The Tobacco State makes progress in implementing smoke-free policies in affordable housing units.
By Hyun Namkoong
Mary London’s 63-year-long ritual of smoking a cigarette with a cup of steaming hot coffee was disrupted in 2013 when her landlords at the Woodbridge Apartments in Reidsville decided to ban indoor smoking. The new policy meant London had to take her coffee and cigarette out of the comfort and warmth of her home.
“I started smoking when I was 15,” London, 78, said. “All of a sudden, I thought, ‘This is stupid,’ and I quit instead of having to [smoke] outside in the cold.”
Woodbridge Apartments and many other affordable housing units in the state have gone smoke-free since 2014, according to a N.C. Department of Health and Human Services survey.
Woodbridge Apartments’ policy not only bans indoor smoking but forbids tenants from smoking within 25 feet of an entrance and prohibits littering cigarette butts on the property.
Since 2011, North Carolina has created partnerships and strategies to promote smoke-free housing, said Anna Stein, legal specialist of the Division of Public Health’s Chronic Disease and Injury Branch.
Tobacco use continues to be the leading cause of preventable deaths in North Carolina, where one in five adults smoke. In addition, research shows that tobacco use and its health consequences can affect people who don’t light up. That’s why the Centers for Disease Control and Prevention says that bans on smoking indoors to limit second-hand smoke are important, especially for children.
Stein said state and local health departments provide assistance to property managers going smoke-free and share tobacco-cessation resources with residents interested in quitting.
“The number-one thing we have to overcome is fear,” said Scott Wilkerson, the chief investment officer for Gingko Residential, a property company that manages low- and middle-income housing in Virginia and North and South Carolina. “People are afraid of change. They’re afraid they’ll alienate customers.”
Wilkerson told a meeting of public health officials last fall about leading his company through the transition of more than 60 percent of Gingko’s properties to smoke-free after years of urging his bosses to make the change.
“The reason we have been successful doesn’t have a lot to do with public health,” he said. “It has to do with what our customers want. Our customers appreciate it and they like it. They don’t like breathing second-hand smoke, and even the smokers, for the most part, support the change.”
The fumes of a neighbor’s cigarette can enter through air vents and into the living areas, Wilkerson said.
“If you put smoke in the building, it’s going to come through the building. I don’t care what type of filters you put in place,” he said.
And research indicates he’s right: An outright ban on indoor-smoking is the best way to reduce the effects of second-hand smoke.
For some smokers, like London, a ban on indoor smoking helps them quit. A smoke-free home can also help prevent relapse. And even if people don’t quit cold turkey, smoke-free homes have been shown to reduce cigarette consumption.
Educators from local health departments go out to public housing properties that are making the switch to inform tenants of QuitlineNC, a free and confidential hotline that provides support and information on ways to quit tobacco use.
Tenants also get information on nicotine-replacement therapies.
Short on time
The time it takes for property managers to implement the policy is one of the biggest barriers to going smoke-free.
Gil Howard, site manager for Woodbridge Apartments, said tenants had questions and concerns about the policy, but that the overall transition was smooth.
When the policy was first instituted, Howard said he had to send out warning letters and arrange meetings to remind tenants of the ban.
“It takes time to change the leases, to talk to residents and explain the policy change and get them on board,” Stein said. “A lot of times, property managers are very busy [with their daily duties].”
She said the department coordinates peer-to-peer conversations between property managers who have gone smoke-free and those who haven’t to share lessons learned.
Legal actions to enforce the smoke-free ban are rarely used, according to the DHHS survey. Survey results also show that smoke-free properties have the same occupancy rate as properties that aren’t, alleviating fears of property managers who worry they’ll lose tenants.
Costs from smoking
Yellow walls covered in nicotine residue are tell-tale signs of indoor smoking, according to Howard.
“It was unbelievable how thick the smoke residue was in those apartments,” he said.
Indoor smokers can cause headaches for property managers when they leave, averaging almost $400 more to fix up an apartment, according to the DHHS survey.
Howard said maintenance workers would paint several coats on walls and doors and change the fixtures because the apartment was completely yellow after a smoker moved out.
Multiple coats of paint and deep cleaning a carpet might mask the odors and discoloring from tobacco smoke, but since 2009 scientists have investigated a phenomenon known as third-hand smoke to understand the impact of residual nicotine or carcinogens that linger in ceilings and surfaces long after a cigarette has been put out.
Early research shows that residual nicotine absorbs deeply into surfaces and can be very difficult to remove.
Stein said it’s ideal for a property to already have a smoke-free policy before opening up, like the newly renovated Walnut Terrace property in Raleigh. Walnut Terrace is the Raleigh Housing Authority’s first smoke-free property.
But, Stein added, “It’s not a good idea to say that we can never get it clean. Go smoke-free; clean up the best you can.”
Howard said the decision to go smoke-free wasn’t only a maintenance issue, but also a safety one. The risk of fires caused by people falling asleep with a lit cigarette played a role in the policy change.
Fires were what convinced Wilkerson’s bosses in 2006 that going smoke-free was the thing to do.
“We had four fires that caused more than a million dollars in damage, each that were caused by what the fire department called ‘improper disposal of smoking materials,’” he said. “That got their attention.”
In the properties surveyed by DHHS, 4 percent reported a smoking-related fire in the 36 months before the survey. Smoking is the leading cause of fatal fires in homes, according to the U.S. Fire Administration.
“Our customers want it; it lowers our costs, our turnover costs, our insurance costs, and it has eliminated one of the leading causes of fires,” Wilkerson said. “We’ve done it because it’s good for business.”