Excerpt from “‘If I Pay Rent, I’m Gonna Smoke’: Insights on the Social Contract of Smokefree Housing Policy in Affordable Housing Settings.” By Diana Hernández, Assistant Professor of Sociomedical Sciences and Director of the Community Engagement Core, Columbia University’s Mailman School of Public Health, et al. Originally published in Health & Place, vol. 56, Mar. 2019, pp. 106–117.
It’s no longer legal to smoke in workplaces, airplanes, hospitals and restaurants. In New York City, smoking is even banned in public parks. In July 2018, the option to smoke at home was taken away when smoke-free policies were fully implemented in NYC public housing. Despite well known benefits to decreases in smoking and secondhand smoke exposure, smoke-free policies in affordable housing have raised concerns that individual liberties are being hampered, or that the stigma attached to smoking is growing. Research conducted by Dr. Diana Hernandez et al examined socially disadvantaged housing to attempt to understand the effectiveness of smoke-free housing policies through the lens of the “social contract” framework, where residents self regulate and hold one another accountable.
Participants in the study were asked if people should be allowed to smoke in their own apartments, and the majority either agreed or strongly agreed. But when asked about involuntary exposure to secondhand smoke, the participants were nearly unanimous in stating that people shouldn’t smoke in indoor places if non smokers are present. With poor ventilation and a variety of maintenance issues in low income housing, smoking indoors can be a burden to more than one household. Kathryn, a study participant stated “They say you can’t tell a person what to do in their home, but when it leaks in the hallway, it becomes everybody’s problem,” succinctly describing the tension between individuals’ rights to act freely (including to smoke) and other individuals’ right to be protected from health risks caused by those actions. In terms of how effective the smoke-free policy is, the housing under study appeared to be smoke-free in name only, with almost half of the residents reporting second-hand smoke entering their apartments in the past year.
A lack of enforcement and strong beliefs that the policy is an inappropriate restriction on freedom have undermined the smoke-free policy. To make the smoke-free policy more palatable and feasible, the authors recommend providing smoking cessation support to those in affordable housing and designating official and appropriate smoking areas. Further, the authors suggest that policies must not cause greater harm than benefit to residents’ health, and that these policies should be part of a greater effort to make housing healthier. Lastly, they recommend that smoke-free housing policies should be adopted in housing at all income levels. In order for the smoke-free policies to gain effectiveness, residents will have to employ a social contract to improve and enforce accountability of one another in order to self-regulate smoking in public housing.
Hernández, Diana, et al. “‘If I Pay Rent, I’m Gonna Smoke’: Insights on the Social Contract of Smokefree Housing Policy in Affordable Housing Settings.” Health & Place, vol. 56, Mar. 2019, pp. 106–117.
