Faculty + Staff

Public health expert Peggy Toy on smoke-free air for everyone

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Cigarette smoke
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Peggy Toy is the director of UCLA Smokefree Air for Everyone (UCLA-SAFE), a project of the Center for Health Policy Research at the UCLA Fielding School of Public Health. The project is working to reduce exposure to secondhand smoke in apartment buildings in low-income Latino and African-American communities in the City of Los Angeles. In this brief interview —  part of the center’s Three Questions for the Expert series — Toy discusses a proposed federal rule that would require all public housing and their common areas and housing offices to be smoke-free.

How will the proposed federal legislation affect your project?
The national proposal by the U.S. Department of Housing and Urban Development (HUD) adds forward momentum to a national movement to eliminate exposure to secondhand smoke in all multi-unit housing. According to the HUD proposal, although 500 public housing authorities nationwide already have voluntary plans, these plans are concentrated in only a few areas of the country. That's unequal protection. So the rule will now provide uniform protection for all public housing residents. However, the majority of renters who live in non-public housing are still not protected.

That's how our project can help. UCLA-SAFE is supported by the CDC (Centers for Disease Control) Racial and Ethnic Approaches to Community Health (REACH) program to build the capacity of low-income communities to protect non-public apartment residents from exposure to secondhand smoke. We are doing this through community-wide education on how to implement smoke-free housing practices.

The UCLA-SAFE project has been surveying residents of some multi-unit residences in Los Angeles about smoke-free policies in their buildings. What have they found out so far?
We've completed more than 800 surveys of mostly Latino (56 percent) and African-American (29 percent) residents in Central and South Los Angeles. Our goal is to understand people's views on the effects of secondhand smoke so that we can work with them and with landlords and community partners to craft appropriate and supportive responses. For example, we want to know whether tenants would prefer to live in the non-smoking section of a building or in a completely non-smoking building in general. We want to get a sense of whether secondhand smoke drifts into people's homes, and whether people have a medical condition that could be exacerbated by living near smoke. We also need to know if there are any existing smoking policies in place in the building.

We plan to announce our findings at the official launch of the REACH project in early 2016. But here's a teaser: The data so far reveals that all tenants, and not just those who do not smoke, are interested in finding smoke-free solutions.

Opponents say smoke-free policies infringe on smokers' rights. Even some proponents say a top-down approach is the wrong way to put smoke-free policies in place — that there has to be community buy-in. How do you convince the community to embrace smoke-free public housing?
Even people who smoke want to live in housing free from secondhand smoke. All residents have a right to not have to breathe secondhand smoke in their home. HUD cites CDC studies that report that one of four nonsmokers (approximately 58 million people) continue to be exposed to secondhand smoke, with the highest exposures among children, non-Hispanic blacks, renters and those living in poverty. Children are particularly impacted by secondhand smoke, as it results in asthma, thwarts lung development and has been found to negatively impact their ability to learn. The proposal says 775,000 children are living in public housing that could be affected. Even with the HUD rule, unequal protection for low-income renters will remain unless we address non-public housing.

The UCLA-SAFE project hopes to close the gap by focusing on apartments in the City of Los Angeles, where half of all Latinos and African-Americans in low-income neighborhoods live in multi-unit buildings, many with children and family members with chronic health conditions who are potentially exposed to secondhand smoke.

We agree that it takes a community-wide effort. That's why we are working with community partners and apartment owner associations to provide the data, training and resources to enable them to educate residents and owners about the benefits of smoke-free apartments and how to adopt smoke-free housing practices. We are also working with community clinics to increase local access to smoking cessation services to help residents who smoke to quit. Smoke-free housing will improve health of residents by cutting asthma, lung cancer and other smoke-related health issues. Economically, it will lower health care treatment costs of residents and lower insurance costs, potential liability costs and cleaning and maintenance costs for building owners by more than $18 million a year in California, according to one of our studies, Estimates of Smoking-Related Property Costs in California Multiunit Housing.

This story was originally published in the School of Public Health's "Three Questions for the Expert." To learn more about the work being done by Toy and her colleagues, see the UCLA Newsroom story Room to breathe for L.A. apartment residents.

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