sr-062811-8aCity Council Meeting: June 28, 2011
Agenda Item:
To: Mayor and City Council
From: Marsha Jones Moutrie, City Attorney
Subject: Information and Recommendations Regarding Residential Second-Hand
Smoke Policies
Recommended Action
Staff recommends that City Council direct the preparation of an ordinance for first
reading that would: (1) require owners of multi-unit residential properties to designate
and disclose to potential renters and buyers the status of each unit as smoking or non-
smoking; and (2) prohibit smoking in all newly constructed hotels. Staff also seeks
Council direction for possible additional areas of second-hand smoke regulation as
described below.
Executive Summary
Council directed staff to return with further information in several areas related to
residential second-hand smoke policies. This report describes recent smoking
regulations in other California cities; updates current local responses to the City's
existing laws; discusses the possible impact of further smoking regulations on low-
income populations; and addresses some other questions raised previously by Council.
Council also expressed interest in adopting an ordinance containing the two
requirements described above. This report describes the options available to Council in
those areas and recommends that Council direct staff to prepare the ordinances.
Background
Following its meeting of July 27 2010, Council directed staff to return with further
information on several subjects:
• Ordinance options to require owners of condominium units and apartments to
designate each unit as smoking or non-smoking, and to disclose that status to
would-be renters and buyers
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• Ordinance options to prohibit smoking in all newly constructed hotels
• Developments in other California cities and Santa Monica regarding residential
smoking regulation
• Possible impact on low-income and other populations of further residential
smoking regulation
• Possible utilization of designated federal stimulus money through the Los
Angeles County Energy Program, to help-create structural protections from
second-hand smoke in local multi-unit properties
• Enforcement options and potential recommendations for existing City
regulations.
Discussion
A. Update On Other California Cities
Attachment A is the most recent compilation of California cities' residential smoking
regulations prepared by the Center for Tobacco Policy. Staff has also spoken with
officials at other cities and has learned the following developments.
Burbank: In October 2010 the City of Burbank adopted a new secondhand smoke
ordinance which went into effect May 1, 2011. The ordinance prohibits smoking in all
multi-unit residences that share a common heating or cooling system and ducting
system which results in air from one unit being distributed to another unit. The law also
prohibits smoking on all private patios and balconies and certain outdoor common
areas.
Glendale: In March 2010 the city expanded its smoking ordinance to require landlords
to disclose whether smoking is allowed in a prospective unit. Owners must display a
map with the locations of the smoking and non-smoking units, the location of all
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common areas where smoking is prohibited, and where smoking is allowed. The
ordinance also prohibits smoking on all balconies and patios of multi-unit housing of two
or more units including those units that are designated as a smoking unit.
South Pasadena: In August 2010 the city adopted an ordinance prohibiting smoking in
all apartments and condominiums. For units constructed after September 2010,
smoking is prohibited in 100 percent of the units. For existing units, 100 percent must be
smoke-free as of September 2013. (Landlords may designate 20 percent of units as
smoking if certain requirements are met.) The South Pasadena ordinance also states
that for those units where smoking is allowed:
• the non smoking units must be grouped together to the best extent possible;
• smoking is prohibited within 25 feet of any non-smoking unit and on private
patios and balconies of smoking units;
• landlords must disclose to tenants and prospective tenants the location of
smoking and non smoking units.
This information must also be made available to the City. Many advocates state that
South Pasadena's ordinance is the-first in the state to make non-smoking units the norm
while providing a process for landlords and homeowners' associations to create units
where smoking is allowed.
B. Santa Monica Update
City Attorney staff has received six formal complaints this fiscal year of violations of the
City's smoking laws. Most of these alleged that landlords were not giving the required
notice of the newly expanded common area and 25-foot zone. After staff wrote to the
owners, each complied with the law's notice requirements. In addition, staff has
received approximately 80 telephone calls from local residents with questions or
concerns about residential smoking. The predominant issue raised is the notice
requirement for landlords. Some residents have expressed concerns about other
tenants smoking inside their units and smoke drifting from one unit to another. Many
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have informed their landlords of this problem and report that landlords either contend
that their hands are tied due to rent control, or have tried to relocate the affected tenant
or asked the smoking tenant to smoke in another place. According to some, the
affected tenants in this situation sometimes end up moving out.
Staff also conferred with several other local agencies and groups regarding the latest
reactions to and compliance with the City's residential smoking laws. The Apartment
Association of Greater Los Angeles (AAGLA) reports that its members have not had
many problems with compliance. One AAGLA member said that on about six occasions
he has had to notify tenants of the ordinance's requirements.
Rent Control staff report that they receive calls from tenants whose landlords have not
posted signs or sent the required notice advising the tenants of the law and its
requirements. Staff states that tenants often feel uncomfortable approaching a smoking
tenant without a sign to point to or a reference letter.
Cessation programs. The City of Santa Monica does not itself have programs to help
people quit smoking. There are many such programs in Los Angeles County including
Santa Monica, such as St. Johns Health Center Community Education (1328 22nd
Street) and Nicotine Anonymous (1260 18th Street).
S.B. 332. This bill, currently pending in the Assembly, would among other things allow
landlords to ban smoking anywhere on their property including inside apartment units. It
currently contains a clause stating that it does not preempt "any local ordinance" in
effect as of January 1, 2012. This would appear to leave in place the local rent control
protection in Santa Monica which prohibits evictions based on a tenant's violation of a
unilaterally-imposed new rule.
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C. Enforcement Issues
Council asked staff to address possible new enforcement options for the existing
residential smoking law. Some have expressed dissatisfaction with the current remedy
of notification followed by small claims court. However, the options are limited. In
general, property owners do not want to be responsible to enforce the rules. Most
parties agree that direct government enforcement is impractical. Council thus far has
not wished to expose tenants to the risk of eviction for violating smoking laws.
The following is a chart summarizing current enforcement mechanisms for residential
smoking restrictions in key California cities. These laws are very new and there is not
yet helpful data about the success of various remedies.
City Remedy Enforcer(s)
Santa Monica Civil Private
Burbank Misdemeanor or infraction Police
South Pasadena Infraction or civil Various city officials or private.
Glendale Infraction or civil Various city officials or private
Calabasas Misdemeanor Code Enforcement or police
More generally, it is not clear to staff at this point that the remedy framework for actual
smoking violations- posting notice, attempts at informal resolution, and eventual small
claims court - is in need of change. Staff and the other agencies contacted have
received relatively few complaints about the process or lack of compliance (either by
owners or smokers). Also, there is no way to determine the number of cases that have
been brought in small claims court or what the results have been. Staff believes that
expanding or changing the enforcement of residential smoking violations to Code
Enforcement or other City officials would be difficult and likely impractical. Since Council
thus far has not wanted to expose tenants to possible eviction for violating the smoking
laws, the current system appears to be the best option. Finally, since smoking
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regulations historically have taken several years to solidify in compliance, staff
recommends revisiting the topic in the future to assess the matter then.
One thing Council could consider changing is to have Code Compliance or other City
workers enforce the requirement that owners post notices about the common area law.
Unlike policing the smoking itself, which would be far more problematic for the City, the
sign requirement could be treated like other code requirements on the property and City
officials could respond to violations. Most other cities currently. assign residential
smoking enforcement to the government.
D Possible Utilization Of Los Angeles County Energy Program Funds
Council asked staff to study whether the City could utilize funds from the Los Angeles
County Energy Program (LACEP), created through AB 811 using federal stimulus
money to encourage energy-efficient and environmentally sound improvements in
construction. The idea was to subsidize the construction of physical barriers between
units or improvements to existing ventilation systems to increase protection from
second-hand smoke.
Staff has confirmed that the LACEP program has been cancelled and therefore is no
longer a potential option for such funding. The City is now participating with the County
in a statewide energy upgrade program for residences, but it is a rebate program and
Office of Sustainability and the Environment staff doubts that the rebates would apply to
smoke prevention measures.
E. Potential Impact On Low-Income Groups
Council has noted concerns about disparate impacts of anti-smoking laws. Staff spoke
with officials at the National Network on Tobacco Prevention and Poverty and the
Health Education Council, to verify demographic statistics associated with smoking and
6
to explore the potential impact of residential smoking regulations on various low-income
populations.
As an initial matter these groups confirm that, as expected, smoking is generally more
prevalent in lower-income and less-educated populations. For example, they report the
following percentages of smokers within certain groups:
Group Percent smokers
Very low income 36.5
At poverty line 32.8
Less than high school education 32.0
Above poverty line 22.5
College graduates 13.3
However, they also report that the current national trends in low-income housing are
strongly favoring the creation of smoke-free housing. A key argument is that, unlike
many other unhealthy addictions, smoking exposes third parties, including children, to
grave health risks in their housing.
Nonetheless, one group is considered a special case: the homeless or formerly
homeless in transitional housing. The incidence of smoking is very high in this group,
and the priority is getting them housed prior to addressing smoking or other substance
issues. Attachment B is a set of recommendations by a national expert panel convened
by the Health Education Council. The recommendations stress the importance of
smoking cessation programs while increasing requirements for smoke-free transitional
housing.
7
On the subject of possible impact of further (and current) residential smoking
regulations, staff consulted with the City's Homeless Services Administrator and
Housing Manager. The Homeless Services Administrator stated that at least one
nonprofit housing provider in the City is having a hard time complying with the City's
smoke-free common area law. The housing providers' property is structured so that it
does not give enough area for people to smoke. When the building management
realized this they moved the smokers to the alley next to the building. They then
received complaints from neighboring properties due to smoke drifting into their
apartment buildings. This housing provider believes that it does not have any other
place for these people to smoke.
As to potential banning of smoking inside units, the Homeless .Services Administrator
expressed concern since, she says, the majority of formerly homeless individuals are
usually trading one addiction for another (often from alcoholism to smoking). The
Administrator said if something like this was passed it would impede assisting people in
finding housing and create more obstacles to their placement.
Housing staff stated that if Council decided to ban smoking inside units, especially those
that are designated as affordable, it would run counter to the City's policies. Staff said
the majority of people on Housing's waiting lists are smokers; and that if these people
are not housed, the City could lose funding from HUD. Housing staff also stated that if
the City banned smoking inside units, they recommend that it be either phased in over
time or only in new developments.
Staff has additional materials obtained from the Health Education Council on issues in
second-hand smoke protections in affordable housing, which can be made available.
F. Ordinance Options
Designate and Disclose. The first ordinance mentioned by Council would require
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owners of all multi-unit properties to designate each unit as smoking or non-smoking,
and then disclose that information in various ways. The way this typically works, in cities
with such regulations, is for owners to poll all tenants and have them designate the
status of their units. There are several questions for Council to consider.
First, should owners be required to file with the City their designations for all units? Staff
recommends not, at least initially. The trade-offs of such a rule would be likely increased
compliance with the designation rule on the one hand, and additional City staff time and
cost (plus likely resentment by owners) on the other. The largest California city with a
designate and disclose rule, Oakland, does not require owners to file such
documentation with the city.
Second, how is the designation to be accomplished? One idea will be to allow all
occupants a reasonable time to designate their unit after proper notice, and then
classify all units as non-smoking if there is no response. In order to be fair, this would
require proof that tenants received actual notice and the opportunity to designate. Also,
when a previously smoking unit is vacated, it could be converted (either by law or at the
owner's discretion) to non-smoking status.
Third, how will compliance be achieved? Council has several options here. If someone
smokes inside a designated non-smoking unit, remedies could be made available
against the smoker, the tenant in whose unit the smoking occurs, or the owner.
However, to date, Council has expressed the intent not to jeopardize the tenancies of
tenants who violate the. City's anti-smoking laws generally (S.M.M.C. 4.44.040(c)(1)).
Council also has expressed reluctance to regulate smoking inside apartments.
Assuming that these policies are continuing, Council could consider a contractual
remedy between the landlord and the tenant in the designated non-smoking unit. Since
the non-smoking designation would be given either voluntarily by the tenant, or by
default through the law, there would not be a rent control defense to contractual action
9
by the owner. If there is a concern about owners not enforcing the rule, Council could
also consider a remedy between prospective renters or buyers, and the property owner.
In other cities, smoking in designated non-smoking units is treated like other violations
of the residential smoking lavv. They do not specify against whom exactly the remedies
may be pursued as between the smoker, the tenant whose unit is used, or the owner.
Fourth, Council should consider how much time to allow in phasing in the designate-
and-disclose requirement. For example, one timetable could be 90 days to poll existing
occupants and compile required information; 120 days to provide information to existing
occupants; and 180 days to begin disclosing the information to all prospective renters
and buyers. Based on past experience staff recommends that Council allow sufficient
time for any phasing-in period to include public outreach and education with this new
form of regulation.
New Hotels. The second area in which Council mentioned an ordinance is to prohibit
smoking in all newly constructed hotels in the City. Since this is an area separate from
apartment buildings and condominiums, staff would likely add the new prohibition to
existing S.M.M.C. 4.44.020(a) along with a specified effective date. (Many large hotel
chains already prohibit smoking in all rooms and outdoor areas.)
The main concern here is to be sure and capture all hotels that are currently in the
permit pipeline. Staff recommends phrasing the rule to include all hotels which have not
yet received final Planning approval as of the effective date of the ordinance.
Alternatives
Council could consider various alternatives to the proposed approaches as described in
more detail above.
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Financial Impacts & Budget Actions
No likely financial impacts from ordinance options being considered.
Prepared by: Adam Radinsky, Head, Consumer Protection Unit
Paula Rockenstein, Consumer Affairs Specialist
Approved:
Forwarded to Council:
e
~r
Rod Gould
City Manager
Attachments: A: Matrix of California cities' smoke-free laws
B: "Addressing Tobacco Use In Homeless Populations"
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to ot1y37Jia ~ ~ CALIFORNIA CI'flES with Smoke-Free F9ousing Provisions.
' set DISCLOSURE Nom9mokin Units Required SHS
Pop. When NMMON by ~ by Condo Nuuance
(2010) adopted" axsns landfprds Sellers .Exisiting New Provisions Designadon
Belmont Multi-story,ind
(San Mateo) 26,078 10/2007 ~ r v v 100% 7D0% condos,7/9/09 ~ r
Novato
(Mafln) 52,737 4/200$ v r ~ S0% 75% l0+urins, 7j22J08 r
Calabasas
(Ins Angeles) 23,725 3J20D8 v r $Oq 80% 1/1/2012 ~ '
Loma Unda
(San Bemadino) 20,136 6/2008 v 70% 70% 2+units, l/]J2072~
Dublin{Kameda) 46y34 32(2008 v' v SO% SD% 16 un"rts-2010" ~ v 9(p6
Oakland (Kameda] 420,183 72/200] r r r 12/2007
Albany (Kameda) 15,877 6(2008 r v ,r 6(2D08
Glendale ~ '
(LnsMgelesj 207,157 ]D/2008 r v
RohnerL Park
(Sonoma) 43,062 4/28/09 v r r 50% 75% 6/2011
Martinez -
(COntraCosia) 36,144 5/6/09 r 6(1/2010 ~ r
Pophmond
(COrrtra COSta) 103,577 7(21/09 r v r 100% 100% 2+units, l/1j202i
Lpntra Costa " ~ 100%-
(unlnwrp) 170,310 10/20(09 + r olNxor4 4+unds, 1/1/2D11 . '
PleasanE Hi(1
~ 4+unit opts, Apnl-
(Contra Costa) 33$47 04/05/10 r . r 60% 100% 2015 v
Sebastopol ~ ~,
(Sorroma) 7,730 DS(03/10 r - ~ 100% 10035 2+units, Nov2011 r
south Pasadena
(Los Angeles) 25,832 08/04/10 r r ~ ~ 80% 7D0% 2+un"ds, 9/4/13 r
Santa Cfars Coumy '
(uninwrp) 91,832 11J2i/10 r 100% 300% 2+units, 2/23J32
Untan Cry
(AWmeda) 75,054 7.1/13/10 r. ~- 100% " 100% 2+unhs opts, 2123/12 r
Eor more detailed intnrmation, go to: hitp://www.tenter4EObacmpollcy.otgJlocalpoBcies-smokeSeehousing ~h11Eg1CAN NtNG kSS'OCIgpON
wmxi
Factshee#sfor landlord, ter>ants, condo owners,pol}oy makers:www.casmo~ireehousing.org
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ATTACHPIBNT B
ADD ¢P941Nfl LOBa OGO USE IN HOMELESS PO PULAiIONS
TA6LE OF CONTEMS
Plonning Gommltlee Members.._...._.._._.._......_......__.........___._...__._ .....:......._...._...._.._._..........,._...1
Fxoart Ponal Padlcroan8....___.._......_..__._.........._.._...__...__.~__._._...._.._._.._....._....._........_..i
eaCkgrountl__.._-.__.__..._........__.._____._....._....._.._._.._.....~_._._...__.._._..,.._._._._.. ._.....__....3
I.Aeafing Goak an0 Process_._.._._..._..............__..._._.._._....._...._____....__...._..._..._..___.., ......._....._3
Problem ldeni19ec1ian__..._._._._..___._....._.._..~.........._...._:_.__.._:.._,,._._,...„..__.._....._ _.._ _......a
General Recommandofions_.___..._...__._._..._____.___...__.._.._..__.__.___._.~....._....__. ......._.._...4
Policy Recommendatlons.._.....__„______..._._..__.._._..__..___.__.._ ..................__:~. _.._._..._,..5
Tobatto Cessotien RncommentlaHOns..._..._..._...._.._._.__ ................___._._...__.._._....._.... ......__._...6
Rewmmantletl Infervenfiom torSOCbI SaMce Pmvldars__.__..._._.__.__..~_:..__.__...._...._ ......_........9
Research PM1Ohties ItlenHfied by the Ponef........,._..___.._._.....__..._.._..._._..__......____. ......_..__.1g
Resources and ^nW ~_...__._.___._._._.__.._.____.._........._.._._......__......_.._.._.___...,. _,..._......72
Documents Reaewetlby the Panel__.._.___...._.__...._„.._..__..._.__..,_.....__ .............__.._._ _.........13
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ADD4ESSlNG iO BAGCa VSf IN HO MFLFSS fOPVLAYIONS
PREAMBLE
In fhe Unitetl Stales, every pelsron shoultl twva iha tlght to be heaUYy ontl
every ifa ahould ba valued. The high piavalence of tobacco use in homeless
populati6ns b o nationd haotth b5ue. the ponel convened recognP[es that }he
PAaSOiood otsuccass 1osalW ofi the to0owiAa recommendoflons begins wfth the
- eradication of homaiessneu"
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nD DA E951N6 TO BAC<O'USE IN Nc MEl E55 POPY IAilO N4
BACRGROIIND
Mea%n9 Bouk
1T6 mnelcomenad forfhe Purp«e of vatlrenEy? the
blbwF9 gmK.
Tne Heb%h EdU<o%on Coencll
The Hedlih Humllon Cousscah a pdwte. mnpars
erganIIalion whose mialon b fo Pmmob heonhy
communities gourd the w pk1, The Cevmli H
tledlmled to pmvkling accen, advrolbn oAromry
and baFingfc empower bdrviduakioxords v hea%hy
6(e.
Break frx Nllence
Break Tree AGamels P nPl'wrwl netwarkol
grgenfmiiw~s, date lobecro Progmm, re9iond
podrien and reseorcisepwoAgnp bend iheaYCle of
IoL cco usaar~d povedy_WepMnerwlthavotalVOP
slckehddarsio devabp Alfivnoa Snlnallves,program
and sesWeas ant disserrvrsote psomldrg shafegies ant
remrcmmdaslom nottnnaM.iha Alfgncah landed by
the Gaolers tw dse«G Conlml and Prevention. Office
onSmakng and Heclih and admirrislered by the Haolih
Educa%ps Cowspl
the wok of freak free A&onaais gcmmpYShad
through the leadership of she AYlance's CopolnaiNg
C/ UncYantl shrovgh podnarshlPr vrithdakefioltlen
rMicnwbe. Both the Nanonvl Heanh Cps br
the Homeless Courrll (NHGHC~ Ond iha Nai'pnaf
Cool'dlon lesihe Homeien (NCHi »rvaas membps
arthe Cmralrofmg CqunN and itataholds body
raspedNeN.Tfik panel w«mnvenad wits Chet
»ppod, both grgaNSOflhm hrn'mg fecognized the
need to devGbP COmprehamNe{obpCW pofay and
ProgrommA9ind'gtlve5lo retlU:blobaCCD WOYGteS
among homalsws pevasv.
ieba<m U» arb Homdesmoss
The panel estimates That behveen 7g&1R of hpmalcY
patrons spe tobacco, compered io 19ROf advih In Iha
9onem3 PoWkdbnlCOnroc DIUGHeifroM 199J: Sachs
Ericssm,1999}. Homeless pebom face urdque barims
when %mmes b qumin9 oW row »^RCe provftlers
af§r adagmte labmm ceneiion plppmms io meet
fha needsof tNS pvrncubr pppNafipn of tobacco
»ss. iobvccq useamong Ydmdless Verson[ needs to
bo gtldrdsed much nAOredmrgN a/ ppary mvkpT,
iha acedvmlc commlmiry,TUntlers and hpneless
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of fobamovseF she pdpvb%en and loreduce overaY
prevoence rates.
w tt~C~ 3
I, bontiN thesuc»ses roddtatlengesto etlpesing
tobacco use fn homeless populatbns.
2. IdenliN cvnanl tobamo ceaMiws practtces and
maae6 fphwrreless popuk:ibm.
1 Devtloptargeted remmmandaMmfor -
dlxeminanonamxp meorchen. vaEq mvkers.
funding aeendm, Avfe lobamo mMrol wograms
and spice prevwav.
Panel memberswme «kedb ilese apeaiflc '
W w.vkdga of iha Problem c s if rehted f c ihaY
dlxlParle. Pp1ldPale N b IatlBlased wWcgmuP
of 1IY15other panekh to satpMp%es, and woR
mavbpafNeN w%h other vaneasn to mnax on
specific remmm andcilom to rwtbrwl duets nv%on.
Process
mMSaYrom to ppndpala N the rtmpti ng ware u M
to lobo cm <onird advmafes. f crtnertY homeless
indivitluvly r«ewchers, socid seMro povders ant
acrsldmrswml5ng vrilfihomeless Persons, dnd fenders
cpnihe wtama arse pahTC »cbe.Tneinrenl w« ip
MYf iha pvnelio no more thon3g iMidddols In pderfo
Henerma dwbgve cM tlebme.
Pene6iswere ccnvenetl on October27.29P9, in
Washington, DC.The bYOwing pm»ntafbmware
madafo M1pmaiha dhcumom
Overview vlHOmetessrenin me US. Michael Simpc
Okada of CemmvnlN Orgarimng, National Coa5lbn
sorita Homeless
Tgbacco U» among Hie Homeba ChaYesges and
OPpwlvMiac Oonrw SheasY. MD. MPH, CIINcdi
Asctlote ProtwsxoE NYU Co%sge of DenfMly and
SchmlolMedlcne
Paneltsfs were ozkea «a BrovP to ProNdo a garsvPl
overvlaw a the problem of iohacm use omorsg
homeless pencm.They were then dMdatl Flo grDVpa
of fourdepend~ng anihairorev of exi eHla (health
antltoWCromnteol, fimmng/research eammvniy
-advocates. poficyl.fach otfhese grouPSwere inked
togena'aleresponses sped6c to 1) ihesucceues and
chatlengei loaddmvhspiobacm u» M homeless
popUbibn, ana2t promWn9 shategies, pmgram
modek and'aPProochex to address chotlengas
and bamars.fie groUPS lplermerged fogeiherio
nmfidMe,F}egrvlecnd mfegolize hhetra+pames.
GxPend they 6v~ogue, crM pdosThraihelmpMance
ADD RE591NG TOBACCO "USE IN HOMEtE 55 fOPU LATIO N9
oliherespamac Ae panel then devebpetl dmtbn
crReda and recommendononcalegores. '
ThH document coMalma summary of the pmblem «
lamiined hYthe Panel and prorRieq Inlemn%pe «
IhaY rglnle b potty, tohacm canfrd pro8'am, sotlrd
seMCe Pmgmm, and Ivlwa r«epch For eaUASOpi<
areo.lha ponelidenllfad a%imiPacfars toa<hleving
zuccea, challeAgesaM hinters. what Is needed to
rcomeihe choYengezaM banierz and Ihetop f
recommended totelventions/asvtegiez
PROBLEM 1DENiiF1CAT10N
there«ass Ip iha kgh rai a ai f obame vsa c mong
homelss persdm ore vodetlaMmmpiex Honwkss
seMCe provs]ev have betls slrnv to recoprirmiobbcm
se «a sedow addldlan 1hct.warards Mesame
onenn«r asafi it amocnd vlmhdaaaaim,p,n «
pubYc health and loboodo mnGdwpken how bean
sbw fo pW nerwnhsodalservimpmWden b atldress
Iheksve TObacm mnlml among homeksi persom
eeds to be approoeM1M as both a health «eisand
sv iol Wsiice Issue.
Why do ho moles pee»ne hove v nodond smoking
prevalenccraia ofevalTS,°69Why&)Ns hvppemng?
WMfrn 9arng on?
ATeng FGmei@E peROrIF dgpRfden, anMBtY end
otherrm~tal heolHr tliwrdss conlnbNe to tobacco
use. C]9arett« ore c«ay ava9able and are a Cheap
way for Iarneress 1 MiviMa k to sort-madkate.
OHSm ronirbNon fo bbvcc use Ixlude axpavro
to vloknceMauma. hunger boredom, the ncetl
facompanlomNp and »cbfpPSbn (cLgoraltas
proNde Hris). nicoAne adtlblbn and fobamo
Ndwirymv"ce1FB of bbacco protlucts to ncmdess
pmulaiiorV.Theroba beYeformng monY hamsters
iMividuols Ihal ihey mnrwl chvrgea F9venca iheY
ent.SOmehomelea iMlNduvtdo not vmepi
serMc«end marry havecogni%ve deficiencies ihos
naka ceuanon wheach dhd success rtwre tlilfiatt.
AwnY do rwl seethe beneMSOf gWIlFg fobocm v».
AmoM'vg so Paneisls, iobacro cemlbnls o low
prioriryamorp Apmaless service pravitlers. McnY
of them smoke vntl nbaiine odo9ct"ron's not being
atlpessea F m«I Cfmlwl»nir~ where homaler
IndMtlwd receive »suc¢s. Whle come i2-dep
meetings IAICDh Wes Asarryapus, Mrollre Arlmymoral
aw smoke-f roe, tM.re are slgl few vxcesslN
pogram to refenah. Fatleq W to ymfevbnei pmd lm
5landpds orouM Ireolirg iabaam addlcfion fp
homeless persom and nine profesdorwlaAZOVn1aESiY.
Asa result, tobacco qWl rglex pe edremeh law In
homek papvbllom.Thpe Ira need sotrainxerviee
providersio address tobmm use b cfirir<d encounlen
wlih hamsters patients c nd f a ercovra9e ahem t o t real
Ncollne adtlicllDn es IhcYwoWd other "mono urgent"
medkalaN sodel toncem.
WhmshesmrsaMcsws do Nw homNass hev.~outrme
of tobvoce sne Halls imPOdpM b knew In femu PI'
addmanrg the hnm?
H omeless InoMduah egsanence shessprs f hat
confAbule to lobvmo use and makasobagco
esmlion more dlfacvlt.The» lacbda svbdarrca abuse
crass, bCS of she%ec hck of sodvl wppat low se%
esteem anomplgmant, lock of care 4em saciely.
b<k of rodatempafhy, bck OP edvmf"nn, hunBpaM
sfcrvallort Mtlaarw access fe healthmre, toomm
mong peers, bckof pdvote fiNrsg rnhmfiom.
and iM'dress of cadng fp famM pM chlkk®nwh~le
homabss.
Why does Me Fifueoftohacco~se amon9homelnc
persom need b 6e addresudmgre shongly?Whol arp
the l<r nernn sdafeaanaolhn conrmsvprroes prod
add,.srmgrha issue?
Cardlovascvbrdlsea» kthe pdrvrmybllmof honulatt
and (ameryhomeless inrMldvgt. Whae daloa
fim%ed, the nalbnal hev%h care costs epodaled wills
tobacco vsa cmon9 homeless pe:»m 6 edimaletl IP
be exlremeN hbh. Tfio prevalence of ebslrvdive Nng
dva«a a rM the inter of death from obs}NCilva lung
dta«eare higher man'ghomel«.s pemem lhmF
lhegenerol popJafiw (Snyder.2004 hhvgssg, 1997f.
Add%IOrwM• sobocco vaein Ihk commursHy canMbufes
to a higher rata of mmmurvcabk d W psa as main
hcmeksslrWividuafr dWrecigarettes arrd saWage
dhcaded c'Igoreife bulls oN the dreels.
GENERAL RECOMMFNPA770NS OF
THE EXPERT PANEL
O Homeless sarvke providers droNtlinfeBnie
tobomo ceaadm Ftervenilosss IMO aY pdnis of
access 1o homeless Persom-from dreat oubeach
to haudrg plecnmenl.
® Medlmlarrtl sofialservlm pmvbers shwldemuro
access fph meIG19 persons to oA Ireotmeni
modvYfki fdrn'1eo11nereplocemenl lfe:mpy (NRil.
' other cessefion moo'konons/aidsarN counu0re
repardessot Insumnceand dliiemNp alehn.
® Hamsters seMce poWdersshoub atlopf lpbmco
nonuse poYCles forcfients and doff al tacnAks
- irevtirrgaM prordlne sarvlces io homelav persons.
6 tl~~RUK NACEEY
ADDRESSING TOBACCO YSE IN NOMELP 49 PO PUTAilON9
® Tobmco control protesloxbsnoWd sidveto
lnvevsa the use of enklrg eessofiea roaxeesby
pravafinp se vitas fo maralbseMrrp hamdats
persons.
ID Sldle Mealmid proEPOmusMUltl mvertobaxo
tlepenrlexa freelmenl, iraNdine cwmeGnq and
NRT.
m kesimlaM SOdat scrvlce vgendm serving
homeless person shout 1nleerote the US. P WIc
Health Serviceeppmvetl. CIN9caPSach"m
Gupe1/ne: TraaNg Tobacco Use aM Depentlaraa
into cvlm¢i prpcNce and ryslemp
m Agendas seMng homeles persamshovk lMegmte
tobacco ceaahon propmmminpas a purl ct
bahadael?IeaHhmrcandsubdance obure
services.
a sabccco cpnwlatlvomses and stale/mmmuNly
(amore progomsshoWd wale to bLald mpaciN
within homeles prodder ralworb l0 atlean
lobamo we.
9 Tobomo mnlmlaWOmfes as Jsfcfa/commonly
tobocco proyenis snwkl lnvile fomkHy Morales
fidivbw%and edvorotes fojoin awsfnH iobocm
mnholnafwvks and maHbre.
® Musa publk lundnp ontlmseorchanaaded fo
Imesli0ate lheaHecfivenaual a Jsilrg lobccco
eoal"nn slralagks Iv the genpin7 Pcpdvflon antl
iheirinpea on,Mmeka parscas tp tlBtermi9e
prom%ln9 pmclic¢v.
D Toboccq ceswfien lMerveMien mooeb fhai
vaspadfimHyicilcrad fa Mmekss versons ae
needed '
.g Advom!as Should enmLRO9eslotagtrllbne
sariae pmvitlersiodevelop heotm<nt prOtomis
specifim6y for homeles pemanv
m Oufree<n wokersand teMCe proNtlers shout
uHFTe sfratepez olherfhan the ProMSbn dtobmm
in enpvginp Mmaless pprsons in eve.
POLICY INTERVENTIONS
andprokbif g'smoldrp lnvehblaswllhyounq Chldmn
vans. WhBG there pol4]ex here hctl an byvcf on the
genemlpcpvlaACn. paneEdz beferefhal lney nave had
less of anlmpael on cuddngipbacm useamong homelesv
PmWM.
Accortllr~g fo the poBry¢ psi members of the pan¢L ine
(aoowing are cormdered pmm'vlnp peAaY+abfed simlepiw
to reducing tobamro vsB vnoarg namelau pemm:
• Passage of cHY/munN OrsMances reauirb~0 homeles
sheHers to hefobxco-§eamrJ Hmltsmabng wHh'm Tg
feat of bliLdlnp enhances and awls.
• Enadmanf of vpWMary POkias bf hmme~SSSeMCe
sxovitlers Ihbi requieiMaka peuanrzl tousle o client
about n%/ner}oboo-a use.
• Requ4meN Of aHe+aNOfionimbsuch mthe
GOV<rllment PBILOIn10nW PM RGtVBS A<I )GPRAI
used by5ubstanee Abuseontl Menfvl Heath Services
Adpunhtmfbn ISAMHSA)-fursdetl projech lorpeiing
homeless person to ircluda quedlon oboW tobocco
uses tmakaana rnroulRh«d Ireatmenf.
• PassggB Ol slOtewida, clean indoor OQlmihafp0
NOT exempt homelcnxMlluz, food {xsErs. okclsaU ,
dug hentmern canterswd bars.
• Adop1'on oPpubSC hcudng poOdes lhoSproNbB texnts
hen smokng Imitle N unns.l hus retl UainB eryos ure OI
olherom~panh lotecattlhvntl smoke.
• Eni<rcement of lpmloMinvxes iholpronIDHrelrnlers
fiom segnH IDrrHk rig veHes (lOwles).
• Enbrgemenl of Fmtl and Dvg AdrNnldrotlon (FDA)
regWafbnof lobacm pmduds, which imili hav
}ObPC<a CAmpanlKand IelOli¢R wn OdVallltapnd
maker fobacmpromds. '
• Valuntaryedop0on oftobcwo-freegrovnds potdes b/
homeleuseMmagendasixWdmp mental heath and
rvbdance abuse seMCe provides.
• Passage oicly ant sfatewldeunhreaof.heobhmre
cevervee guide Iseady ofSon kondim vampk
fafatl in lM Resourcesectbn of tMS domment).
• Posoge of lap'elation regWme riafe Medimid
[Werape lOr NRI.
Tmdk"ronplN. robmco control poHry'mllivlivo' M1cve
FOd v ueel impoe}an mtludne overolltommq use
rates anan9lhe gerwalpopvlOhon An example of
a populatbnMsed pcficylnfervanllon woWd IxNaa
a clean btlmreklow lkr example. ardlnpncm
gmhibilb9lohocce usein redaumis, bars. Pub4c
pbces, wohm'les. etcJ.Otherpoepy sbotegles hove
Indutled'mcreosing iomcco excbe taxaz limiting the
wayrefvlkrs can 3sploy ant sal lomcm praducls .
~~ ICE 5
CHIIeM FacfaafvAChleNnp Polley SUCttsz
fireafmaM For ntmlina vtldcHOn among hvnelen
person ihwld be lnl egm}ctl Inf o bustler santla rtls m
wm fo.slreHeri and health orW aod<ISeMCe proNde2
ParlnersNps beiweui st W e/bm I lobacm control '
vogvna dnd homeles service cTpan'vofiom/advoMes
xvn lectl to mmmvNN rmblkoPOn b gansvppon for
poAryexclmeM erd kIY Latium. Rexamn by and with
Me hpmalesscvnmvNlyb essanlblfognlMng knowledge
amid bbacco mntrolpokciev 3Mt impact homeles
penom. espaclaPy woman and colleen. Paicv otloplion
takes pemevemxe, polknce OM the InvaNCmeM oP
pofHlmlantl mmmuruty chmplom tledlcale0 b the
Issue of tobacco conHOt Thpre%o mnlinvel need fu
adequate Iundlrcd to atldrcsfhe problem antl game(
IuppM for H+a pazmpe oP PoAdes. LomL dcleond
xHawl orpoNZatam should w<rktogetherlo support
o NHUre ivPOkcY chon9a.
Chvilen9ezaM evrlers IdeMIMd
Thereh a kekofzrid pmvalexo ecorwmb and
hmbh mreerpendlvedafo onlobm<o um among
homeless pelivnx, Ixomorodon by agences of
voWnfary pofclesto proNbb tobacco use oHen fakes
a backseof to MmmvaHna po4aes Hat curolHegal
tobocco confrolkgsbfion such os cleanindov Nz
What b Neadedio Addesv IFe dratleiges antl
a¢nlarsx
FvMin9 k nestled la mmmunXy-bored pmfiipobry
resaareh and d of a eolktlbn selat etl to lohdcm
useamone nameless advlls/(amlfes oswall at
fa eMdenc~based cessation 4eogrtTmmmp and
assessments ofsezvice proNtlers' level of reodneu
to adopt tom^.^ urepo6cles.SUdf dmo w91 help
conNnae po0.W mokersthrH this %an'vnmdaM lmue
that neatls to be addressed. Etlvcotbnly potty
mope s one senire ogenry dxecips an soc'vljudlce ,
Iffues. tpbacaereblad heolHsdlspvM'Iw asltl }he msl
of fGC1IveMn of cessaHan seMCet fY(IgmelCn pGrsnru
wAl hap gamer iuppwf fp'the passage oP poBcles
that impact homeles persrns. EducO}bn amW fhB
problem d lobccco vze omosg hamakss persons for
community Otlwcales%also a must. Honreksperson,
end IhosawMxerve them. need to beernpowared to
advomfe for POfcY Change.
Padrlcdrps behueen pub6cheahh and acaeditinp
apencles that oversee antl icense seMC<pratiders
could ekorwH Ps}M impbmenldbn of}obacmuse
poACles aspW ollFa ztondvtls of care. antl agencies
raeeivine tedercl igmak6s do6m mWtl be mqured
fo atlopi tobmco xnase paldez Homeless service
provMers and po6xy makes shout baenmumgatl
to eemelwLnidypoAtlm thbl Wohbif ahem from
vccepline fommc mduiry n»rues and/vimwnd
mnfribWbm from lobocm mmpankss.
AD DRL8bIN6 TOBACCO USE IN MOMPLESS Pp PU CATIONS
Iap Me rusty InlavenNere IdenilHad byiho Panel
1. State MadiceW covemgeshoup in<ludn tobocco
emsaflantteatmeM. Nltf and coune0rp selvlCas.
2 Agendas saMrp homeless parsomihwld
vOXmlalUy addpl tobacco npmin<polldd Ihaf
PmhpHfobacm vsa In the fadfly antl en lha
emvntli. Tna[a yo9tles timultl apply io mtb cfpn h
aMsWH.
3. FaHF.basad orgardxdlorc, weblseMde
oroori¢al'av, PubP[ heoHh oeendas and oihea
shout podrrerlo pdopl or#~»afc Then agency
IsoACIH Ontl bcol clean Ntlov q4 bwi Io furlhe
cMng<commuNNxamorovntl lobvmousa.
4. ProNders seMng homeles penov shoud enmt'
poBtles Ihaf inivgafe bbacm muatbn troatmgst
into the confinuwn of AaG.
5. Commuriliesshould adopt ckanindusab
pcfides that rb not e%empt homeless ahellenpnd
tranpl"anal houdne faclmiaz.
TOBACCO CESSAflON IMERVENTIONS
IDENTIFIED BY THE PANEL,
CDCS Best PTacHCer Iv COmpmhamivB 7obacm
CorrhOlProerv THW lean eNdence-pasatl BUltle
b Mp s1Met pksn antl edabGSh eHecllve tobocco
cbnlrol propromslo Prevent and redviceiabacm
use. ma goo br mmpreremlva pragvmm{ng tr f a
raduce<sTSOSUra lO Bnvbonmental loboccomnka.
pfeVGnf Wlolian In YOVlh. gbmdBCeAa110MnadVlS
and Youth orrd khntly ant eliminafa haalln ddPadHas
among popNVilons
wane Hb no1 cbvHtM bast gacHCOS oNHnatl b
the CDC document oreeftecflve omanp honuBtes
persons, tobocco<onirol expert members oP1ba panel
agree IMt the folbvnng prortiing gAerxMiom aimed
m redutlnp tebomo useamonH tMspcpulaflon AoWtl
be mmlderetl by stotefobagco control praHrams.
c0lmwnlN-based arBmtraHOns antl ahps wfro fund
qnd Iriglement lobo crn con Irol progmmming:
• IMegrab mofivafpmlinl¢sviowing t¢ghngve5
1nlosenncadeAVerysyslemstMl servahomeless
IndMtlUpb.
• insepafa tobocco CeaaHOn mumNmg into
drown Nsikaf cOnbs. shatters arvJ othersandca
- centers. StaHshould behoined In bi~sl iMerverdion
muree4ne techNgvas b ask cbenh Hshay use
}obacca if 1MY wahf fo 9uiL ant Provitle them
who mbacce a~na, resouae:
d ALLIANCE
nODRE SSIN6 TOBACCO US£ IH XO MELE53 IOPY LAi10 NS
Prwitla cauafb n <bsrox state q uhlmm refertol
infartwfbn and dh«r~oumas tw AaHwhowalt
with fiomele4 oaPDWIIOm.ilkewise. Yainsdtl
who have onmorvonainlwvcUOnswhn c~enls to
ptaviQelabvCW eesa{bn CWNefng f«Ihem.
Devebp ce4atbn curdpulo spaciRC o4y 1ogaYd b
nomelas IntllWduob aM aeMCe deG~esy sYSlams.
3e.8, Adaplgtion,d lne Mahtt MVtlel-zee RPWBOh
1995: hHpJNrww'.tlrugvbvsu,gov/BIDP/ERectNe/
I$awsaM1ntMQ
~nWge lhesvppodal Battling tobacwwnbol
e~meds IotlevebPaadapt fobcxn etluwtion
and seV~help mofedals 1«homele4 populailons
{ey, adopt Palhway5 k Feadom and/pre0 boys
1a FRedom b RNkOINEm mpreappAPObW-f0
tromslax Pwsoml.
Tmin cwe manages sn sociotseMw mHings on tna
5 A'i IAsk AduSse, Axsaa. AaNI andAaongel and/
«Ihe 21's+li (Atlc Advme and Re(« («cB4aflvn
ireolmant)model l~ m.2WO1.
XaaAh dapgdmBnh ihoWd da+abp PVdnBxNpc
wNh homelea shehea and pravde hee areduced-
eozf NRT ontl olFxweeseatlon meNwX«s/okk fo
rcsidcnh wiUn9 b qvA.
GNkal Fallen ter ACNlevNg £viceea
WbAC health entitles mvs7 buRd nbllomhipswnh
bmeka service providers and AnkihBm }o hee
t rolning reroumes in toba xo wswltOn, Thh k cr711co1
IolNasucaaa vPmtegvling e~atbn progmna end
raourca bio serrice defvery sBZf ems for homeless
MdMdvals. IdenllMn9 a iBe chompron «dedcMed
cbH person to "oveneo" a iobcccocasvtion program
ho kreYwmponenl to a SufKmSB1U1 program d waU.
ivbocco conhol advocates should work with innrele4
seMce providers to ambm wap to provide tree «
Icvnca} NRf, ontl vU daRworkNgln ogendaxmvirg
NomaleaindMdvabrhould bcfrcnned to poNde
' brief Oexialbn cWmeEn9 inferventbm. MorelMeme
An<E i
hsimrvenibm sFrovltl be eaihyaccaubb and tdbmd
to drenh wAh substance cbuse dsordwzaM mental
AlneMx. CeaafbnafHitanaa mwt afro be glvenm
xlvHwhowavi to qNl.
CNaAengex and Awdars Idm£tled
nomclea IMNklvak ore o nerd popvlvlbn to reach
and maintain ranted w11n tlua to thecfmmient nature.
and ghhough nwMlndrvitlVals have w1lDhones, the
cod oP mlrUSta used creates a challengefwmMw
praNde4 to siaytn wMad. £eMw as)mnpy states
aHlNdatow«ds adtlreaing fobocw use ore often
nBgdive ahtl many siaffam tobacco aien Men3BHa.
HWOACa@y:lobacwTrm been used b) ovtrevcn
waha4 arN hea£h cwe provders as an IncBMNe la
enpdpln0 dlffiatl-toreach dlenb in cat. serdmpa '
negaAVe message about ine Mahn etfBCN of labvxo
ere. NgroPliam ore dlen nwte:GSfen! and mantilla
camel oHoN to purchase Ih'v BHac1IvB medtcafpn for
cEentx veterans are oP spmcid concern os many ere
botRlobacco user vM hernelen and few wziafbn
jNaglOms eYbt Ihvl ere Spetlflcalyttil«ed fMVefefCro
recBntN retumin9 tram war. Most slate tobacco
«adbn qulbrles ore rwisd uplo oddre4 the needs
d homeless persam, ontl nlmfhe odddlen treatment
poGda ontl programsin faallBeS vary homagenry
to glenry. CoAobwal'on between sociolservice
provWws, public, hePlfh ontl ssboccocpnisol programs
to odOea fhb have 3s vramy.
Whdis Needed b sWsLeisthe ChvUengez ana
HanlerYE
ToLncw wnhd atlvowtaand Wbric hedfh
pfagram6 xhWld GCidJMale wlhhmmee65 and
socblswice pmuden to adapterbHnp Intake and
d4chw0e Procetlvrps usetl when providing services lw_
hamele4 paxm aM developlrac4rig mechonwm
tv 6434 and mvniid}vbflCCO V9e e9 hldlNdvaS
moves fhroWhine hous3g continWm. By builPSnO
pwtnenhf;3 Wiwem tobacco carofbn aAPelii
and BmCger¢yiheAGlS hpn{1tlOna hClIN19 }vCgBex,
' rescue mi4bm ontl
dhersn mat hePVSab]e
fo hackindlvtdva5 arW
oHwcont'mvetl wssanon
mppod services fw ihh
lraxWent.POpvlatlon.
TmNInO madehonsodrsl
7uzYbe Iaves nwm been
devabpadbY pvbAC health
enENazb nelp vddrm
negdrve etvH dYdWe{
'about the lmpwtanceof
casPlbh iervkw. One
nth model was devebpetl
by PvbACHeo6h SeoNle&IBng Cnunfythnvgh Hs
communMTobveco Ceadlen PedronNp program
-a syitemzc`harpe opproachthol integrates trief
tobacco InterveMlon intothe daMwarkd wmmunly
agencbr.MOremformafionoboN int «ogram can be
found in the resource sedlon of ftis docament.3lafe
and bpvl health depdimenh can lake advaMoge of
iha fnedlwid Mdch pmgom to genwdla dalhrf b
p V rc hodng Nrl/ tw camnuNy ageryvla who tams
ahwd h. (Medlcoltl Mdch'ca program that rambursm
lornigovemmenl health programs f«wak 1heY do
mot Promda htedk:vb swvicm~
No}c Thls~ d'P.«en} than MetlbvH wveroge mdan
indl+Iduvl c)krtt w oab' 'use to Bat NRi a M ay nee tl fl
andW 1Mksroie MeaFCaid proevom coven N. Some
slpfGS lap We Medkad'lwvppge Yw NRT-)1193e '
mx'mnbg motle6 can be o tauuee to ofh v sbfo
WorAanxs shug9£ng with this rssrx. RalaM theresovpe
sddbn err fhb dacumen} /« a 85f at slate invf PmvEa
N9dMVltl coverage Iw NNT.
pe eE ES51N6 SOBnCtO USE IN.HOMELE55 POP UIgTIONS
tl b oho'vnppdvM to nde Ihah mvey h«r~eka smite
pemvidea empb/ihe "ibuting Nrsl' motleL"Fbuslrp
FI51^ OSiUmex tlbl NdVdUVb who MVB sOfe ShoA 81
will be rnwezucceaMwlfh cesohon oHOmph free
babes), but lrainin0 is needed foriervice provbas
M tobacco cettaf"ran. Peer-topeermurveMg ha
been shown to ba an effactlvamotlel f«aahtvp
mdlNdsabwph a nwnbwot taus, and Ihaebre
ferment homekw IndNiWah sMVld be engaged
to proNde ouheach and C W meGrg to help Iif030
MM1SgloquA. Tne Na9or~d ABianwf«}ha Memfatlyb '
Wang providesls6nin0 krservba Dmtideain heOling
nledlrte odca<fron. slates arW crommuniry4sasW
oyontotlomshoWd padrswwlih loml NaM1 chopiars
ryo Mdyaurbcd NAML visit hflp://wnw,nartd.ag/
fempble.cfmZSecAOwyour bwLnoml. Cettatbn
swvkezwn oho be iMegMmd as Part al the Vetezan
Adminlshahm'x fvAl "Blond berm" Program Ilse
balowl.
Crp£q Fµ£
e ALLIANCE
There ore ahosucceafW nx;oBneddtlbfion henlmant
mvdeN Mel nave bean proven to be auxeahnln
'the 9enerol popNOtbn and are showing promlre m
nor4tradrlbnal setfirgls. These'inclW a moAwtiond
imervlewfrg, cognAive hahavarol therapy, $A'z, and, ,
the MdMMOdeI fwlreahng tl/u-addkibr4.The
f'a^~agreed the Infagrdhrg NcdinaatlcOdbn
trochneM "alto the xubsfaneaabvwirealvneM motletN
very feadble '
AppRE531Np Y08AC La VBP IN HOMfLE 33 YO YOlAt10 N9 ,
Top Pve Gavoflcn Irdanarrfions IdeMfiad byt8s Parcel
t, Slats and bmlheaHh daporimeMsshouW pswide
fvnan9 fa tree w red aced-cori NR! ice iwmeless
Pefmm bYmnfln9 eessatlortepstlAC9unds
wailvbla to homele5iservka pNNtlelx
Z. Stafeantl bcciheoXh depadmentsahould
pwlnerw5lh hemekazervice pmNdeavnd ether
rnrnunAy apenGw fa proNtlabosc Imllh mra
seMcesiw Mmeless pessom.
3. iobvccv mnirolvtlvecalnalwWdtlwelop
ralclbnshlpiwfin bgencies Ihal serve people
who are carenlly IX revanily homeka to create
eopotlly fa promollrg IX+d rUpparOng ]oeaeco
cessetlen
4, Stale vnd bcvh«Ith tlepMmanlssheNd work
vhM stoic qull&lesavlce pmridersto pHei lest
xunselmp pro5ceols and oulrepcn simegles
apedOmlly taAOred f e homeless person.
5. itlenfiry'Ytecnomplors"wnnin she FOmeku
seMw mmmunifywho mn mo¢vpfe and
conNnce agercy kadershlpio tsfegrofe ceoalion
progmmming senAVes tacEents one stall. nvilo
tneEeindwttluPh fofdnttvle antl bmitobomv
mrAM cop4Flom and wcMproupx
RECO73rlsM1ENDED IMERVEN710NS FOR
SOCIAL SERVICE PROVIDERS
Smal service pro+idev who servo hernd®indnidvvh
can Play an impwlanl rob In redvdn9 ivbecm use
prevalence omorp nomeas per9or2 Chren though
msnyare not tobacco gessall«apoicy ew9sdr.
they urWeMand ihakwe9 0} homelessness, the
ssessors homdes indJb ads face and the bovlaz I hey
expsr~enao la recarvnB seMCSS, As of alstl preNoudj,
podnershlps be}ween pab5c health and codalservice
praNdersareesseMidfo redudsg tobocx wevmonp
IlomBleSS per9om. FfOrr1111a pERpecllve olcoMmuntly
adwcafes pod sodaisesvlco proJdesv the foGOVrirg
WweldeniRetl qs gomlang intervenmrurabled ro
redudrg fobamo are among the Mmetea iMendep'
spacificoD/Iwmndckralkn 6ysmalzerviceopendlPs
• Regulvfe and/w pmkSli fabvcmvsawXivn your
fad6W.
• Rwae mweoppoduNYies tw homalanindMduok
foamevivbocw-Irve. affardvbk nou9ng,
• a9egrafetvbaxocesalioncWr631~lmofhe
mudirg swNCa drvdwe whore homeless avlNdavh
receAresavcr.
ALr LtNCE S
• iroin mrvl«dvRlo prwitla podM1VerelnFomemerR
antl.PeetlLVCk f o i hose maYJCq o q uX aNempt a
mntemPlatlrp a gldf ottemPl.
• Provldea wfe anevomnent Mlnd'uidav4 mlhk wl0
ancourvpe cessation vH empb.
• Inleeadiea compreAendv¢vpprwchb neoMlnto
eYANg9wWCe9 MM IntlWer NcoHneotltlkHOn
trmimeM.
• ProvbeawhelycPpharrnawlhervPY Op7wrc(NRII
V paalhleaM ro1lwliharvcvflne poach erclurively.
• Eslabil5hsuppwF(youpswiHunyoW agarwyfa those
mvdng aquH allertpt.
• Hra nonu«ISnp dell.
• MOke loba<cocesallrnapdoMywXh'myvur
agency and inwmnethe nurnbera mse managers
who prel9aned in fiaWmB Nmlineadtlkfwn.
• Provitlebask tobaccoasd healthetlvmmn
clviusfttctanirihal hdutleiobocxeducoiion
InfamsaXOn one N2emwli« about the dargars of
sacorcAnrvJ mloFe.
• Seekoutaro'1denLfy local iobocm control
mpifbM lo7oharsd pvdnerwlln them foidenlly
mbbvrbliueopPOrfuilliar vrd rMPWCax
piHvtl PoetoafwACNevina SUOOVu
HvNng v6IaNAy daHCamMHetl ie tobvcca ce9sWbn
and deaepdrgfoboccoaseamong Malr c6enisk
irrq~xdNe h a ttrvice tle6very rydem. ProNdr~g a«ess
fo NRiand o sate vnd emoke$ae onvppnmenl w]I
Nneereiha glMCeslhala cfienf con 9ui1 tabG«o
svccessluW.TreaMTenlfwnicolira vddlclionsMW ha
InlegrcrteP Info a mmprelxmio aPpr«ch fo imaoNrrg
iheovelaA health ofci nix
CNrAenges and B'mtlen ldenHAed
The luck of eessaf ion iota Walton hio said seMm
natwwtr, 6eMNVaI hevllhseMces, fdlh~Wred
apercki footl banki.carecHelwl taa3tia hod '
1romIH«d housXrB aganclesremalra a 4wfzr9o
reducing tpb«m use pewlence arrong Ih'e hpmelesx
Hwneka' atlrvidvpp are urge r edrertle dress bemuse
that betbadc needs fi.e.shdfac atlequaiaf«d. jobb
rtes, etc.). Lockof ch'Ikicae and irorsspoHaAOn io
cosxvlbn sgYCes xnlfibala to c«t'nac-0 tobacco vas,
Fadl'f ks Mal Serve the homeless oHen Zack the awedka
an d pnYSisal space f o Amvkde caavmn uses w
needed seMCec Menfvl kness vman8 the hameba also
makes M mwa dX6cvlf fw them td execs mprapivle
eamibnhdp.Offen, there is also o bole acammusvy
vnd (amByeduxhonand suppM. '
WFwtb Needed fo Addreszihe<hvResspesend BamwYf
CIeeM. mom turdirrg breeded Yo LroNda homeless
sen+a~ ana bade rxWSlriclWing dotnina Melia:
food.labsk&arc5lob pbcemeM, BY Providng bvxc
seMCesii tmare 6Yx]Y ihd mmakrsSntliNdwk
+.iAaHempl cessafan Keepng c6dms busYwilh
adtNFeswWk IheYarerece'NDq shelterserviceswH
ohoi«remeihercha«ei o)quMXnO wcceatulry. '
If pcasale. intagctopezsalansaMCaealvtocgfla:
tHV1 serve homeless Parsom ar opPOSea tv bvkirg to
oNSitle vpendesto provY~e them. a pWicvac iha
hfegsalbn d coaalbn servbes into dheratlFACifpn
aervicas mm/ be pwf aWady useful znce n«ra kn
mekws hv~e veryhlgh ogles vi «rscorNtanf tlltOhol
e M drug use. U6~ hee mmmuNty ce nler space to
PmNdecNOdcpmasW cessallonservicsfac6enisand
engage bml darrvnvrJty ceM mx vm1 aswches ie aHpf
fallrly eeummn andsupPpd Proyams r«homoless
persons d tesnptirp to q W. EngeQe prcviden who'
we beMviwal he otlh spedpFeh, miegrala t oba«o
educatbNcn9alionlMO behoviwvl hepMh ryedprat5
fob fesporsSdAHes and trnplemeni iha raecf IM
CLMeblProelice GuHe5nr.TreafrgTOba~co Use and
-spendenre NS -aPMment of HeoXh vnd HUmvn
SeMCes. PWBCH«ilh Sarvicel.lE«sita ecveiion
alomes use na pvdbk, mMtlar prvNeTrrg tobocm
cMAHOn afopnvHOn Nv SaleHta Stafe gVtineseM«s
mvy bean opflon bat madratawXh yourbcdskfe
toWxo xnfrolprogmmotficc rotl¢xsz Hsefmsa6tly
a pavidlnp Phvrres of c9Mrs ontlshellas fw quXine
amens.
Bahtha "Howl"s FVd^modgl and the New York
univwdry "bundle" moddoreatldreaed apafn below
a s tissse matlel: we of i he heed d O tramewoK is
addrauiobvaaamonp homakrs pw»m antl ila
PenJ'rvPpwkiM1¢v.'
Tap Flue InserveNbnsbr Sadd Servka PmWdms
IdenHXedbYMe Perna '
1. Integrate f obavn ttssaf ion servkvs mio the
'HOYBng FM"prcte4.adOXp atminin9 xmPOneN
fwslalf to addrev tobocwcessaHOn..
2. hnpkmeN the New Ywklln"rveMiy'buMk''motlet
to atlrbea fobvmo ass omonfl cEanh raceMnp
as (sec boron page 13j.
z. rcm9arfma9mamdrptagi~asa~dhdmnawn
drug remveyard Treatment svdgram mddah leg.
12atep plOglams cunt as AkM c6a Arlanymaui
and Ne W Inc Anom/rcaus mry a Yeaay b e In many
shelters}.
4. Iniegrvle I M CMlimi R V CSLCe GtQtlellne Revfb+g
7 ~m Ike vnd9ependence Ns. -epwlmenl of
HeaWsvnd Vnrman Barites. PUbic Heaph Servke.
.lane aTwf. '
S ategrole loboxoceaMionlntov brxtlwseMCe
delvery sydem iwimpoNng the ovelgll health a
hwnalma penom.
AD D4E551Na T00 A000 D9F IN HOMElE 55 pOrU tgTIONr
RESEARCH PRIORITIES IDENTiP1Eb'RY TWE
PANEL
Tobacx cessoH«is a bur prioMY M1a fanderswho
provide find«Ial apporf for hcmelea servkes.
Ukowke, nomekss Pwsons ores loo PdwXY in NMars
ottobatxo ronirol prpgrams.fiaetwe. lhae UC
eeedia robaowwanass vmonp ep Pundev {public
vnd pdwle) about fhalmpocl of the homeless
papubllon i iobacm use vnd paprheollh bdwWOrs
on haatln xre «dsand r«IaI swNva sydams, mere
k a bck of raGOblefobacm vseprevakn« dab
ontnk poWbHCn bexuas homeleslndMdwb are
aadab«Mnof intlrdstl in smoking casspllon dvdar
wstofadata cvfiec8on and swvalAance ryatema. Few
mtegadml suntlln9 oPMnunl6arte address tobaccd
use among homekas persons are vvobbleiHough
special Furidng OppoduWy Announcements IFOASf
from taderolaga«les wihcwph lhsso6cnalion of
Speclallnlaresl Pn»ech.AerNOre.llpmere many
unoevwered quezlbrs ihallmpeda progress In
reducing }obacm use arswnB homeless persons.
Reseamh Quadlerrc ~ .
The panel IdeNi9ed the (oOaaAne gva6om and
remmmentled thq ba addresztl by fulwe research
mtrmrvec .
• What<Maimpadf Mfpbvxomrvroi pcxiesana
tamccotoe ln-veozes oniMtobaxo use behovla
ornomalaa persome
• whprstrdaa~rxnbekntalemantea 5ovfweamme
deennd Iwfabv«ecessafionsmrces Mhornek95
ndrvitlw8e
• when kthahesl fknafvded nlmmeaddcnen
treatment the homaess persons rya,wh6eln '
heolmant to olherco-mafirBty kwes orwhmr
nousetl7a
• Are PPPYIPIiphbPa6d emiptlonirecimerA
Intervenlav eHeciNe and Hnot, how do
lnlervenlbrb need to be la&retli
• Howdoweimplemenf c6Ncalprocikx pdWehpss
fw Treating iobxx use oral deg erdance ana
somcco conlml pv6dd In aganrta0om xerlmp
homeksspersone
• Wnpfbihe eTacladefves'urp tOba«m <evai'an
ren+cestw Mnraksv palsonsa norreSNCaisaHlrgsO
• Whdlk 3heelfmryofa treainfanenfion the
NscolheArom/movs. o l2aiep grogram fatoboc«
mssatbna
WhM isthaprawknceofsmotdm tobacco use
and menihel prodvcia amwlg Fpmek¢ p~a///n'o+~gny's8
' 10 ~RLIAFp1RCE
AD DAES SING TOi A[Ca VSf IN HPMEIF55 POPULASION9
Wtwt wetlsasmoling paHems of homalaa perb'are
for ewmpk dD fhrypvrch¢sa unabcgmaHesvs.
pocla.smokelass lov¢«¢. etc)S '
How tlceS Me badbrydem used by homeless
peeom impact tobacco wa and aef sMianE
Nov cenine mediCPl Ymlment motlel ba paired
wlih an understan~nG OfsocmldeiemAnadsoF
na¢ena
PXlwl F«kNSlm Acfilevk9 SVCCCtt
Fvrders and reseamtwn need to 1MnkbmcdN
to sNd/Irtg {hC prebkmcisobav~o vseamong
n vlefevs Pewn+. CnmmLn-ybosed Pa~fidpataY
meanyt EhoublmoWe mnkadf'wnalpartnuswllo
serve homelessindMdvaH ¢M lam5es. There isa
neetl for fleddSN In msearah d esgn and the odEN
olreseamharsi¢toke rove)onryoaG+milwladrof
to the ipedsof thX popubt'bn NrCaes evetgtbn
measures should be the plmHy N resealcil design m
aderfo beitervndaTaM arid document lhesuccacu
and chafenga efwoHdna~ah NemelasindMtlwH.
fandan shoWd fNnkbeyoMtobacco fa raseadllhe
Impact of proNd'mg baskraeds ¢nlndrvltlud heaHh
bahavwrahanga and the prevevlbnotahtoNc
drsevsn among horr:eles persona ProN'rbr:g ncentiva
brheokhsy~iams, paMders and IntlMdualcfelHs '
Invdredln mseach FbnrwNVnf.In 9enalat mwh hm
Sean Homed obwH whoi RIalCples wcR f o reduce
tobacco use intbN gavel¢IPOp.AWI¢n bW mve tunQxlg
Is needadloled the laWlEy of tnex Arafeylafar
hPm_°lesspersora.' .
~~LIANCE ll
ADDRESSING iABTCCO USE IN HOMELESS tOPULAiIONi
RESOURCES ANP LINKS
.aDDer+fo Aroeaem [a cevWbn c:mlMatorMe Nrl:.arAmwkm: Church. nvotoMe m. www.MdlNedcwnuWp
BedPwdleaf fa ComMNwnrive ieheeea CanMIPro9ram~t-DT. MhrJ/wrm•.abAw/tabam/tebem4<PnM1nLPmimm+/
rldemdcammuNly/bMp:o<IkmlpdhflYl]/BaslPmtllleo C4mple10.p]f
CrnlealarnXeVVa COnh<L OMwencmokvH aAd NevNM. www.IXbgov '
CHy ot3an fianeNrn NaetlH 4eeerr lmglalm hHµlJwwwJwe9hpanhrnpvppr¢
GovaameM PellormoMamid R..M6 AdaPiv9J(GPtaYhNp/(v+ww,wlill®MXegev/emb/mgmfyp ~IwM1M
HDa OXce of PP64 a6men Neadng Nema,eNOmErmNngtaH:b b PPFAa NeurMH': M1NpJM1~-nvclwd®ar/offcm(pdJ
p~cdkns/nolice+Nt/p1+9t0P21yM ,
NeeHh Fducetlan Caund~ B~eokPree AH`ence entl Nvmnd Mkan Ometkan tebeceo EdueWbn t(elwgk(NMl W k
wmv.MdlHedao .IwaAu"uddreerAXmc® '
NoHwd ASwae on Atentd lEnm(NAAVJ: uww.rwmtag
NaYOnd Codmvnfarihe HOmeksx wmvnolbmhanekstalq
NeXOnel HeeMl:wrcfwlhe Xanekrs CCUnNjNNCNC): www.Nlchetxg '
Nc9amllobocce CenhW N<Mrohc www.iobaccxcnbgroMroM.olg
tnaonne Manyrveu+web,He nHPJ/w..wnt<or ymo:npr~
PdNwv/xfohaeda:m WNnlnafM flpMAtrolmlYeba<m (A ewrallen g.HdeMrabkaP emMee J. Sea; XfiR/Ixww,cdegw/
T09A000/91t)_mmld~g/IdW 1CQV111WHrvvWUrweLMm
PJbBC NedMSwHb Gg couMy,CemmwMyTOb«co UaMlcn PaNncnNp ProoNm: MIR/lW Ww1uN~uInNAw/
healNervcvlhwllWdn+cl/tabaeeel<IcPa+PA
Wick ROlelance Gelds brCpMChmx Mlp;/(mwv.nYBeangbrcmlOw/bSM1mAdfo¢althn
SmoWn94+vo1[an batlenhlP CaMtt;hMp//tmobnqumolfa.9aadeMilpUClxN/
Rate Ma9<okl COVaregeru NkL Mlp'JAuw+.ojGgev/mmwW ~IawfmmwrhhNMmENgal.Mm
unneaswln nreaHmwdvdom„aXma-mna aewnrmamm: W.-.w..a.aw/nomues _
US aapadmeat of HevXh mtlNmnan EeMU, PaWk Hearth SeM<e. ~kdkacHw Gddelhe: irevirg Tobacco Uu aW
aaf+anGanm Jvre.'d.M. ~ '
tY ~K
A
AOU0.F SSINO YOBACCO UiE IN NOMELF SS POI UTAiION$
DOCUMEN75 REVIEWED BV THE PANEL
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Tab CMlmL ldlb1.400.15
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mman'ifiex Y+cWMB qOw Ivrcvnve IN benaBMnB M1amalen People and mo4uq cm4b~n"nom b'uuvd M1omeba epelivalbm.
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REFERENCES
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PiNDSNCI "1'HE CYCLB OF TOBACCO AND pDV1eR1'Y
www.breakFreeall iance.arc3
EDUCATION
COUNCIL
Health Education Cauncj)
3950 Industrial Boulevard, Suite b00
West Sacramento, California 95b91
916.556.3344 phone
91 b.446.0427 fax
Breale Frca Alanca is wpponed by CoopercJive Ayreenivnt Number lUi8DP00i518~01 Irom Ihv Cenlars for Diume Conhol mxl Prerention (COQ,
Office on Smopieg mid HvaRh. The conlen6 Of lhiz docamentare sofeFj lh~rapomihiGly of the wlhars and do rol mcassarily ropazwJlhv o(Fekil views of CDC,
~r
~,vo~
Santa ~lwriea'
Mem®
~~JN 2 ~ 2011
To: Rod Gould, City Manager ~ _-_,
From: Barbara Stinchfield, Dir ctor ~ ~-
Julie Rusk, Manag -
Date: June 27, 2011 '~' _
Subject: Commission for the Senior Community Correspondence to City Counc
,~ -
Purpose of Document Submitted:
Attached is a letter from the Commission for the Senior Community expressing their
recommendations to City Council regarding potential changes to the Santa Monica
Municipal Code relating to expanded protections from second-hand smoke in multi-unit
residential properties. This item is scheduled for the June 28, 2011 City Council meeting.
Please distribute copies of these letters to .members of the City Council for their
consideration. A copy has been forwarded to the City Attorney's Office.
Document Reviewed By:
Robin Davidson, Human Services Administrator ~~~
sz
JUN 2 S 2011
Administrative Office
1685 Main Street, Room 212
Santa Monica, CA 90401
TeI: (310) 458-8701
TDD: (310) 458-8696
FAX: (310) 458-3380
Police Activities League
1401 Olympic Boulevard
Santa Monica, CA 90404
Tel: (310) 458-8988
TDD: (310) 458-8696
FAX: (310) 458$995
- ~-., -
- - o r
Senior Center
1450 Ocean Avenue
Santa Monica, CA 90401
Tel: (310) 458-8644
TDD: (310) 458-8696
FAX: (310) 917E637
Virginia Avenue Park
2200 Urginia Avenue
Santa Monica, CA 90404
Tel: (310)458-8688
TDD: (310) 458-8696
FAX: (310) 399-4326
Youth Office at Reed Park
1133 T" Street
Santa Monica, CA 90403
Tel: (310) 458-8540
TDD: (310) 458-8696
FAX: (310)451-3569
City of
santn Monica°•
June 27, 2011
Commission For The Seroior Community
1685 Main Street
PO Box 2200
Santa Monica, California 90A07-2200
Richard Bloom, Mayor
Members of the City Council
1685 Main Street
Santa Monica, CA 90401
~Ei;EI~tED
CIFFICE OF THc
01`v ClrE~
201! JUG 27 A 1~~ 26
sa~ar~ rs~raicr,. catiF,
Re: Protections from Second-Hand Smoke in Multi-Unit Residential Properties
Dear Mayor Bloom-and Members of the City Council:
The Commission for the Senior Community recognizes that the existing ordinance
governing second-hand smoke in multi-unit residential properties is a great first step.
However, we urge the City Council to take further steps to strengthen the ordinance
and reduce the potential harm from second-hand smoke.
The Commission acknowledges and respects the right of smokers to smoke. But
this right cannot interfere with the right of others, especially seniors, children and
those with health issues, to enjoy asmoke-free environment.
The Commission is aware of the steps in the existing ordinance related to
enforcement, but we are concerned that many people will resist going to small
claims court. They also may not want to create an adverse situation with their
neighbors.
The Commission for the Senior Community would like to recommend steps for
building managers and owners that may encourage smokers to curtail smoking in
their units. The Commission recognizes that smoking should not be used as
grounds for eviction, but does believe the City should incorporate more forceful
steps into the ordinance.
Building managers/owners must take responsibility to enforce the ordinance by
posting it and if necessary, taking the recommended steps below:
• Keep smokers housed in a separate section of the building;
Improve ventilation systems in older buildings;
Hold group meetings with all tenants to help resolve potential conflicts
about smoking when there is a problem; and
Advise tenants of resources to help smoking tenants quit this harmful
habit.
tel: 310-458-8701 + TDD: 310-458-8696 + fax: 310-458-3380
In addition, we encourage City Council to establish thoughtful guidelines for all new
.senior housing built in Santa Monica, such as insisting that all new buildings be non-
smoking. For existing senior housing we suggest designating specific units as
smoking/non-smoking and once smokers move out those units are designated as
non-smoking.
And finally, we hope that more concentrated efforts be made toward enforcing these
new rules, thus protecting all Santa Monica residents seeking to live in smoke-free
environments.
Sincerely,
~~
Rochelle Le Blanc, Chair
cc: Marsha Jones Moutrie, Santa Monica City Attorney