Housing and Urban Development Secretary Julian Castro testifies before a House Financial Services Committee hearing on oversight of the Federal Housing Administration on Capitol Hill on Feb. 11. (REUTERS/Joshua Roberts) 
 
 The government is seeking to ban smoking in all of the nation’s 1.2 million public housing units, the latest step in a decades-long crackdown on tobacco products that help kill hundreds of thousands of Americans each year. 
 
 In its proposed rule, announced Thursday, the Department of Housing and Urban Development would require more than 3,100 public housing agencies to go smoke-free within several years. The agencies must design policies prohibiting lit tobacco products in all living units, indoor common areas, administrative offices and in all outdoor areas near housing and administrative office buildings, HUD officials said. 
 
 “We have a responsibility to protect public housing residents from the harmful effects of secondhand smoke, especially the elderly and children who suffer from asthma and other respiratory diseases,” HUD Secretary Julián Castro said in a statement announcing the measure. “This proposed rule will help improve the health of more than 760,000 children and help public housing agencies save $153 million every year in healthcare, repairs and preventable fires.” 
 
 Though HUD will not design a final rule until after it hears public comments over the next two months, there seems little doubt that the government is headed toward the smoking ban, since the Obama administration is already moving in that direction. Since HUD strongly encouraged public housing agencies to design anti-smoking policies in 2009, more than 600 have done so. That means that more than 228,000 of the nation’s public housing units are already smoke-free. 
 
 [Banning smoking in subsidized housing could save millions} 
 
 The latest move escalates even further the anti-smoking crackdown that has unfolded in the five decades since the U.S. surgeon general first linked cigarette smoking to deadly diseases such as lung cancer and heart disease. The campaign has seen some successes: cigarette smoking among adults has been cut more than in half from its 42 percent rate in 1965, and the United States now has more former smokers than current ones. 
 
 But cigarette smoking still kills 480,000 Americans each year, making it the leading preventable cause of death in the United States, according to the Center for Disease Control and Prevention (CDC). Officials primarily cited that health data in justifying the proposed public housing smoking ban, noting especially the risks to children and the elderly people who live in more than 500,000 public housing units. 
 
 “Everyone – no matter where they live – deserves a chance to grow up in a healthy, smoke-free home,” said U.S. Surgeon General Vivek H. Murthy. “There is no safe level of secondhand smoke. So, when 58 million Americans – including 15 million children – are exposed to secondhand smoke, we have an obligation to act.” 
 
 Anti-smoking and health groups on Thursday hailed the proposal. “Secretary Castro has taken an important step to improve public health by eliminating exposure to secondhand smoke and creating an environment that discourages smoking in public housing units,” said Chris Hansen, president of the American Cancer Society Cancer Action Network. 
 
 American Heart Association CEO Nancy Brown said the move would “clear the air in public housing where children and the elderly are especially vulnerable to tobacco smoke exposure. No level of secondhand smoke is safe, and tobacco in any form is a major risk factor for cardiovascular disease.’’ 
 
 But housing authority officials and lawyers, while generally supporting the government’s move, raised a series of concerns, including whether some residents will resist the smoking ban and how it will be enforced. “Obviously, there is a clear public health issue,’’ said Amy M. Glassman, who is of counsel at Ballard Spahr in Washington and represents public housing authorities. “But especially when you’re talking about banning smoking within their housing unit, folks take that as an issue of personal space and freedom, ‘You’re telling me what to do within the confines of my own home.’ That’s the main pushback issue.’’ 
 
 In New York City, home to the country’s largest population of public housing tenants, Housing Authority Chairwoman Shola Olatoye said, “The dangers of second-hand smoke have been clearly documented.” The authority bans smoking in public areas, but not in private apartments. The success of the new ban will depend on “peer support and accountability,” she said. 
 
 A 2012 survey of public housing residents showed a smoking rate of 14 percent, in line with the 13.9 percent rate in the city as a whole. 
 
 Olatoye said it was unclear how the ban would be enforced, in part because “we’re at our lowest staffing levels in many years.” She said it likely the housing authority will designate an area where residents can smoke, although officials have not decided whether it would be inside or outside. 
 
 “Reasonable accommodations [for smokers] are going to have to be made,” she said. 
 
 Timothy Kaiser, executive director of the Public Housing Authorities Directors Association, which represents 1,900 housing authorities, said the smoking ban “addresses an important health issue.” But he said local housing authorities have higher-priority concerns, like a shrinking budget for operating expenses and massive cuts to capital spending that’s resulted in a loss of 10,000 apartments a year to decaying conditions. 
 
 “Your average executive director is trying to figure out how to keep the light on and the doors open and operating in the next three to five years,” Kaiser said in an interview. 
 
 He said housing officials also are concerned that the smoking ban will create hardships for elderly and disabled tenants, many of whom light up in their apartments. “We have elderly residents who are addicted to nicotine,” he said. “They will have a very difficult time. They may not be all that ambulatory. They’ll need adjustments to the new rules.” 
 
 The surgeon general’s office, which famously first called attention to smoking’s health dangers in 1964, has continued that campaign into the digital era. In a report release last year, then-Acting Surgeon General Boris D. Lushniak added liver cancer and colorectal cancer to the list of health problems associated with tobacco use. 
 
 [Report links more diseases to smoking, tobacco] 
 
 And in March, the Centers for Disease Control and Prevention targeted e-cigarettes in its anti-smoking ads for the first time. 
 
 In addition to the health benefits of the smoking ban, the government cited economic gains: officials said it would also help reduce damage and maintenance costs associated with smoking. HUD cited estimates that smoking causes more than 100,000 fires each year, resulting in more than half a billion dollars in property damage, and is the leading cause of fire-related deaths in multifamily buildings. 
 
 The agency also cited a study last year by the CDC that estimated that banning smoking in public housing would save $153 million annually, including $94 million in secondhand smoke-related health care and $43 million in renovation of units where smoking is now permitted. 
 
 Lisa Rein contributed to this post. 
 
 Read more: 
 
 A family in public housing makes $498,000 a year. And HUD wants families like this to stay 
 
 After criticism, HUD says it’s trying give the boot to families who earn too much 
 
 Public housing officials blast Obama administration’s move to oust wealthier tenants from subsidized homes ||||| The green-painted brick rowhouse in the 800 block of Fifth Street NE has been in Edwin Gray’s family since 1964, when his mother, who worked three jobs, bought it to raise her eight children. 
 
 Now Gray lives in the house with his four adult sons. And every once in a while, he said, he likes to relax by smoking a cigarette, burning incense or even lighting up marijuana. 
 
 “It’s my house, and I should be allowed to do what I want inside my own home,” said Gray, 53. 
 
 [Should everyone be allowed to smoke at home?] 
 
 But his next-door neighbors, who arrived at their newly renovated home in September, say Gray’s habits are endangering their health and making it difficult to enjoy their space. Lawyers Brendan and Nessa Coppinger said smoke seeps through a common wall into their home, filling their bedroom and their daughter’s playroom. 
 
 When neighborly overtures didn’t resolve the problem, the Coppingers went to D.C. court, suing Gray and his sister, Mozella Boyd Johnson, for $500,000 alleging negligence, nuisance and trespassing — arguing that the smoke has intruded on their property. 
 
 Last week, D.C. Superior Court Judge Ronna Lee Beck, at least for now, banned smoking of “any substance whatsoever” in the Gray home. 
 
 The judge further ordered Gray to deny “reentry to the premises of anyone who has violated the prohibition on smoking or this order.” 
 
 “This is a health concern,” said Nessa Coppinger, 38, who is pregnant with the couple’s second child. “We don’t smoke. We don’t allow smoking in our home. We have smoke in our house all the time. All we have ever wanted was for the smoke to stop coming into our house.” 
 
 The lawsuit, first reported by WJLA (Channel 7), is part of a growing trend of court disputes pitting smokers against nonsmokers. 
 
 In 2013, a jury in Orange County, Calif., found that a homeowners association failed to resolve a secondhand smoke dispute among neighbors and awarded a family $15,000. In 2011, a cigar-smoking resident of Manhattan’s swanky Upper East Side was sued for $2 million by neighbors who said smoke wafted into their luxury condo. The neighbor eventually agreed to pay a $2,000 fine anytime the couple smelled the cigar smoke. 
 
 In Washington, civil attorneys say they are noticing more disputes between neighbors reaching the courthouse, involving matters including driveways, trees and access to passageways through yards. A feud between smoking and nonsmoking neighbors wasn’t that surprising. 
 
 “The trend is going in the direction where people are getting more invested in what their neighbors are doing and quicker to pull the trigger and initiate some sort of litigation, particularly if there is some health angle to the neighbor’s actions,” said David H. Dickieson, a litigation specialist and partner at the Washington law firm of Schertler & Onorato. He is not involved in the Coppinger-Gray case. 
 
 Dickieson said that although he was not surprised over lawsuits between neighbors arising from secondhand smoke, he was surprised that the judge ruled that a homeowner could not smoke within the confines of his own home. “This is contrary to the traditional idea that a man’s home is his castle, and it represents another step limiting what used to be called smokers’ rights,” he said. 
 
 The judge’s no-smoking injunction will remain in place until a follow-up decision by the judge or until trial, which is scheduled for the fall. Gray says he is now compelled to leave his home and walk several yards away from his property to smoke. 
 
 “I’m a nervous wreck,” said Gray, who lives on disability checks. “I’m a grown man. They passed a law that says you can smoke marijuana in my house. I can’t do anything now. What if I’m in here frying chicken and they complain they smell smoke? She going to send the marshals to come get me.” 
 
 Nessa Coppinger, an environmental lawyer, said her family filed the lawsuit out of fear for their health, including that of their 18-month-old daughter and the couple’s unborn child. Coppinger said her basement, which they have converted into a playroom for their daughter, and the bathroom are often full of smoke. She said she has awakened at night coughing because of the smoke. And she said she and her family have had to leave the house for hours to allow the strong smell of smoke to dissipate. 
 
 During earlier court proceedings, both families agreed to inspections of their houses. Inspectors discovered cracks in the common wall between the homes. Inspectors also said that the chimney on the Gray home was decaying and as a result was sending smoke from the Gray home into the Coppinger’s home. 
 
 “If they just get these things fixed, the lawsuit will go away. This isn’t about the money,” Nessa Coppinger said. 
 
 Before filing the lawsuit, she said she and her husband sent several letters to Gray and his family trying to get them to agree on the fixes. But she said the letters were ignored. 
 
 “If they continued to refuse to speak with us or to take any action, and have no concern about the health of our children, we had to pursue our case,” she said. 
 
 “This lawsuit would probably be gone tomorrow if they got it fixed and brought it to code,” said the Coppingers’ attorney, Eric Klein, a colleague of Nessa Coppinger’s at the law firm Beveridge & Diamond. “It would all end. We just want the house to be safe for these children.” 
 
 But Johnson, who owns the Gray family home, said she is concerned that the Coppingers, who have said in letters filed in court that they are willing to pitch in on the cost of repairs, would have too much say over whether any work was done properly. She also questions whether the renovation next door, done before the Coppingers bought the home, could have caused some of the damage to her home. 
 
 “You’re not going to dictate who comes into my home to do work and how the work is done, and then have the chance to sue me again if you feel the work wasn’t done the way you want it done. This is my home,” Johnson said. 
 
 An earlier version of this story incorrectly said the judge ordered inspections of both houses. The families agreed to the inspections. 
 
 Julie Tate contributed to this report. ||||| Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail. 
 
 Comprehensive Smoke-Free Laws — 50 Largest U.S. Cities, 2000 and 2012 
 
 Secondhand smoke (SHS) exposure causes heart disease and lung cancer in nonsmoking adults and several health conditions in children (1). Only completely eliminating smoking in indoor spaces fully protects nonsmokers from SHS (1). State and local laws can provide this protection in enclosed workplaces and public places by completely eliminating smoking in these settings (1). CDC considers a smoke-free law to be comprehensive if it prohibits smoking in all indoor areas of private workplaces, restaurants, and bars, with no exceptions (2). In response to growing evidence on the health effects of SHS, communities and states have increasingly adopted comprehensive smoke-free (CSF) laws in recent years (1,2). To assess trends in protecting the population from SHS exposure, CDC and the American Nonsmokers' Rights Foundation (ANRF) compared coverage by local or state CSF laws in the 50 largest U.S. cities as of December 31, 2000, and October 5, 2012. The analysis focused on smoking restrictions in the 50 largest cities because these cities represent an important indicator of nationwide trends in local and state policy and because they are home to an estimated 47 million persons, or nearly 15% of the U.S. population. The analysis found that the number of these cities covered by local and/or state CSF laws increased from one city (2%) in 2000 to 30 cities (60%) in 2012. A total of 20 cities (40%) were not covered by a CSF law at either the local or state level in 2012, although 14 of these cities had 100% smoke-free provisions in place at the local or state level in at least one of the three settings considered. The results of this analysis indicate that substantial progress has been achieved during 2000–2012 in implementing CSF laws in the 50 largest U.S. cities. However, gaps in coverage, especially in the southern United States and in states with laws that preempt local smoking restrictions, are contributing to disparities in SHS protections. 
 
 In the United States, the strongest smoking restrictions traditionally have originated at the local level (1). Local jurisdictions began to adopt CSF laws in the 1990s (1,3). The first local CSF law was implemented by Shasta County, California, in 1993 (3). The first state CSF law was enacted by Delaware in 2002 (2). As the past decade progressed, more states enacted CSF laws, often after a number of local jurisdictions in the state had implemented such laws (1–3). 
 
 Data on the 50 largest cities were obtained from the 2000 and 2010 U.S. censuses.* The data are based on the population within city limits. In 2010, the population of these cities ranged from 365,438 in Arlington, Texas, to 8,175,133 in New York, New York, with a median population of 600,690. During 2000–2010, New Orleans, Louisiana; Honolulu, Hawaii; and St. Louis, Missouri, dropped off this list, and Louisville-Jefferson County, Kentucky; Raleigh, North Carolina; and Arlington, Texas, were added to it. 
 
 Data on local smoking restrictions in effect for the 50 largest cities as of December 31, 2000, and October 5, 2012, were obtained from the U.S. Tobacco Control Laws Database† maintained by ANRF. This database categorizes various types of U.S. municipal and county laws relating to tobacco, including smoking restrictions. Laws included in the database are identified through various means, including systematic scanning of tobacco control publications, websites, and e-mail discussion lists and partnerships with the National Association of County and City Health Officials and the National Association of Local Boards of Health. Senior staff members use standardized guidelines and codebooks to abstract the laws. 
 
 Data on state smoking restrictions in effect as of December 31, 2000, and October 5, 2012, were obtained from CDC's State Tobacco Activities Tracking and Evaluation (STATE) System database.§ This database contains tobacco-related epidemiologic and economic data and information on state tobacco-related legislation. State legislation is collected quarterly from an online legal research database of state laws and is analyzed, coded, and entered into the STATE System. The STATE System contains information on state tobacco-related laws, including smoking restrictions, in effect since the fourth quarter of 1995. In addition to information on state smoking restrictions in worksites, restaurants, and bars, the STATE System contains information on state smoking restrictions in other settings, including government worksites, commercial and home-based child-care centers, multiunit housing, vehicles, hospitals, prisons, and hotels and motels. 
 
 The ANRF database tracks state smoking restrictions as well as local smoking restrictions. The STATE System and ANRF databases generally are in agreement in categorizing state smoking restrictions. However, in the few cases where these sources differ, this analysis relies on the STATE System categorization.¶ 
 
 Only one of the 50 largest U.S. cities (San Jose, California) was covered by a local CSF law as of December 31, 2000. None of these cities were covered by statewide CSF laws on this date, since no such laws had been implemented at the state level. 
 
 On October 5, 2012, 16 of the 50 largest cities (32%) were covered by a local CSF law (Table). Twenty of the 50 largest cities (40%) were covered by a state CSF law, including 14 (28%) of the cities that were not covered by a local CSF law and six (12%) of the cities that were covered by such a local law. Thus, 30 (60%) of the cities were covered by a local CSF law, a state CSF law, or both. 
 
 The remaining 20 cities were not covered by either local or state CSF laws. These cities are home to approximately 16 million residents, or 5% of the U.S. population. Although 14 of these cities have 100% smoke-free local or state provisions in place in at least one of the three settings considered in this study, the remaining six (Los Angeles, California; Oklahoma City, Oklahoma; Fresno, California; Virginia Beach, Virginia; Atlanta, Georgia; and Tulsa, Oklahoma) do not. The 20 cities that lack CSF laws are located in 10 states. Ten of these 20 cities are located in the southern United States (Florida, Georgia, North Carolina, Tennessee, Texas, and Virginia). Ten of the 20 cities are located in states (Florida, North Carolina, Oklahoma, Pennsylvania, Tennessee, and Virginia) with less than comprehensive state smoking restrictions that preempt (i.e., prohibit) local smoking restrictions that differ from state law.** Six of the 20 cities that lack CSF laws are located in California, which has substantial statewide smoking restrictions that were enacted in 1994, at an early point in the evolution of smoke-free policies, and fall short of current standards for CSF laws.†† The same is true of the local laws in place in some of these California cities. 
 
 Reported by 
 
 Maggie Hopkins, Cynthia Hallett, MPH, American Nonsmokers' Rights Foundation, Berkeley, California. Stephen Babb, MPH, Brian King, PhD, Michael Tynan, Allison MacNeil, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor: Stephen Babb, sbabb@cdc.gov, 770-488-1172. 
 
 Editorial Note 
 
 The results of this analysis indicate that substantial progress was achieved from 2000 to 2012 in expanding CSF policy coverage in the 50 largest U.S. cities. In the year 2000, only a relatively small number of communities had local CSF laws in place, and those communities were largely concentrated in a few states such as California and Massachusetts (1,3). No statewide CSF laws were in place at this time (2).This stands in marked contrast to the situation today. As a result of growing awareness of the health effects of SHS, diffusion of smoke-free policies as word spread about successful experiences with these policies, and changes in social norms, 26 states (including the District of Columbia) have implemented CSF laws to date (2).§§ Because of the same factors, many communities in other states have implemented CSF laws at the local level.¶¶ Consequently, a majority of the 50 largest U.S. cities are now covered by state or local CSF laws or both. 
 
 The first CSF laws in a state often are enacted by smaller communities (1,3). The successful implementation of smoke-free laws in smaller communities lays the groundwork for the adoption of similar laws by larger cities and, ultimately, at the state level (1–3). Regardless of whether they are implemented at the local or state level, smoke-free laws have been shown to receive high levels of public support and compliance, reduce SHS exposure, and improve health outcomes (1,4). The education and debate that accompany adoption of these laws generally result in increased public awareness of the law and its rationale (1,3,5–7). This education and debate, as well as the experience of living under the law, often lead to changes in social norms that result in increasing public support for the law (1,4,5). 
 
 State CSF laws can extend policy protections to a broader population than local laws, thus eliminating disparities in these protections (1,6). State smoke-free laws that set a floor for local smoking restrictions, rather than a ceiling, allow local SHS protections to evolve in step with emerging scientific evidence and changing standards (5–7). 
 
 The progress in extending comprehensive SHS protections to the majority of the 50 largest U.S. cities reported in this study is a major public health achievement. This shift reflects broader progress in extending these protections across much of the United States (1,2). Nearly half of the U.S. population is protected by state or local CSF laws today, compared with <3% in 2000.*** However, the findings of this analysis indicate that important gaps remain in smoke-free policy coverage in large U.S. cities. In particular, a number of cities in the southern United States have ineffective smoking restrictions or none at all. This gap in policy coverage creates disparities in public health protections that are likely to both reflect and contribute to broader tobacco-related population disparities (1,2). 
 
 The findings also illustrate the barrier that state preemption laws pose to local SHS protections. Ten of the 20 cities in this study that lacked CSF laws in 2012 are located in states with such laws. These laws preclude local action to increase SHS protections (1,5–8) and are associated with lower worker coverage by smoke-free workplace policies and reduced support among smokers for smoke-free environments (5). Conversely, the findings illustrate that, in states that do not preempt local smoking restrictions, cities can implement comprehensive local protections in the absence of comprehensive state protections. 
 
 The findings in this report are subject to at least five limitations. First, this study reports on local and state smoking restrictions as of October 5, 2012; the information on city population size comes from April 1, 2010 U.S. Census data, which are the most recent census data based on actual population estimates (as opposed to projections). Second, the STATE System only captures information on certain types of state smoking restrictions, primarily statutes and executive orders, and does not include information on state administrative laws, regulations, or implementation guidelines. However, most state smoking restrictions are enacted through legislation. Third, this analysis does not include laws that restrict smoking in workplaces, restaurants, or bars without making the setting in question completely smoke-free. However, the U.S. Surgeon General has concluded that only completely eliminating smoking in indoor settings fully protects nonsmokers from SHS (1). Fourth, neither the ANRF U.S. Tobacco Control Laws Database nor the STATE System collects information on how local or state laws are enforced or observed in practice. However, if adequate preparation and education have occurred, local and state smoke-free laws are, in most cases, largely self-enforcing. Finally, the laws considered in this report do not cover all settings where nonsmokers are exposed to SHS. In particular, private settings such as homes and vehicles can be major sources of exposure, especially for children, and nonsmoking apartment residents who do not allow smoking in their homes can still be exposed to SHS that enters their homes from their neighbors' apartments (1,4,9). 
 
 Continued progress in protecting nonsmokers from SHS in workplaces and public places can be achieved through local or state action. In states with preemption, local action is not an option. New local CSF laws continue to be adopted in a number of states that lack state CSF laws but do not preempt local smoking restrictions. In early November 2012, North Dakota became the 27th state (including the District of Columbia) to enact a state CSF law, and the first state to do so since 2010. 
 
 References 
 
 What is already known on this topic? The number of states that implemented comprehensive state smoke-free laws prohibiting smoking in private workplaces, restaurants, and bars increased sharply, from zero states in 2000 to 26 states in 2010. What is added by this report? The number of the 50 largest U.S. cities covered by comprehensive local and/or state smoke-free laws in workplaces, restaurants, and bars increased from one city in 2000 to 30 cities in 2012; 20 cities were not covered by a comprehensive smoke-free law at either the local or state level in 2012. What are the implications for public health practice? Although substantial progress has been achieved during 2000–2012 in protecting residents of the 50 largest U.S. cities from secondhand smoke, substantial gaps in these protections remain, especially in southern states and in states with laws that preempt local smoking restrictions.
– HUD proposed a federal mandate Thursday that has some smokers fuming: a ban against lighting up in public housing nationwide, the New York Times reports. If the law passes, more than 3,100 public housing agencies would prohibit smoking in all living units, indoor common areas, administrative offices, and outdoor spaces near those other areas, the Washington Post notes. The reason: to keep residents safe from secondhand smoke, cut down on fire risks, and curb building maintenance expenses, per the Times. "The argument about secondhand smoke is over," HUD Secretary Julian Castro tells the paper. "It's harmful." Since HUD started encouraging public housing groups to implement bans in 2009, more than 600 agencies with at least 228,000 units have gone smoke-free, per the Post—but now the federal housing department wants to make it universal. A study by the CDC backs up the economics, predicting that a nationwide ban would result in annual savings of $153 million. The group that would feel the biggest burn: the NYC Housing Agency, the nation's largest public-housing group, with more than 400,000 residents in about 178,000 apartments, per the Times. But some worry that, without community support, it will be difficult to enforce, and they don't think the cops should be involved. "It should be resident-led," the chairwoman of the NYCHA tells the Times. HUD says it will listen to public comments on the potential law before making a final decision.