.68-$6.03) | $1.08 ($0.61-$1.69) | $0.55 ($0.31-$0.87) |
| West Virginia | $4.34 ($2.32-$7.16) | $1.75 ($0.87-$3.12) | $2.27 ($1.27-$3.54) | $0.32 ($0.18-$0.50) |
| Wisconsin | $6.47 ($3.37-$10.96) | $3.97 ($1.97-$7.06) | $1.85 ($1.04-$2.89) | $0.65 ($0.36-$1.01) |
| Wyoming | $0.58 ($0.31-$0.94) | $0.19 ($0.10-$0.35) | $0.33 ($0.19-$0.52) | $0.05 ($0.03-$0.08) |
King BA, Peck RM, Babb SD. "National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States."
