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Your Environment. Your Health.

Cost savings associated with prohibiting smoking in U.S. subsidized housing

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost Analysis (CA)
King BA, Peck RM, and Babb SD
Am J Prev Med
This cost analysis is the first to assess costs that could be averted by prohibiting smoking in U.S. subsidized housing. The authors estimated cost savings would be $521 million per year, including $341 million in secondhand smoke-related healthcare expenditures, $108 million in renovation expenses, and $72 million in smoking-attributable fire losses. Prohibiting smoking in U.S. public housing alone would yield cost savings of approximately $154 million per year. These findings suggest that efforts to prohibit smoking in all U.S. subsidized housing would protect health and generate substantial cost savings to society.
Not available

Health Outcomes

  • Not available

Environmental Agents

List of Environmental Agents:

  • Air pollutants (secondhand tobacco smoke)

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source


  • Cost Analysis (CA)

Cost Measured:

  • Healthcare costs related to secondhand smoke
  • costs of renovation of units that permit smoking
  • smoking-attributable fire costs

Potential Cost Measures:

  • Societal costs associated with smoking
  • long-term healthcare costs
  • time lost because of illness
  • costs associated with investment of money or staff time to implement and enforce smoke free policies

Benefits Measures: (Not available)

Potential Benefits:

  • Benefits associated with smokers who quit due to smoke free policies


  • United States (excluding Alaska)

Models Used: (Not available)

Methods Used:

  • The authors estimated annual cost savings associated with secondhand-smoke related health care, renovation of units that permit smoking, and smoking-attributable fires in all U.S. subsidized housing. The authors — 1) used residency estimates and previously reported national and state cost estimates for these indicators; 2) applied a price deflator to account for differential costs of living or pricing across states; and 3) performed a sensitivity analysis to develop a range around each cost estimate.

Sources Used:

  • National Health Interview Survey (CDC, 2009); Vital signs: current cigarette smoking among adults aged ≥18 years—U.S. 2009 (CDC 2010); Top 50 States. Cost of living by state (; Resident characteristic report as of March 31, 2012 (U.S. Department of Housing and Urban Development); The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants (Klepeis et al., 2001); 2006-2007 tobacco use supplement to the current population survey (National Cancer Institute); How much does secondhand smoke cost a landlord? (Smoke-Free Housing Coalition of Maine); The total cost of fire in the United States (National Fire Protection Association, Fire Analysis and Research Division, 2010); Home structure fires (National Fire Protection Association, Fire Analysis and Research Division, 2010); additional sources cited in publication

Economic Evaluation / Methods and Source


  • King BA, Peck RM, and Babb SD. 2013. Cost savings associated with prohibiting smoking in U.S. subsidized housing. Am J Prev Med.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding:

  • There were no sources of direct or indirect funding for the reported research.
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