Social landlords have duty to protect the majority from smoke

Smoke-free homes: an issue for health and housing policy?

Following the article in The Sunday Times on smoking in social housing this week, there has been a lot of local and national media interest in my suggestion that social landlords could introduce voluntary agreements not to smoke in new tenancies, in new properties coming on stream, where children would be living.

To be clear, I was not proposing a blanket ban on smoking in council estates, as some reports suggested.

For children, most exposure to second-hand smoke happens in the home where it can spread throughout, even if you open the windows. Eighty per cent of cigarette smoke is invisible and persists long after the visible tar-containing elements have disappeared.

“Social landlords have a duty of care to all their tenants.”

Second-hand smoke is particularly dangerous for children. When exposed to passive smoke they are at higher risk of respiratory infections, asthma, ear infections and glue ear, bacterial meningitis, cancers and cot death. It has been linked to around 165,000 new cases of disease among children in the UK each year. If you are a smoker, smoking outside can help reduce your child’s exposure.

Where there are multiple-living dwellings in the same block, social landlords have a duty of care to all their tenants.

The majority, who do not smoke, are not being given a choice to breathe smoke-free air.

The proposal would bring the social housing field more into line with agreements private landlords are able to make.

In the United States, public housing agencies will be required to adopt a smoke-free policy in their tenancy agreements from August 2018.

Most adults in the UK do not smoke and many tenants would positively welcome a smoke-free home environment.

Action on Smoking and Health groups in England and Scotland report regular requests for information and help with complaints about smoking neighbours.

There are a range of smoke-free homes initiatives, mainly educational and voluntary, across the UK.

Some housing organisations are considering the evidence base for introducing voluntary agreements with tenants who would agree not to smoke in their home to protect children both in their own and neighbouring homes. My faculty is supportive of and encourages housing associations or local authorities that would like to pilot such schemes to undertake this research.

“The majority are not being given a choice to breathe smoke-free air.”

There are wider policy issues that flow from this discussion. People do need to be helped to stop smoking. The Faculty of Public Health, the Association of Directors of Public Health, Action on Smoking and Health, the British Thoracic Society and others have been calling for a new tobacco control plan for more than a year and any further move on smoke-free homes needs to be set alongside services to help people quit and further education about passive smoking risks.

Recent and ongoing cuts to local authority ringfenced public health funding are causing vital smoking cessation services to close.

I have called for the reversal of these funding cuts, which are a false economy and risk increasing smoking prevalence. The smoke-free homes moves are proposed principally as a further protection for children’s health and well-being.

There is a much bigger issue in housing policy, too. There are not enough houses for people to live in.

Some of my radio discussions have been around choice.The reality is there is very little choice in social housing for anyone.

Throughout my professional life, I have argued for eradicating poverty, reducing health inequalities, and greater provision of better quality social housing at affordable rents.

Certainly, at least some of that housing offer should be smoke-free. To tell people we can’t provide enough good quality housing, but they can have the freedom to smoke in their council flat seems an inadequate way to treat people. In doing so we are failing to advocate for real improvements in people’s lives, and for better living conditions, better health and better housing.

Professor John Middleton, president, UK Faculty of Public Health