It is clear that smoking is certainly becoming more and more socially unacceptable given the influx of no smok- ing bans in this country. The Boston Housing Authority (BHA) is taking matters one step further and is propos- ing to ban smoking in all public housing developments. In June, the Washington-Beech complex in Roslindale became Boston’ s first smoke-free public housing facility and the recent BHA proposal aims to enforce similar re- strictions in all 64 public housing developments by 2013.Opponents of this proposal are feeling that per- sonal choice and civil liberties are being jeopardized by such mandates. The question becomes, is implementing such directives an infringement upon civil liberties or are there other reasons that justify suchcontroversial directives? To answer these questions wehave to examine the reason for such propositions. Essentially, the rationale is that by do- ing so, we are protecting the most vulnerable segments of our populations, the elderly and children, who are es- pecially susceptible to the harms caused by tobacco exposure. However, it is also meant to protect non- smokers in general be- cause of the known risks that tobacco causes to anyone that is exposed to secondhand smoke. The well documented risks include cancer, lung and heart disease, respira- tory complications and Sudden Infant Death Syndrome (SIDS). The 2006 Surgeon Gen- eral Report, entitled the Health Consequences of Involuntary Exposure to Tobacco Smoke, goes as far as to conclude that active smoking causes damage to virtu-ally every organ in the human body. In fact, tobacco is responsible for over 440,000 deaths in the United States and is the leading cause of preventable death and illness in this country responsible for more deaths than those attributed to HIV/Aids, car accidents, homicides and suicides combined. Given these grim statistics, it is clear why such no smoking policies are being proposed.I must contend that I am a bit biased when it comes to such policies because of my full time work as a Mas- ter Certified Tobacco Treatment Specialist (M-CTTS) managing a quit smoking program for a local HMO. I speak with tobacco users daily who sincerely desire to quit smoking and find it challenging to ” kick the habit” . However smoking is more than just a habit, it is an addic- tion and society and our healthcare system in particular, has to understand that tobacco dependence is indeed an addiction that requires multiple intensive interventions and which deserves the attention that other medical con- ditions receive. The good news is that there are scientifi- cally proven interventions that exist that are efficacious in treating nicotine dependence. We know that using a Federal Drug Administration (FDA)-approved cessation medication such as the nicotine patch, gum, lozenge, in- haler and the nasal spray as well as the prescription pills Bupropion (Zyban) and Chantix can significantly im- prove cessation outcomes. What also helps is to obtain support by participating in a quit smoking program or by obtaining support from a local telephone quit line, the more intensive and the higher duration of such supports, the greater the outcomes.My position on the matter is that only and if such treat- ments are provided to the smokers within these public housing units can we then move forward to implement such no smoking restrictions. I would go as far as to pro- pose that these treatments must be provided at no cost given the social status (low income, inequitable health care) of the many individuals who reside within public housing units. There is a known correlation that tobacco use has a higher prevalence within individuals who pos- sess lower incomes and those with lower educational attainment. It makes sense that given these facts, policy makers must take such matters into consideration before rolling out policies that affect the most addicted, the most vulnerable and those with the lowest socioeconomic sta- tuses. It is a matter of equity and justice to provide such supports and when they are implemented in this man- ner, individuals’ quality of lives are improved and health is maintained – a win-win for all.
Hyperlocal Humannitarian
By Angel Cosme
| November 2, 2010
| November 2, 2010