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Home My WebLink About2018-12-10 Community Health Commission AgendaAgenda Community Health Commission City Of Edina, Minnesota Community Room, Edina City Hall - 4801 West 50th St. Edina, MN 55424 Monday, December 10, 2018 6:30 PM I.Call To Order II.Roll Call III.Approval Of Meeting Agenda IV.Approval Of Meeting Minutes V.Community Comment During "Community Comment," the Board/Commission will invite residents to share relevant issues or concerns. Individuals must limit their comments to three minutes. The Chair may limit the number of speakers on the same issue in the interest of time and topic. Generally speaking, items that are elsewhere on tonight's agenda may not be addressed during Community Comment. Individuals should not expect the Chair or Board/Commission Members to respond to their comments tonight. Instead, the Board/Commission might refer the matter to sta% for consideration at a future meeting. VI.Reports/Recommendations A.Smoke Free Multi-Unit Housing Survey VII.Chair And Member Comments VIII.Sta& Comments IX.Adjournment The City of Edina wants all residents to be comfortable being part of the public process. If you need assistance in the way of hearing ampli+cation, an interpreter, large-print documents or something else, please call 952-927-8861 72 hours in advance of the meeting. Date: December 10, 2018 Agenda Item #: VI.A. To:Community Health Commission Item Type: Report and Recommendation From:Nick Kelley and Deb Miller, Bloomington Public Health Item Activity: Subject:Smoke Free Multi-Unit Housing Survey Information CITY OF EDINA 4801 West 50th Street Edina, MN 55424 www.edinamn.gov ACTION REQUESTED: INTRODUCTION: Bloomington Public Health will present data gathered through a multi-unit smoke free housing survey conducted in Edina. ATTACHMENTS: Description Edina Multi-Unit Housing Survey Smoke-Free Housing Strategies City of Edina Multi-Unit Housing Resident Survey September 2018 ACKNOWLEDGEMENT This report was made possible through funding from the Statewide Health Improvement Partnership, Minnesota Department of Health and the collaboration of: City of Edina Health Commission Bloomington Public Health Association for Non-smokers Minnesota: Live Smoke Free Program Minnesota Department of Health Office of Statewide Health Improvement Initiatives Evaluation and Research Unit WE WISH TO THANK THE FOLLOWING PROPERTIES FOR THEIR SUPPORT OF THIS PROJECT Heritage Court/Premier Properties, LLC Oaks Lincoln/Oaks Properties, LLC Ponds of Edina/KCS Property Management Oaks Braemar/Oaks Properties, LLC The Durham/RMK Management York Plaza/Stuart Company 1 TABLE OF CONTENTS Executive Summary ...................................................................................................................................... 2 Background ................................................................................................................................................... 3 Scope of the Issue ......................................................................................................................................... 3 City of Edina profile ..................................................................................................................................... 4 Methodology ................................................................................................................................................. 4 Highlights from comparison of smoke-free vs. smoking-allowed properties ............................................... 6 Key findings .................................................................................................................................................. 9 Next Steps ................................................................................................................................................... 11 Appendix ..................................................................................................................................................... 12  Survey Results  Resident letter  Resident survey cover letter  Resident survey 2 EXECUTIVE SUMMARY The multi-unit housing resident survey was conducted to learn about smoking in apartments, and what residents think about secondhand smoke and smoke-free building policies. In early 2018, Bloomington Public Health (BPH) and the Association for Non-Smokers (ANSR) Minnesota’s Live Smoke Free program administered a survey to residents in to two types of multi-unit housing properties in the City of Edina: those with a smoke-free policy (i.e. smoking of tobacco is not allowed anywhere indoors) and those with a smoking-allowed policy. Questions included: o Basic demographics o Whether residents allowed smoking in their units o Frequency of secondhand smoke exposure o Any smoking behavior changes as a result of or following a building-wide smoke-free policy o Support for a smoke-free property policy o Support for citywide ordinance around smoking in multi-unit housing  Residents from smoke-free properties were asked to provide details about rules in place for tobacco smoking.  When asked about smoking behavior, all residents had the option to indicate when a question didn’t apply to them because they were nonsmoking or no one in their household smoked.  Surveys were available in English only. A total of 893 surveys were distributed and 458 were returned representing a 51% return rate. Individual return rates were as follows: Smoke-Free Properties: 50% return rate  Oaks Lincoln 48%  Oaks Braemer 50%  York Plaza 51% Smoking-allowed properties: 54% return rate  Heritage 58%  The Ponds, 59%  The Durham 52% 3 Key findings include:  Majority of all respondents (97%) don’t allow smoking in their units even with a smoking-allowed policy present.  Majority of respondents surveyed (94%) support a smoke-free building-wide policy.  Despite 97% of all respondents not allowing the smoking of tobacco products in their units, (99% in smoke-free vs 93% in smoking-allowed properties), 46% of these respondents are still exposed to secondhand smoke from all buildings. This includes 39% in smoke-free vs. 64% in smoking-allowed buildings.  Negative health impact of secondhand smoke exposure were reported by 8% of respondents.  Majority of respondents (91% in smoke-free properties and 90% in smoking-allowed properties) indicated they would support a multi-unit housing smoking related citywide ordinance. BACKGROUND The City of Edina has been a leader in reducing resident exposure to secondhand smoke and protecting youth from tobacco products. In 2017, Edina was the first city in the state to set a high standard for the sale of cigarettes and tobacco products to young adults under the age of 21 by passing a Tobacco 21 ordinance. This ordinance increased the tobacco sale age from 18 to 21. The City of Edina also protects its residents from secondhand smoke by prohibiting smoking in public parks and recreational spaces. In February 2018, at the request of the Edina Health Commission, Bloomington Public Health (BPH) and the Association for Non-Smokers Minnesota (ANSR) Live Smoke Free program began outreaching to select multi-unit properties (both smoking prohibited and permitted) asking to survey residents on the topic of smoke-free housing. The goal of the survey was to learn about smoking in apartments, and what residents think about secondhand smoke and smoke-free building policies. Bloomington Public Health (BPH) has long supported programs, partnerships and policies that cultivate healthy, active communities. We collaborate with communities, schools, worksites and healthcare providers to reduce the risk of chronic disease by targeting poor nutrition, physical inactivity and tobacco use for those who live and work in the City of Edina. SCOPE OF THE ISSUE Research strongly demonstrates an association between tobacco use and chronic disease risk factors. Scientific knowledge about the health effects of tobacco use has increased greatly since 4 the first Surgeon General’s report on tobacco was released in 1964.1 Since the publication of that report, more than 20 million Americans have died because of smoking.2 The harmful effects of tobacco do not end with the user. The US Surgeon General has concluded that there is no risk- free level of exposure to secondhand smoke. Since 1964, 2.5 million deaths have occurred among nonsmokers who died from diseases caused or exacerbated by secondhand smoke exposure. Secondhand smoke causes heart disease, lung cancer, and stroke in adults and can cause a number of health problems in infants, children, and older adults including asthma, Type II diabetes, hypertension, high cholesterol, and obesity. An estimated 58 million Americans remain exposed to secondhand smoke each year. The home is the primary source of secondhand smoke exposure for children, and multi-unit housing residents are particularly vulnerable to involuntary exposure in their homes.3 Many factors influence tobacco use. Risk factors include race/ethnicity, age, education, and socioeconomic status. Significant disparities in tobacco use exist geographically; such disparities typically result from differences among states in smoke- free protections, tobacco prices, and program funding for tobacco control.3 Tobacco use is the largest preventable cause of death and disease in the United States. Each year, approximately 480,000 Americans die from tobacco-related illnesses. Further, more than 16 million Americans suffer from at least one disease caused by smoking.4 CITY OF EDINA PROFILE The City of Edina is located in the metro region of the state. The city’s population is estimated to be 49,976 in 2016.5 Of this population it is estimated that 42,489 (85%) are non-Hispanic White, 1,092 (2.2%) are African American, 1,516 (3%) are Hispanic, and 3,521 (7%) are Asian.6 The City of Edina is estimated to contain 21,325 occupied housing units in 2016.7 Less than a third of those units, 5,915, are occupied by households renting. It is estimated that households that are White (not Hispanic) own 94.4 percent of the owner-occupied housing units and rent 75.3 percent of the renter-occupied housing units. There are significant racial differences in household occupancy based on ownership or rental status. METHODOLOGY The project team, including the City of Edina Community Health Administrator, staff from Bloomington Public Health, Association for Non-smokers Minnesota: Live Smoke Free Program and the Minnesota Department of Health met in December 2017 and January 2018. The project team determined criteria for who to survey and developed survey questions over two meetings. 1 DHHS Publication No. (CDC) 89-8411 2 DHHS Office on Smoking and Health, January 2014 3 Healthy People 2020 4 DHHS Office on Smoking and Health 5 2012-2016 American Community Survey 5-Year Estimates Table S0101 6 2012-2016 American Community Survey 5-Year Estimates Table B03002 7 2012-2016 American Community Survey 5-Year Estimates Table S2502 5 Bloomington Public Health maintains a list of all multi-unit properties in Edina which includes information about their smoking policies, number of units and if available, the number of residents residing in those properties. Although the exact number of smoke-free properties is unknown, our best data shows 47% of 53 properties contacted report having adopted a smoke- free policy. A map was created using ArcMap in ArcGIS version 10.5 to visualize the geographic distribution of multi-unit properties with and without smoking policies in Edina. The project team then prioritized the 53 multi-unit properties based on their geographic distribution, smoking policy type and number of residents to ensure the selected properties provided the best representation of the city and then narrowed the selection to six. The property managers of the six properties were contacted to ascertain their interest in participating in the survey process. Of the initial six properties selected, four agreed to allow for the survey to occur and provide assistance with the survey. The two properties that declined were replaced by two other properties from the original pool of 53. Property managers distributed paper copies of the survey with instructions for completion to all households (one survey per unit). Residents received written instructions to return completed surveys in a sealed envelope to the on-site manager or management office at which time they would receive a $10 gift card. Property managers received a $50 gift card for their role in survey dissemination and collection.8 Decisions regarding timeframe for survey distribution and collection were left to property managers and what they felt was the best time to achieve the highest return rate. In most cases, that meant surveys were distributed toward the end of the month and returned the first of the month when rents were due. The average length of time from survey distribution to collection was 7-14 days and occurred between April 2018 and July 2018. Paper survey results were compiled by ANSR and entered into Survey Monkey. All survey data was analyzed by BPH in Statistical Package for Social Services (SPSS) version 24. 8 Gift cards were purchased from retailer that did not sell tobacco products. 6 HIGHLIGHTS FROM COMPARISON OF SMOKE-FREE VS. SMOKING-ALLOWED PROPERTIES Demographics of survey respondents by property type Smoke-free properties N=287 Smoking-allowed properties N=168  It is estimated that the demographic makeup of renter in Edina include 75% non- Hispanic White, 14% Asian, 4% African American, 4% Hispanic and 4% some other race9.  The three smoke-free properties surveyed are similar demographically to renters in Edina.  The three smoking-allowed properties surveyed are demographically more diverse than renters in Edina. 9 2012-2016 American Community Survey 5-Year Estimates Table S2502 Note due to rounding, totals are greater than 100. 1% 11%4% 79% 4% 2% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 1% 34% 8% 53% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 7 Smoking rules set by respondents for their apartment Smoke-free properties N=289 Smoking-allowed properties N=167  Housing cost was ranked first followed by proximity to work or school second and a smoke-free policy third as what tenants considered when selecting a place to live by respondents from both smoking-allowed and smoke- free properties. o Overall, 71% of all respondents surveyed indicated a smoke-free policy was in their top three consideration when selecting a place to live. Top considerations from respondents in smoke-free properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 72% 19% 6% 97% Proximity to work/school 10% 44% 26% 80% Smoke-Free Policy 13% 35% 28% 75% Transportation 1% 10% 24% 35% Good school district 9% 7% 15% 31% 1% 99% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 7% 93% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 8 Top considerations from respondents in smoking-allowed properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 75% 16% 5% 96% Proximity to work/school 12% 35% 32% 79% Smoke-Free Policy 12% 26% 26% 64% Good school district 11% 19% 10% 40% Transportation 1% 15% 24% 40% 9 KEY FINDINGS  Majority of all respondents don’t allow smoking in their unit even with a smoking- allowed policy present. Respondents that do not allow smoking of tobacco in their units by property tobacco policy type  Several respondents who didn’t allow smoking in their unit indicated they had secondhand smoke exposure Respondents secondhand smoke exposure in their apartment who do not allow smoking of tobacco in their apartment by property tobacco policy type  Majority of respondents surveyed support a smoke-free property policy 97% 99% 93% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 46% 39% 64% 0%10%20%30%40%50%60%70% All respondents Smoke-free properties Smoking-allowed properties 10 Respondents support for smoke-free property by property tobacco policy type  Majority of respondents indicated they would support a multi-unit housing smoking related citywide ordinance Respondents support for citywide smoke free ordinance for apartments by property tobacco policy type 93% 95% 91% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 90% 90% 91% 0%10%20%30%40%50%60%70%80%90%100% All respondents Smoke-free properties Smoking-allowed properties 11 NEXT STEPS Upon survey completion and analysis, BPH and ANSR conducted face-to-face meetings with property managers to share property-specific results, discuss policy changes and offer technical assistance. For those properties with existing smoke-free policies, technical assistance was provided to strengthen policy compliance in the form of consultation, policy review, recommending strategies to increase resident engagement, and provision of tools like signage and a resident letter which shared survey findings and reinforced policy specifics and enforcement protocol. For first-time policy adopters, technical assistance provided included educational resources (e.g., an FAQ document that addressed common questions residents may have as to why the property is going smoke-free, how the policy will benefit residents, and an explanation of policy enforcement, etc.); sample implementation tools (e.g., a resident letter template that shared survey findings, the hazards of secondhand smoke, fire risk, and details about the new smoke-free policy, a sample lease addendum, etc.); cessation resources for residents; and ongoing consultation. With the completion of the final report, BPH staff will meet with City of Edina staff to review the findings and evaluate the options for city policies. Our findings highlight the importance of smoke-free policies to help protect all residents, especially youth and those with low income status, from secondhand smoke exposure. 12 APPENDIX 13 SURVEY RESULTS BPH distributed a total of 893 surveys, and 457 were returned representing a 51% return rate. In smoke-free multi-unit properties, 580 surveys were distributed and 289 surveys were returned (50%). In smoking-allowed multi-unit properties, 313 surveys were distributed and 169 surveys were returned (54%). Five multi-unit properties had an individual return rate of 50% or greater. Demographics Race and Ethnicity. N=434  It is estimated that the demographic makeup of renter in Edina include 75% non- Hispanic White, 14% Asian, 4% African American, 4% Hispanic and 4% some other race10.  The three smoke-free properties surveyed are similar demographically to renters in Edina.  The three smoking-allowed properties surveyed are demographically more diverse than renters in Edina. Race and ethnicity for all respondents 10 2012-2016 American Community Survey 5-Year Estimates Table S2502 Note due to rounding, totals are greater than 100. 1% 19% 5% 70% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 14 Race and ethnicity for respondents by property tobacco policy type Smoke-free properties N=287 Smoking-allowed properties N=168  Of respondents to this survey, more respondents of color reside in smoking-allowed properties compared to smoke-free. This could be due to costs, amenities, and other factors. Age. N= 456Age ranges for all respondents 1% 11%4% 79% 4% 2% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 1% 34% 8% 53% 4% 1% American Indian or Alaska Native Asian or Asian American Black or African American White Hispanic or Latino Other 7% 51%12% 30% 18-25 26-55 56-65 Over 65 15 Age ranges for respondents by property tobacco policy type Smoke-free properties N=288 Smoking-allowed properties N=168  Renters over 65 were more represented in responses from smoking-allowed properties. A larger young adult population (18-25) was observed among respondents of smoking- allowed properties. Income. N= 437  The median income for households in Edina is estimated to be $91,84711.  The median of the respondents is within the $55,000 to $79,000 category, lower than the median income for Edina households. 11 2012-2016 American Community Survey 5-Year Estimates Table S1903 8% 44% 14% 34% 18-25 26-55 56-65 Over 65 4% 64% 8% 23% 18-25 26-55 56-65 Over 65 16 Income reported by all respondents Income reported by respondents by property tobacco policy type Smoke-free properties N=276 Smoking-allowed properties N=161 6% 11% 21% 25% 17% 21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 6% 13% 23%23% 15% 21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 6% 8% 17% 27% 21%21% 0% 5% 10% 15% 20% 25% 30% $23,000 or less $23,001-$39,000 $39,001-$55,000 $55,001-$79,000 $79,001-$100,000 More than $100,000 17 The apartment that you live in Tenure in apartment by property tobacco policy type Smoke-free properties N=287 Smoking-allowed properties N=169 Children under 18 present in all respondents apartment N=458 29% 47% 12% 12%Less than 1 year 1-5 years 6-10 years More than 10 years 25% 54% 10% 12% Less than 1 year 1-5 years 6-10 years More than 10 years 78% 22% No Yes 18 Children under 18 living in respondent’s apartment by property tobacco policy type Smoke-free properties N=289 Smoking-allowed properties N=169 Adults over 65 present in respondents apartment for all respondents n=455 84% 16% No Yes 69% 31% No Yes 67% 33% No Yes 19 Adults over 65 present in respondents apartment by property tobacco policy type Smoke-free properties N=288 Smoking-allowed properties N=167 Apartment unit smoking rules and exposure Respondents smoking rules for their apartment by property tobacco policy type Smoke-free properties N=289 Smoking-allowed properties N=167  A small percentage of respondents (7%) indicated they allowed smoking in their units on smoking-allowed properties.  A small percentage of respondents (1%) indicated they smoked/allowed smoking in their units on smoke-free properties. 64% 37% No Yes 72% 28% No Yes 1% 99% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 7% 93% Yes, smoking is allowed in my unit No, smoking is not allowed in my unit 20 Secondhand smoke exposure (SHS) for respondents who don’t allow smoking in unit by property tobacco policy type12 Smoke-free properties N=286 Smoking-allowed properties N=156  In smoke-free properties, 39% of respondents who don’t allow smoking in their units indicated secondhand smoke exposure. In smoking-allowed units, 56% of respondents indicated exposure.  Despite not allowing smoking in their units, respondents are still largely exposed to secondhand smoke potentially due to smoking in shared areas, adjacent units, and/or outdoor areas that seep into individual units. 12 A few respondents who allow smoking in their individual units also smelled smoke from other units. These responses have been eliminated from this ‘secondhand smoke’ exposure analysis. 2% 9%11% 17% 61% 0% 10% 20% 30% 40% 50% 60% 70% Everyday A few times a week A few times a month A few times a year Not at all 7% 15%17%17% 44% 0% 10% 20% 30% 40% 50% Everyday A few times a week A few times a month A few times a year Not at all 21 Willing to Use designated smoking areas. N=458  When asked whether they would use a designated smoking area if provided, 81% of all respondents indicated that the question didn’t apply to them because they did not smoke Respondents willing to use designated smoking area for all respondents Respondents willing to use designated smoking area by property tobacco policy type for all respondents Smoke-free properties N=289 Smoking-allowed properties N=169  From smoke-free properties, 81% were nonsmoking compared to 79% of respondents in smoking-allowed properties. 81% 7% 13% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 81% 7%11% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 79% 6% 15% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% I do not smoke Yes No 22 Secondhand smoke (SHS) exposure for residents who indicated they were non-smokers. N=369  Half (50%) of the 81% of residents who indicated they were nonsmoking (when asked if they would be willing to use designated smoking areas) reported secondhand smoke exposure. Secondhand smoke exposure (SHS) for all respondents who indicated they were non-smokers. Secondhand smoke exposure (SHS) for respondents who indicated they were non-smokers by property tobacco policy type Smoke-free properties N=235 Smoking-allowed properties N=134 5% 13%14%18% 50% 0% 10% 20% 30% 40% 50% 60% Everyday A few times a week A few times a month A few times a year Not at all 3% 10%13%17% 57% 0% 10% 20% 30% 40% 50% 60% Everyday A few times a week A few times a month A few times a year Not at all 9% 18%17%19% 37% 0% 5% 10% 15% 20% 25% 30% 35% 40% Everyday A few times a week A few times a month A few times a year Not at all 23  Despite living in a smoke-free building, 43% of nonsmoking respondents indicated secondhand smoke exposure. In smoking-allowed buildings, 63% of nonsmoking respondents indicated exposure. Respondents with secondhand smoke exposure who reported tobacco smoke nuisance to landlord by property tobacco policy type Smoke-free properties N=114 Smoking-allowed properties N=96  In smoke-free properties, 68% of respondents who indicated secondhand smoke exposure did not report it to their landlord. In smoking-allowed properties, 78% of respondents exposed did not report.  Of the respondents who reported secondhand smoke exposure, those with more frequent exposure indicated they reported it to their landlord; o 91% of respondents with at least weekly secondhand smoke exposure in smoke- free properties reported secondhand smoke exposure to their landlord compared to 69% of respondents in smoking-allowed properties.  Some respondents that didn’t report smelling secondhand smoke in their apartment, reported secondhand smoke exposure to their landlord; 5% in smoke free properties vs. 3% in smoking-allowed. Reasons respondents provided for not reporting smoke  Respondents who smelled smoke but didn’t report it in smoke-free properties provided reasons including; o Had no idea it was a smoke-free property o Could not pinpoint exact source of smoke o Smoke was too infrequent or didn’t bother them enough to report it  Major reasons for not reporting in smoking-allowed properties included; 43% 48% 22% 13% 5% 0% 20% 40% 60% Everyday A few times a week A few times a month A few times a year Not at all 54% 15% 26% 17% 3% 0% 20% 40% 60% Everyday A few times a week A few times a month A few times a year Not at all 24 o Problem was insignificant o Property allowed smoking, management wouldn’t do anything o Others have already reported it o They had countermeasures  In smoke-free properties, 17% percent of all respondents had countermeasures for the smoke, compared to 28% of all respondents in smoking-allowed buildings. o This percentage includes respondents who indicated they had no secondhand smoke exposure. o Countermeasures included laundry and cleaning supplies, air purifiers, odor absorbers and door/window seals. Most respondents selected using multiple countermeasures. Respondents’ perceptions of the follow-up frequency on smoking violation or nuisance reported to landlord  In smoke-free properties; o Twelve out of 37 (32%) respondents who reported smoke (including a few who didn’t indicate exposure) indicated that landlord responded to smoke complaints always or most of the time. o Twenty out of 247 (8%) respondents didn’t report smoke but indicated that landlord responded always or most of the time to smoke complaints.  In smoking-allowed properties; o Six out of 23 (26%) respondents who reported smoke (including a few who didn’t indicate exposure) indicated that landlord responded to smoke complaints always or most of the time. o Nineteen out of 142 (13%) respondents didn’t report smoke but indicated that landlord responded always or most of the time to tobacco complaints. 25 Respondents’ knowledge of smoking policy by property tobacco policy type Smoke-free properties N=116 Smoking-allowed properties N=109  Many respondents, 173/289 (60%) in smoke-free properties and 60/169 (36%), in smoking-allowed properties selected multiple options which have been excluded from the above charts. Respondents’ perception of landlord’s policy enforcement. In smoke-free properties (N=281);  More than half (71%) of respondents indicated they didn’t know how landlord enforced policy.  Two percent of respondents didn’t think landlord enforced policy.  A few respondents (2%) indicated question didn’t apply because smoking was allowed in the building. In smoking-allowed properties (N=154);  More than half (51%) of respondents indicated they didn’t know how landlord enforced policy.  Three percent of respondents didn’t think landlord enforced policy.  Six percent indicated question didn’t apply because smoking was allowed in the building. 3% 19% 47% 3% 28% 0%20%40%60% Smoking is allowed in individual apartments but not in shared… Smoking is allowed in some outdoors areas Smoking is not allowed anywhere inside the building Smoking is not allowed anywhere outdoors Don’t know/not sure 20% 8% 29% 1% 41% 0%20%40%60% Smoking is allowed in individual apartments but not in shared… Smoking is allowed in some outdoors areas Smoking is not allowed anywhere inside the building Smoking is not allowed anywhere outdoors Don’t know/not sure 26 Health problems: Percent of respondents reporting a smoke related health problem  Of all respondents who responded (N=421), 36 of them (8%) indicated they believed they or a family member had a health problem due to secondhand smoke exposure. o This includes 22/288 (8%) of respondents from smoke-free properties and 14/169 (7%) of respondents from smoking-allowed properties.  Self-reported health problems include: o allergies o asthma o headaches o breathing problems o cancer Smoke-free policy experience and ordinance perception Smoking behavior change since being in a smoke free property In smoke-free properties (N=284);  All properties already have a no smoking policy.  Majority of respondents (86%) indicated question didn’t apply as no one living in my apartment smokes tobacco.  Other respondents responded as shown in graph above N=35. o Of these respondents, 31% indicated they had quit or tried to cut back due to smoke-free policy in place at their property. 11%9%11% 69% 0% 20% 40% 60% 80% Yes, quit smoking Yes, quit smoking cigarettes and now smoking e-cigarettes Yes, tried to quit or cut back smoking No, no changes in current smoking behavior 27 In smoking-allowed properties (N=165):  All properties have a smoking-allowed policy.  Three fourths (75%) of respondents indicated that no one living in my apartment smokes tobacco.  A few, 12% indicated that question didn’t apply since property didn’t have a smoke-free policy.  The remaining 13% of respondents indicated behavior changes: o The majority, 81% indicated no change to their smoking behavior. o Some indicated they quit smoking, 10% or tried to cut back on smoking, 10%. Property wide smoking policy N=359  Of all respondents who responded, 93% indicated they would support a property wide smoke-free policy. o This includes 95% in smoke-free and 91% in smoking-allowed properties o Only a few respondents (4%) in smoke-free properties indicated they opposed or strongly opposed a property-wide policy compared to 8% in smoking-allowed properties. Support for a property wide smoke-free policy by property tobacco policy type Smoke-free properties N=284 Smoking-allowed properties N=165 95% 5% 0% 20% 40% 60% 80% 100% Support or strongly support Oppose or strongly oppose 91% 8% 0% 20% 40% 60% 80% 100% Support or strongly support Oppose or strongly oppose 28 Citywide ordinance support N=359  Of all respondents who responded, 90% indicated they would support a city-wide smoke- free multi-unit housing ordinance. o This includes 90% in smoke-free and 91% in smoking-allowed properties. Support for city-wide smoke-free multi-unit housing ordinance by property tobacco policy type for all respondents Policy support by smoking behavior for all respondents  Note: Graphs show respondent who indicated they support or strongly support property-wide and citywide policies/ordinance 90% 90% 91% All respondents Smoke-free properties Smoking-allowed properties 50%55%60%65%70%75%80%85%90%95%100% All respondents Smoke-free properties Smoking-allowed properties 35% 71% 92% 82% 92% 0%20%40%60%80%100% Willing to use designated smoking area Supports buildingwide smoke free policy Supports a citywide smoke ordinance NonSmoker Smoker 29 Consideration used to make housing choices  Housing cost was ranked first followed by proximity to work or school second and a smoke-free policy third as what tenants considered when selecting a place to live by respondents from both smoking-allowed and smoke free properties. o Overall, 71% of all respondents surveyed indicated a smoke-free policy was in their top three considerations when selecting a place to live. Top considerations from respondents in smoke-free properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 72% 19% 6% 97% Proximity to work/school 10% 44% 26% 80% Smoke-Free Policy 13% 35% 28% 75% Transportation 1% 10% 24% 35% Good school district 9% 7% 15% 31% Top considerations from respondents in smoking-allowed properties when considering housing Rank 1 2 3 Percent citing in their Top 3 Housing Cost 75% 16% 5% 96% Proximity to work/school 12% 35% 32% 79% Smoke-Free Policy 12% 26% 26% 64% Good school district 11% 19% 10% 40% Transportation 1% 15% 24% 40% 30 Sociodemographic Differences for all Respondents Secondhand smoke exposure (SHS) for respondents who indicated they did not allow smoking in their units N=442 55% 42% 46% 55% 35% 46% 42% 65% 46% 50% 43% 50% 44% 55% 46% 40% 51% 0%10%20%30%40%50%60%70% All Respondents More than $100,000 $79,001-$100,000 $55,001-$79,000 $39,001-$55,000 $23,001-$39,000 $23,000 or less Over 65 56-65 26-55 18-25 Hispanic or Latino White Black or African American Asian or Asian American Has Adults over 65 Has Children Under 18 31 32 33 34 35 36 Promoting Promoting Promoting Promoting SmokeSmokeSmokeSmoke----Free MultiFree MultiFree MultiFree Multi----Unit HousingUnit HousingUnit HousingUnit Housing:::: Advanced Policy StrategiesAdvanced Policy StrategiesAdvanced Policy StrategiesAdvanced Policy Strategies As more scientific data on the dangers of exposure to second and thirdhand smoke in residential multi-unit buildings becomes available, cities and counties are beginning to take action to protect their residents from exposure. This educational sheet provides a brief explanation of policy approaches and the benefits and challenges of each approach. These are arranged by strategy options at the city, county, and state levels. To discuss which approach is right for your community, contact info@mnsmokefreehousing.org. City Level 1. Incentivize smoke-free policies through city housing programs, like STAR Local city and county programs such as the Safer Tenant and Renters, or STAR, Program, provide incentives to property owners for participating in crime reduction programs. These incentives include a reduction in licensing fees or a reduced fine if a violation of city or county licensing ordinance occurs. To encourage adoption of smoke-free policies for multi-unit properties, similar incentives could be added to existing programs, or new programs could be initiated. Pros • Encourages adoption of smoke-free policies • Reward-based incentive, not a penalty or a mandate Cons • No guarantee that program would result in any additional smoke-free properties • Potential lack of city funding to support incentives • Potential pushback from city staff due to the incentive being funded by fees/fines Policy Options: • Build criteria into existing programs versus starting up new program 2. Require property owners to disclose the smoking policy for the property This approach requires property owners to disclose to potential renters or prospective buyers the policy on smoking for the building, complex, and unit, and whether the policy is smoking permitted or smoking restricted. Pros Informs prospective renters or buyers of the policy before they have signed a lease or contract Educates owners/managers on the legality of going smoke free Educates prospective renters or buyers of their right to live in a smoke-free environment Could reduce liability exposure for owners/managers Could result in new voluntary smoke-free policies adopted Affirmative disclosure of a smoke-free policy gives residents (living in a smoke-free building) an assurance that they can seek redress if the smoke-free policy is violated Cons No guarantee that ordinance would result in any additional smoke-free properties Potential opposition from owners/managers May result in the stalling of the adoption of new smoke-free policies Potential reduced likelihood that a building will go completely smoke free Potential reduced likelihood that a resident could get relief from secondhand smoke exposure after entering into lease agreement Risk of alienating prospective renters Policy Options Limit disclosure requirement to rental properties Include a disclosure requirement in a comprehensive multi-unit housing law so that all prospective tenants are aware of it. For example, New York City law requires certain multi-unit housing facilities to adopt a policy on smoking (ie. declare if smoking is permitted or prohibited) and also requires that smoke-free policies be disclosed. Current policies enacted: • Variants of this approach have been adopted in the states of Oregon and Maine; the county of Rockland, New York; and in the cities of Oakland, California; San Francisco, California; Buffalo, New York; and Duluth, Minnesota. • New York City has also adopted a law requiring certain owners to adopt a smoking policy (i.e. a written declaration of where smoking is permitted or prohibited on the premises) and to disclose that policy to prospective tenants. The relevant portions of the NYC administrative Code state: § 17-506.1 Obligation of owners of class A multiple dwellings to adopt and disclose a smoking policy. a. Adoption of smoking policy. 1. The owner of a class A multiple dwelling shall adopt a smoking policy. 2. The smoking policy shall address all indoor locations of the class A multiple dwelling, including common areas and dwelling units, and all outdoor areas of the premises, including common courtyards, rooftops, balconies, and patios, and any outdoor areas connected to dwelling units. 3. The smoking policy shall apply to tenants, including invitees of tenants, and any other person on the premises. b. Disclosure of smoking policy. 1. Upon adoption of a smoking policy, the owner of a class A multiple dwelling shall provide a copy of the building’s smoking policy to all tenants or post, in a prominent location within such dwelling, a copy of the building’s smoking policy. 2. Except as provided in paragraph 3 of this subdivision, the owner of a class A multiple dwelling shall incorporate the building’s smoking policy into any agreement to rent or lease a dwelling unit in such building. 3. Incentivize or require smoke-free building policies through the rental licensing program Many, but not all, municipalities require that rental properties be licensed through the city. This approach would create incentives for a property to have a smoke-free policy, or require that all properties have a smoke-free policy in order to obtain a license. Pros • Economic incentive to go smoke free at the city level • May generate increased revenue for the city if fees are increased for properties that do not have a smoke-free policy • Reduce the risk of fires and increase health of residents Cons • May generate decreased revenue for the city if fees are reduced for properties with a smoke-free policy • Pushback from city due to potential reduced city income • Pushback from property owners due to increased fees • Not all cities have rental licensing programs • There may not be an avenue for residents who are affected by secondhand smoke to find redress Policy Options - Include a question about a building’s smoke-free status as part of regular inspections - Reduce the license fee for properties that have proof of having a policy, or alternatively, increase fees for all properties that do not have proof of a policy - Require that by a specified date, licenses are only issued and renewed for smoke-free properties Rental licenses could include provisions that allow tenants, as third-parties, to hold property owners accountable if the property owners do not enforce the smoke-free policy in accordance with the licensing requirement. Because rental licensing programs typically rely on periodic inspections to ensure compliance with the terms of licensure, there is a likelihood that landlords may not adopt robust, responsive enforcement mechanisms. Making tenants third-party beneficiaries to the licensing scheme would go a long way to ensure accountability and responsiveness to tenants’ concerns. Although I have not seen this done in rental licensing programs, residential leases that incorporate smoke-free policies provide a good example. Some smoke-free policies designate other tenants as beneficiaries of a smoke-free provisions of a lease agreement such that a tenant can bring a direct action again another tenant who violates the smoke-free policy without waiting for the landlord to take action. 4. Incentivize multi-unit residences to go smoke free by establishing a city or county fund to support implementation and maintenance 5. Incentivize multi-unit residents to go smoke free by adopting a municipal resolution or declaration Current policies enacted: • April 2018 Richfield, MN City council adopted a resolution entitled “A RESOLUTION OF THE CITY OF RICHFIELD, MINNESOTA, ENDORSING SMOKE-FREE HOUSING WITHIN THE CITY OF RICHFIELD; AND PROVIDING AN EFFECTIVE DATE. City, County, or State Level 6. Incentivize or require multi-unit residences to be smoke free through city, local PHA, county or state development projects. For example, including a smoke-free requirement for any housing development projects to which the city, local PHA, county or state loans money Minnesota: Housing developers in every community in Minnesota can take advantage of a Low-Income Housing Tax Credit point for adopting a smoke-free policy. In spring 2010, both Dakota County and the Minnesota Housing Finance Agency approved Qualified Allocation Plans (QAP) that included awarding a point to development applications for new construction or rehabilitation if the project adopts a smoke-free policy. St. Paul and Minneapolis have had a point for smoke-free policies in their QAPs since 2008. Washington County included the point for a smoke-free policy in their 2012 QAP. Hawaii: The Hawaii Finance and Development Corporation require that all new and sold or renovated properties that receive tax credits through their program have a smoke-free policy as of 2015. Maine: The State Housing Authority requires that smoking be prohibited in all units of all buildings built and financed by the state’s Low Income Housing Tax Credit program as of 2013. Montana: The Montana Board of Housing requires buildings that receive tax credits through their program have a smoke-free policy as of 2016. New Hampshire: The New Hampshire Housing Finance Authority requires buildings that receive tax credits through their program have a smoke-free policy as of 2017. North Carolina: The North Carolina Housing Finance Agency requires buildings that receive tax credits through their program have a smoke-free policy as of 2015. Washington: The Washington State Housing Trust Fund requires that affordable housing projects receiving funding must adhere to the Evergreen Sustainable Development Standard, which requires all properties to have a smoke-free policy as of 2016. City or County Level 7. Establish secondhand smoke as a nuisance Local city or county ordinances could be amended to include secondhand smoke intrusions into multi-unit residences as a nuisance. Pros May provide support to residents in legal actions to get relief from exposure to secondhand smoke Cons Utility of language may be limited to those who can afford a lawyer or who have access to legal services Controversies could still arise as to whether level of smoke intrusion is a nuisance Policy Options Establish specific criteria in the ordinance on the severity and/or frequency of smoke intrusion that would constitute a nuisance. A smoking nuisance provision could be enacted as a stand-alone provision with other provisions addressing nuisances or, alternatively, it could be incorporated in a smoke- free housing ordinance. Current policies enacted: • This approach has been used in Utah at the state level. The relevant Utah law, Utah Code § 78B-6-1101, states: 1) A nuisance is anything which is injurious to health, indecent, offensive to the senses, or an obstruction to the free use of property, so as to interfere with the comfortable enjoyment of life or property. A nuisance may be the subject of an action. 2) A nuisance may include the following . . . 3) A nuisance under this part includes tobacco smoke that drifts into any residential unit a person rents, leases, or owns, from another residential or commercial unit and the smoke: a. drifts in more than once in each of two or more consecutive seven-day periods; and b. creates any of the conditions under Subsection (1). 4) Subsection (3) does not apply to: a. residential rental units available for temporary rental, such as for vacations, or available for only 30 or fewer days at a time; or b. hotel or motel rooms. 5) Subsection (3) does not apply to any unit that is part of a timeshare development, as defined in Section 57-19-2, or subject to a timeshare interest as defined in Section 57- 19-2. Considerations: • For this policy option to be effective, the ordinance has to set out clear parameters as to what actions/activity amount to a nuisance. For example: the Utah statute sets out specific circumstances where smoking amounts to a nuisance — “drifts in more than once in each of two or more consecutive seven-day periods.” If a policy simply declares smoking to be a nuisance without specifying the acts that amounts to nuisance, there is a risk that courts may rely on judicial interpretations of nuisances, which may be less protective. Historically, courts have defined nuisances as such things that “substantially and unreasonably “interfere with the enjoyment of one’s property. This approach is very protective to persons who smoke in multi-unit dwellings and puts a heavy burden of proof on persons suffering from secondhand smoke (especially low income families who might not be able to afford expertise to show how substantially SHS has affected them). A few courts that have decided cases involving secondhand smoke under the traditional nuisance theory have said that simply because tobacco smoke is known to contain carcinogens, its infiltration in the home does not make it a nuisance. In other words, there has to be some demonstrable harm for the courts to intervene. • Other provisions of the Utah nuisance law allow individuals to opt out of protections afforded by this law. The Utah smoke-free housing nuisance provision does not apply in instances where there is a lease agreement that indicates smoking is allowed in the rental units. In essence, the nuisance clause is a variant of smoke-free housing disclosure requirement that exempts from nuisance liability those housing facilities that state they are not smoke free. In other words, for this law to not apply to a housing facility, all the landlord has to do is to include a provision in the lease agreement stating that smoking is permitted. City or County level 8. Require multi-unit residences to be smoke free (partial or complete coverage) This policy approach uses a city or county ordinance to require that multi-unit residential buildings have a smoke-free policy. Pros: • Broad protection against exposure to secondhand smoke • More people protected more quickly Positive social norm change (in MUH building and in the community) Levels the field for property owners and managers who may be hesitant to be leaders It provides political cover for management companies that want to go smoke free, but feel like they can’t HUD has already led the effort on this front. Thus, smoke-free multi-unit housing is becoming the national norm. Cities and counties can build on the smoke-free housing momentum the HUD rule has created Ensures equitable distribution of public health goals as all individuals living in multi-unit housing will benefit from living in smoke-free environments Cons: • Enforcement can be challenging • Lack of funding and technical assistance support available for proper implementation • Potential reduced likelihood that a resident could get relief (if suffering from secondhand smoke in their unit) • Potential opposition: o owners/managers; o affordable housing advocates; o social service providers, o city staff, o marginalized communities (e.g. due to penalties/fines, legal consequences for violations) o housing trade groups • Potential opposition from homeowners of common interest communities like condos, townhomes, and cooperatives. Options: Restrict application of ordinance to o just rental units o only new developments o all MUH within the city limits • Graduated/Phased-in approach: • Culver City o Allow several years for compliance, promoted manager education. • Santa Monica o Year 1: no smoking on balconies and patios, common areas o Year 2: no smoking in units which have just become vacant including condos. o Coalition now returning to the city to ask that the landlord be required to provide a smoke-free lease to a new tenant, but no requirement that the landlord must enforce or evict. • Calabasas o Smoking is allowed only in a certain percentage of buildings. City staff report excellent compliance. Current policies enacted*: • 64 cities and counties within California have enacted local laws that prohibit smoking in all or some of private units of specified types of multi-unit housing. These laws typically apply to both privately-owned and publically-owned multi-unit buildings. These laws apply to all existing and future buildings, and do not permit current residents to continue smoking in the building (i.e. no “grandfathering” clause.) *Current as of July 1, 2018 Considerations: • Is there enough political capital? o What is the receptiveness of city council members? o Have there recently been other tobacco-related efforts in the city? • Are there residents advocates (who are willing to stick with the advocacy effort until a law is passed)? • What are the attitudes of city staff? o How will the city’s budget be impacted? What are the potential costs of implementation? • Ongoing enforcement? • Technical assistance for managers? • Who will be in opposition? o Tenant support unions and advocacy groups o Management companies o Fear of losing residents to neighboring communities o ‘Unfunded mandate’ o Smoker’s rights groups o Tobacco Industry • Is there a potential negative impact on marginalized communities? • How will it be implemented? Who will be responsible for implementation activities? o Who is responsible for enforcing the policy? And who pays for enforcement? o No research on long term efficacy of approach is available • What should be the scope of the policy? o Should the ordinance apply to just rentals? Or Common Interest Communities too? o All MUH? o Only new developments? • Are resources available to adequately prepare/educate the community for the policy? o How will renters be educated about the new policy? o How will managers be educated about the new policy? o W • What concerns may be heighted within low-income communities due to the rule? o Fear of eviction can cause stress o Proliferation of misinformation o Cultural considerations o Concern over safety (i.e. being forced to go outside in unsafe neighborhoods). Additional Resources: • Disclosure policies Oakland City Code: https://www.municode.com/library/ca/oakland/codes/code_of_ordinances?nodeId=TIT8HESA_ CH8.30SM Oregon Statutes: http://smokefreeoregon.com/wp-content/uploads/2010/09/Smoking-Disclosure-Law-Q-A-for- Landlords.pdf Buffalo, New York Code: http://www.ecode360.com/13626465 Duluth, MN Legislative Code: https://www.municode.com/library/mn/duluth/codes/legislative_code?nodeId=Chapter%2029A %20-%20Housing%20Code Public Health Law Center: http://publichealthlawcenter.org/sites/default/files/resources/tclc-fs-housing-disclosure-2015.pdf • Secondhand smoke as a nuisance Utah Nuisance language: http://www.tobaccofreeutah.org/laws-secondhand_amendments.html • Links to state STAR programs West St. Paul: http://wspmn.gov/DocumentCenter/View/468 • Smoke-free Housing city ordinances Richmond, California: http://library.municode.com/HTML/16579/level2/ARTIXHE_CH9.57PRSMARMUITRE.html# ARTIXHE_CH9.57PRSMARMUITRE_9.57.030NOKUNREMUITRE Belmont, California: http://www.belmont.gov/home/showdocument?id=5940 Alameda, California: https://alamedaca.gov/residents/secondhand-smoke-policies This document is made possible through funding from the Tobacco-Free Communities and Statewide Health Improvement Partnership of the Minnesota Department of Health, along with Hennepin County Public Health Department and the City of Bloomington Health Department.