Tobacco use remains the single most preventable cause of disease, disability, and death in the United States. Almost 500,000 people die every year in the United States because of tobacco use; approximately one in eight of those deaths are attributable to secondhand smoke exposure. Significant disparities exist in terms of which groups bear the greatest burden of tobacco-related illness and mortality. Reducing tobacco use and exposure in groups most affected and most at risk is a national public health priority. Tobacco control advocates can promote health equity by prioritizing policies that are likely to decrease tobacco use and secondhand smoke exposure and improve access to tobacco cessation resources among populations most at risk for tobacco-related disparities, including people who live in subsidized multiunit housing. In this article, we share the context, process, key milestones, and lessons learned as stakeholders in El Paso, Texas explored and implemented smoke-free policy in subsidized public housing. Partners including the local housing authority, a nonprofit health foundation, the local public health department, and a local university facilitated a thoughtful and community-engaged process that acknowledged the right of residents to breathe clean air in their own homes, potential challenges residents who choose to smoke may face in adapting to smoke-free policy, and the need for support for those who choose to quit. We conclude with five key lessons learned and share resources for other communities, health professionals, and coalitions advocating for and supporting smoke-free housing policy in their communities.
Trends over time in enrollment in non-group health insurance plans by tobacco use in the United States
