2015/04/29 Council Agenda Packet

PREVENTING CHRONIC DISEASE PUBLIC HEALTH RESEARCH , PRACTICE , AND POLICY Volume 11, E171 OCTOBER 2014 ORIGINAL RESEARCH National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in the United States Brian A. King, PhD, MPH; Richard M. Peck, PhD; Stephen D. Babb, MPH Suggested citation for this article:King t3A, bock k vi, tUahb SD. state, cost savings ranged from $0.58 million ($0.31—$0.94 mil- National and State Cost Savings Associated With Prohibiting, lion)in Wyoming to$124.68 million($63.45—$216.71 million) in Smoking in Subsidized and Public }-lousing in the United States. New York. Prohibiting smoking in public housing alone would Pre% Chronic Dis 2014;I I :I:40222 DOI: !nip: ds.doi.orgl yield cost savings of$152.91 million ($79.81—$259.28 million); 10.5888`pcdI1.140222. by state, total cost savings ranged from $0.13 million ($0.07—$0.22 million) in Wyoming to $57.77 million ($29.41—$100.36 million)in New York. PEER REVIEWED Abstract Conclusion Prohibiting smoking in all US subsidized housing, including pub- lic housing, would protect health and could generate substantial Introduction societal cost savings. Despite progress in implementing smoke-free laws in indoor pub- lic places and workplaces, millions of Americans remain exposed Introduction to secondhand smoke at home. The nation's 80 million multiunit housing residents, including the nearly 7 million who live in sub- Exposure to secondhand smoke from burning tobacco products sidized or public housing, are especially susceptible to second- causes disease and premature death among nonsmokers(1). Each hand smoke infiltration between units. year, secondhand smoke exposure is responsible for an estimated 7,330 deaths from lung cancer and more than 33,950 deaths from Methods heart disease among US adult nonsmokers (2). Additionally, lost We calculated national and state costs that could have been aver- productivity resulting from exposure to secondhand smoke is es- ted in 2012 if smoking were prohibited in all US subsidized hous- timated to cost the United States approximately$5.6 billion annu- ing, including public housing: 1)secondhand smoke-related direct ally(2).The US Surgeon General concluded that no risk-free level health care, 2) renovation of smoking-permitted units; and 3) of secondhand smoke exists and that eliminating smoking in in- smoking-attributable fires.Annual cost savings were calculated by door spaces is the only effective way to fully protect nonsmokers using residency estimates from the Department of Housing and from the adverse effects of secondhand smoke exposure(1). Urban Development and cost data reported elsewhere. Data were adjusted for inflation and variations in state costs. National and In the United States,considerable progress has been made toward state estimates (excluding Alaska and the District of Columbia) increasing the number of statewide comprehensive smoke-free were calculated by cost type. policies that prohibit tobacco smoking in all indoor areas of pub- lic places and worksites, including restaurants and bars. As of Results January 2014, 26 states and the District of Columbia had enacted Prohibiting smoking in subsidized housing would yield annual comprehensive smoke-free policies (3). Such policies reduce cost savings of$496.82 million(range,$258.96—$843.50 million), secondhand smoke exposure and the incidence of certain adverse including$310.48 million ($154.14—$552.34 million) in second- health events among nonsmoking hospitality workers and the gen- hand smoke-related health care, $133.77 million($75.24—$209.01 eral public(1,4). However,these policies do not eliminate second- million) in renovation expenses, and $52.57 million hand smoke exposure from all environments.Private settings such ($29.57—$82.15 million) in smoking-attributable fire losses. By as homes remain a major source of secondhand smoke exposure CDC The opinions expressed by authors contnbr tine to this journal do nut necessarily reflect the opinions of the U.S.Department of Health one Human Services,the Public Health Service,the Centers for Disease Control and Prevention,or the authors'affiliated institutions. www.cdc.gov/pcd/issues/2014/14_0222.htm•Centers for Disease Control and Prevention 1