(Kayana Szymczak for The Boston Globe)
Dr. Jonathan Winickoff, a pediatrician at MassGeneral Hospital for Children, recently called for a ban on smoking in public housing in a New England Journal of Medicine commentary.
Q. Why focus on smoking in public housing?
A. There are certain groups who are particularly susceptible to tobacco smoke: the elderly, disabled persons, people who have compromised cardiac or pulmonary function, and children. Those groups have very high occupancy in public housing. There’s an intersection between some of the most vulnerable populations and who resides in public housing.
Q. Why are children especially vulnerable?
A. Young children spend much of their time indoors and they have a higher metabolism rate. They ingest more dust than adults, so when they are in a contaminated environment, children often have a higher load of toxic contamination. In studies looking at [tobacco] carcinogens in children, those levels are higher than for [adult] nonsmokers.
Q. You coined the term “third-hand smoke.’’ What is it?
A. Traditionally when people think about secondhand smoke, they think about visible tobacco smoke from smokers and smoke coming off the burning tips of cigarettes. When you think about the contamination of a building from tobacco smoke, oftentimes it’s not visible. It’s the contamination that remains after the cigarette is extinguished.
Q. How does smoke from one apartment affect another?
A. Tobacco smoke doesn’t stop at the doorway. It will fill every available space in the environment. It travels along air ducts, cracks in the walls and floors, it travels in air shafts, in plumbing and electrical lines. Maybe 10 people smoking in a building could have smoked tens of thousands of cigarettes inside shared air where women reside, where children with asthma reside, where folks with disabilities reside.
Q. Would a smoking ban be punishing smokers who live in public housing?
A. There’s a social justice piece here. [For] this group of people living in public housing, this is their housing of last resort. They don’t have the option to move to another building. This is the place where they are and it’s important that protections are in place such that the air supply in that building where they have to reside and children have to reside is safe. We don’t want to penalize someone who is a smoker. We just want to say you can’t contaminate the shared air. We want to support smokers who live in multiunit housing and elsewhere in their efforts to quit [through] smoking cessation programs that are available.
Q. Is that fair?
A. This brings a certain fairness and consistency to smoking rules. Now workplaces are smoke-free for people who work in buildings, and bars and restaurants are smoke-free to protect waitstaff and bartenders. Well, what about where you live? Where children live? Where the disabled who aren’t working live? In this sense it’s past time that we make these smoke-free rules even.
ELIZABETH COONEY
Interview was condensed and edited.
Elizabeth Cooney can be reached at ecooney@globe.com. ![]()




