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Click to edit Master title style • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level 8/14/2015 1 1

Click to edit Master title style Welcome to the Webinar Breathing Easy at Home: Partnering to Increase Smoke-Free • Click to edit Master text styles Policies in Federally Assisted Housing – Second level • Third level Featuring: – Fourth level • Kara Skahen, Program Director, Live Smoke Free, Association for Nonsmokers-Minnesota • Patricia Baines-Lake, Executive Director, Lansing Housing Commission, Michigan » Fifth level • Amy Moore, Health Educator, Ingham County Health Department, Michigan Moderator: Rachel Cumberbatch , AAAS Science & Technology Policy Fellow, U.S. Environmental Protection Agency Wednesday, August 5, 2015 8/14/2015 2 2

Click to edit Master title style Learning Objectives Participants will learn how to— • Click to edit Master text styles • Take action to promote and implement smoke-free policies in multi-unit – Second level housing. • Third level Communicate the importance and feasibility of smoke-free policy • – Fourth level implementation and enforcement in multi-unit housing, particularly public » Fifth level housing. • Partner with public housing authorities (PHAs) and privately owned multi- unit properties to adopt a smoke-free policy. • Overcome barriers and offer support to property managers when implementing a smoke-free policy. 8/14/2015 3 3

Agenda Click to edit Master title style 1. Describe the benefits of smoke-free housing policies and EPA’s commitment to reducing asthma disparities through healthy • Click to edit Master text styles housing. – Second level 2. Hear from experts in the field. • Third level – Kara Skahen , Program Director, Live Smoke Free, The Association – Fourth level for Nonsmokers-Minnesota » Fifth level – Patricia Baines-Lake , Executive Director, Lansing Housing Commission, Michigan – Amy Moore , Health Educator, Ingham County Health Department, Michigan 8/14/2015 4 4

Why Smoke-Free Matters: Click to edit Master title style Health Disparities Among children with asthma, 53.2% • The Surgeon General has • Click to edit Master text styles were exposed to SHS in 2005–2010. 2 concluded that there is no – Second level risk-free level of exposure to • Third level secondhand smoke (SHS). 1 – Fourth level • SHS is a universal asthma » Fifth level trigger, and more than half Among low-income children with of children with asthma are asthma, 79.1% were exposed to SHS. 2 exposed to SHS. • SHS affects minorities and the poor disproportionately. 3 1 The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. 2006. 2 Kit et al. 2013. 3 CDC. Vital Signs: SHS An Unequal Danger. 2015. 8/14/2015 5 5

SHS: An Unequal Danger Click to edit Master title style • Click to edit Master text styles One in 4 nonsmokers (58 million • people) in the United States are still – Second level exposed to SHS. 1 • Third level – Fourth level • About 2 of every 5 children (15 million) are exposed to SHS. 1 » Fifth level • More than 1 in 3 nonsmokers who live in rental housing are exposed to SHS. 1 1 CDC. Vital Signs: SHS An Unequal Danger. 2015. 8/14/2015 6 6

Click to edit Master title style EPA’s Commitment to Addressing Health Disparities • Click to edit Master text styles – Second level • Third level – Fourth level » Fifth level Recommend that owners and managers of federally assisted housing implement building-wide practices and policies that reduce exposures to secondhand smoke, pests, mold and asthma triggers. 8/14/2015 7 7

Click to edit Master title style • Click to edit Master text styles – Second level Kara Skahen • Third level – Fourth level » Fifth level Program Director Live Smoke Free Association for Nonsmokers-Minnesota 8/14/2015 8 8

Click to edit Master title style • Click to edit Master text styles – Second level • Third level Smoke-Free Multi-Unit Housing – Fourth level Partnering to Increase Healthy, Safe and Clean » Fifth level Housing Opportunities August 5, 2015 Kara Skahen, M.S.W., M.P.P. Program Director 8/14/2015 9 9

Live Smoke Free Program Click to edit Master title style • Click to edit Master text styles – Second level • Third level • A program of the Association for Nonsmokers-Minnesota. – Fourth level • Based in St. Paul, Minnesota. » Fifth level • The program has been working on smoke-free housing full time since 2007. • Educates and assists building owners, managers, local policy makers, residents and housing industry professionals on smoke-free housing issues. 8/14/2015 10 10

Click to edit Master title style Secondhand Smoke • Secondhand smoke • In multi-unit housing, contains more than • Click to edit Master text styles smoke can move easily 7,000 chemicals, through cracks in walls, – Second level including about 70 that electrical systems, cause cancer. • Third level ventilation, etc. – Fourth level • Secondhand smoke is a » Fifth level known asthma trigger. • The 2006 Surgeon General’s Report concluded that there is no risk-free level of secondhand smoke exposure. Source: Centers for Disease Control and Prevention, 2015 8/14/2015 11 11

Secondhand Smoke Click to edit Master title style Exposure and Disparities • Exposure can be measured by testing body fluids for a biomarker • Click to edit Master text styles called cotinine. – Second level • Exposure can cause asthma attacks, ear infections, respiratory • Third level symptoms/infections, heart disease, lung cancer and stroke. – Fourth level • Symptoms from exposure can limit one’s ability to lead a normal, » Fifth level active life. Source: Centers for Disease Control and Prevention, 2015 8/14/2015 12 12

Why Is Smoke-Free Click to edit Master title style Multi-Unit Housing Important? • Click to edit Master text styles Residents of multi-unit housing are disproportionately • Low-wage workers, people of color, the elderly and the young – Second level (under age 18) • Third level • Struggling with poverty, chronic disease, mental illness and chemical dependency – Fourth level • Exposed to secondhand smoke at disproportionately high rates » Fifth level Members of these special populations often have • Limited housing options • Limited resources to move • Limited access to health care Everyone deserves to have a healthy, safe and clean place to call home. 8/14/2015 13 13

Click to edit Master title style Smoke-Free Housing Benefits • Protects priority populations from second- and third-hand smoke • Click to edit Master text styles exposure. – Second level • Encourages people who smoke to reduce their consumption or quit. • Third level • Reduces cigarette-caused fires. – Fourth level • Protects housing investments. » Fifth level • Saves money for residents, property owners and taxpayers— smoke-free subsidized housing would save $521 million a year. (Centers for Disease Control and Prevention, 2013) 8/14/2015 14 14

Smoke-Free Housing Is Click to edit Master title style Gaining Momentum • Who is going smoke-free? • Click to edit Master text styles o Market-rate rental properties – Second level o Affordable rental properties o Public housing • Third level o Common interest communities – Fourth level (condos, townhomes, cooperatives) » Fifth level • Smoke-free apartment buildings in the United States— o More than 600 public housing authorities  Boston, Minneapolis, Maine (statewide), etc. o Thousands of market-rate and affordable buildings o Many management companies are transitioning their entire portfolios 8/14/2015 15 15

Click to edit Master title style Smoke-Free Housing Is Gaining Momentum • Click to edit Master text styles • 349 members of an online global coalition of smoke-free housing advocates – Second level • Advocates include: • Third level o Public health professionals – Fourth level o Private nonprofit organizations » Fifth level o Students o Social workers o Chemical dependency counselors o Asthma programs o Nurses o Medical professionals o Researchers 8/14/2015 16 16

The Asthma Community and Click to edit Master title style Smoke-Free Housing Policies: A Natural Partnership! • Click to edit Master text styles Smoke-free multi-unit housing policies – Second level • Reduce or eliminate a common trigger of asthma in and • Third level around the home. – Fourth level • Promote healthy in-home behaviors. » Fifth level • Encourage cessation. • Improve health outcomes for children and adults with asthma. 8/14/2015 17 17