Public housing smoking ban can reduce heart attacks and strokes

A paper, “Evaluation of Federally Mandated Smoke-Free Housing Policy and Health Outcomes Among Adults Over the Age of 50 in Low-Income, Public Housing in New York City, 2015-2022,” published in Nicotine & Tobacco Research finds that a 2018 U.S. ban on smoking in public housing led to a reduction in hospitalizations for cardiovascular problems.

Tobacco use and exposure to secondhand smoke is a leading cause of preventable death in the United States. Some 480,000 Americans die every year due to tobacco. While the prevalence of adults exposed to secondhand smoke decreased dramatically between 1988 and 2014 (from 87.5% to 25.2%), about 58 million non-smokers in the U.S. experience tobacco smoke, primarily at home.

Beginning in the early 2000s, state and local governments began to prohibit smoking in public places. Studies show that smoke-free legislation for workplaces, bars/restaurants, and other spaces is associated with reductions in systolic blood pressure and hospital admissions for cardiovascular problems.

In July 2018, the US Department of Housing and Urban Development issued a rule prohibiting smoking inside all their buildings. More than 2 million people in the United States live in public housing. With more than 400,000 residents, the New York City Housing Authority is the largest public housing organization in the country.

Researchers here examined the impact of the smoke-free policy on hospitalization outcomes for heart attacks and strokes among adults over 50 by comparing hospitalization trends among New York City public housing residents to a matched-comparison population in New York City. The study included only adults aged over 50 because heart disease risk increases substantially as adults enter their 50s.

The investigation found modest declines in heart attack incidence rates (from 1.7% of residents to 1.1%). It also found small differential declines in strokes (from 1.9% to 1.3%). Hospitalization rates for both heart attacks and strokes in older public housing occupants trended downwards from before to 54 months after the smoking ban.

“Housing remains a focal setting for interventions aimed to reduce adverse health events that may be associated with exposure to secondhand smoke,” said the paper’s lead author, Elle Anastasiou Pesante.

“These results are promising, and going forward, we are eager to understand the longer-term impacts of smoke-free policies on cardiovascular and other chronic conditions, particularly among older adults who reside in public housing settings.”