The idea that the government can tell people what to do in their own homes is controversial, however. As Dr. Winickoff and his colleagues acknowledge, the smoking restrictions they support are “morally offensive to some” because the restrictions would be imposed on residents who are poor and unable to easily relocate if they disagree with them.
Indeed, not all residents of public housing support the idea. “I do want to quit, but at the end of the day, we shouldn’t care what others do,” says Esther Matos, 29, who lives and smokes in Lizica’s housing project. “Don’t bother me, and I won’t bother them.”
Even nonsmoker Lizzie Middleton, a 65-year-old survivor of lung and colon cancer, agrees. “It may be public housing, but people still pay rent and bills and buy their own cigarettes,” she says. “They have the right to smoke in their own home.”
But HUD officials and the Harvard researchers argue that smokers such as Matos are, in fact, bothering their neighbors and harming the health of those around them.
Secondhand smoke and third-hand smoke—the toxic residue left behind on walls, carpets, and clothes long after a cigarette is extinguished—are bad news, especially for children, pregnant women, people with chronic illnesses, and the elderly, Dr. Winickoff and his colleagues note. These vulnerable groups are disproportionately represented in public housing, they point out, and may be at increased risk for sudden infant death syndrome, asthma, respiratory infections, heart attacks, and cancer.
Just a few smokers can cause a big impact in a large apartment building, Dr. Winickoff says. “Tobacco smoke can stick around for weeks, months, even years,” he explains. “Smoke doesn’t know to stop at a doorway. It travels through air vents and cracks in walls, along ventilation and elevator shafts, and up stairways.”
Smoking bans might also reduce the number of smokers and prevent young people from starting in the first place, says Michelle Mello, PhD, a professor of health policy and management at the Harvard School of Public Health, and one of Dr. Winickoff’s co-authors.
“If we can remove the constant exposure to this behavior as well as to the smoke itself, we also stand a better chance of keeping at-risk youth from beginning to smoke,” Mello says.
Even proponents acknowledge that smoking restrictions could prove difficult to enforce, however. Mello believes that smoking could be regulated in public housing in the same way that drugs and alcohol are, but she and her co-authors note that penalties—including eviction—may be hard to impose.
Next page: Few local housing authorities have restricted smoking
