Public Housing Cigarette Ban Illustrates The Thin Line Between Helping People And Micromanaging Them

CREDIT: Flickr/Akos Kokai

Public housing projects will soon be smoke-free under a long-awaited rule proposed Thursday by the Department of Housing and Urban Development (HUD). Barring setbacks, the rule will go into effect in early 2017, threatening smokers with eviction if they light up in a designated no-smoking area.

Policies that push low-income people into choices that the public has decided are better often draw stiff opposition from poverty advocates. When the government acts like it knows better than individuals and forces them to behave a certain way or lose access to safety net benefits, it can infringe both on poor people’s dignity and the very independence that poverty program critics tout as essential.

But when it comes to smoking, that concern isn’t as prevalent. The influential National Low Income Housing Coalition (NLIHC) is embracing the move, Senior Vice President for Policy Linda Couch said in an interview.

“We think it’s overdue. It’s time for public housing to catch up with health research,” Couch said.

The smoking ban would be enforced by evicting destitute tenants who defy it, which does give Couch pause. “Being evicted creates its own public health problem,” she said. “I think housing authorities have to figure out how they’re going to help their residents get to a place where we’re not going to see a lot of lease violations and evictions. But you can’t argue with the fact that smoking kills.”

Nannying The Poor

The eviction-backed smoking ban is the latest mechanism by which impoverished people can be denied access to public assistance, including housing.

Federal law includes a pair of very specific lifetime bans. Public housing is unavailable to anyone who has been convicted of manufacturing methamphetamine in a public housing building or who’s been required to register as a sex offender.

But it also grants broad authority for local agencies to go much further, treating even the suspicion of criminal activity as grounds for eviction or denial. “For example, many local housing authorities will evict or deny housing to an individual or even to an entire household if one household member has an arrest without conviction or pending criminal charges,” Center for American Progress poverty expert Rebecca Vallas wrote in 2014. Housing officials in Alexandria, Virginia moved to evict Shelly Anderson and her children because their father and Anderson’s mother had been busted for possession of drug paraphernalia.

Such one-strike-and-you’re-out policies linking minor drug crimes and public housing, like many absolutist ideas about poverty, date back to the Clinton presidency. Rep. Maxine Waters (D-CA) urged HUD Secretary Julian Castro to formally rescind the agency’s support for the one-strike idea as recently as May of this year. At the start of November, HUD issued guidance to local housing authorities that tacitly disavowed the approach, and also reminded authorities that they cannot use arrest records (as opposed to convictions) to bar tenants.

But while the Obama administration has turned away from that form of Clinton-era paternalism, another more threatening version of it still looms. Both Congress and the administration are looking to expand a still-running 1996 pilot program that gives local housing authorities vast latitude to impose new restrictions on tenants, including linking housing assistance to children’s grades and imposing hard-and-fast time limits on the aid. Castro’s agency has recommended adding 15 agencies to the current list of 34 that have such latitude.

“But the Senate appropriations bill for HUD would expand it to another 300 housing authorities, with virtually no reforms,” Couch said, calling that idea “astonishing.” The Senate bill would mean roughly a tenth of the 3,400 public housing agencies nationwide would join an experiment that’s not even bothering to measure successes and failures.

“The program right now doesn’t have an evaluation component or a research component to it,” said Couch. Because the program isn’t reporting back on how innovations change outcomes, advocates and lawmakers are in the dark as to what works and what doesn’t.

Expanding such an open-ended program so dramatically could end up gutting the entire public housing infrastructure, Couch warned. “If we essentially block-grant out these programs, in a couple years Congress is going to have very little idea of how these dollars are getting spent, who they’re serving, and how effective they are,” she said. “And at that point, the programs could be at real risk come appropriations time.”

Smoking Is Different

HUD’s newest proposal is far less controversial. Decades of science have established irrefutably the dangers of smoking not just for smokers but for everyone living around them.

But people who are eligible for public services of various kinds still have to contend with a variety of other attempts to micromanage their lives and choices from afar. State lawmakers around the country are eager to restrict how food stamps recipients shop and where welfare recipients can withdraw benefits. Multiple states are spending large sums of money to drug test food stamps applicants.

And then there’s the Clinton-era HUD pilot that could be poised to expand before it ever reports its findings. Some of the housing authorities already participating in it require residents to take drug tests, a policy the American Civil Liberties Union has challenged in court.

While the NLIHC generally opposes such “paternalistic policies that threaten someone’s housing assistance based on whether or not people comply with other social goals,” Couch said this one is different.

“The smoking ban is different because of the secondhand smoke issue. There’s just no way to get around the fact that you smoking two apartments away in a 40-year-old building is going to come into my unit. And I don’t have any say in that,” she said. Public health research has established that no amount of ventilation can prevent secondhand smoke from spreading from a room where smoking is allowed to smoke-free spaces in the same building.

Hundreds of public housing authorities have issued smoke-free policies even prior to the HUD ban. None of those policies has been challenged in court, a HUD spokesman told ThinkProgress.

To justify the move to make such bans mandatory, the agency points to both public health statistics and its own bottom line. The ban would save $153 million per year according to a Centers for Disease Control and Prevention study from 2014. Most of that money comes from reduced healthcare costs for low-income children ($94 million) rather than going back into HUD’s roughly $6.3 billion annual budget for public housing. HUD expects that it will save $59 million per year through reduced maintenance costs and fires.

HUD does not have full national statistics on smoking and respiratory illness among the population it serves, but some housing authorities have done their own localized surveys over the years. Surveys in New York, Austin, and San Diego showed that fewer than one in five tenants is a smoker, but far higher proportions of tenants suffer from asthma and other breathing conditions.

In Boston, housing officials managed to significantly improve asthma outcomes long before they decided to take on smokers. Rodent and insect infestations are also linked to respiratory illness, and the Boston Housing Authority pushed the adult asthma rate among tenants down from 23 percent to 13 percent from 2006 to 2010 thanks to an overhaul of its pest control policies. Boston didn’t ban smoking from public housing facilities until 2012.

“We certainly work with residents who I’m sure are not happy about this, and I can appreciate that. My mom’s dying of emphysema and she still smokes,” Couch said. “It’s a serious addiction. And I just hope that people are provided the opportunity to get some help through that.”

Rates of smoking remain much higher among Medicaid recipients than those insured through the private market. Smoking cessation isn’t a simple thing for anyone, but it’s especially fraught for low-income people whose lives are defined by stress so severe it literally saps their brainpower.

“I know it’s bad for me. I’m addicted, not addled. There are reasons that I smoke, and they’re reasonable ones,” author Linda Tirado wrote in “Hand To Mouth,” her book about her own struggle out of poverty and the simplistic, stigmatizing way that society looks at poor peoples’ decision-making. “[My] cost-benefit isn’t a simple I like it versus I’ll possibly live longer. It’s I will be able to tolerate more versus I will perpetually sort of want to punch something.