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Infrastructure and Mortgages: What about the Kids?


During the 2016 election season, President Trump proposed spending $1 trillion dollars on infrastructure to put people to work and rebuild the sinews of the nation. Democrats also have called for infrastructure improvements. Those improvements must include making our homes and schools safe for our children. In its recent (January 2) editorial, "Housing that Ruins Your Finances and Your Health," The New York Times wrote, “One solution would be for Fannie Mae to eliminate dangerous lead conditions in foreclosed homes.” But lead requirements are antiquated or nonexistent not only at Fannie Mae but also at Freddie Mac and HUD’s FHA single-family mortgage insurance program. These federal housing programs are the only ones that were not reformed back in 1999 and are long overdue to be fixed.

In years past, both parties worked together to reduce childhood lead poisoning. But Flint is only the tip of the iceberg, and parents of lead-poisoned children are demanding that we do more to put a stop to the needless suffering. Lead poisoning costs us an estimated $50 billion annually for healthcare, substandard school performance, and lost work productivity (2008 dollars).1 The real tragedy is that we know how to fix lead hazards. The disasters in Flint and elsewhere could have been prevented and will now cost much more than if we had made the necessary upfront investments and reforms. The inadequate lead requirements at FHA, Fannie Mae, and Freddie Mac should comply with HUD lead-safe housing regulations, but they currently do not.

Traditionally, infrastructure spending only goes for roads and bridges and the basic equipment and structures that are needed for a country to function properly. But many are surprised to learn that the lead services lines bringing water into their homes are NOT part of the “infrastructure” and that the burden was on families to replace them. They are also surprised that home inspections required by mortgage companies do not include lead inspections. 

We think infrastructure and federally guaranteed mortgages should be used to make our homes safe for our children. Indeed, we have “shared” our homes with guests and friends and, of course, our families. But 37 million homes built before 1978 have lead paint,2 and at least six million homes have lead water service lines. This “shared” lead has poisoned millions of our children, sometimes poisoning one child after another as one family leaves and another moves in. Existing FHA, Fannie, and Freddie underwriting standards are part of the problem, but they could be part of the solution.

The biggest culprit is old single-pane painted windows, which have the highest lead paint and lead dust levels of any building component. Replacing windows is already a proven strategy. In a pilot program, Illinois replaced lead-contaminated windows in Peoria and Chicago in 500 homes,3 resulting in huge and sustained lead dust reductions not only on windows but also on floors; and many other studies have reached similar conclusions.

The time has come to replace all those old contaminated windows, those lead drinking water pipes, and the other lead hazards in our homes. Enormous benefits follow if infrastructure funds are used to address lead in homes:
  • First, over 75,000 jobs – good-paying jobs for both made-in-America window manufacturing and installation workers;
  • Second, increased property values anywhere from $5,900 to $14,300 per home4
  • Third, a return on investment of at least $17 per dollar spent on lead remediation or removal5
  • Fourth, up to $500 per household saved each year on reduced fuel bills, because new windows are more energy efficient.6 
With the right infrastructure improvements, we can all share safe drinking water and lead-safe homes. 

The evidence is clear – whether in small towns or big cities, rural or urban: We all win when we eliminate lead hazards and protect our children. Our traditional approach has been to respond only after a child is poisoned, but there is no reason to wait until the damage has already been done. We should test our homes and schools, not just our children’s blood. And we should insist that housing finance institutions like FHA, Fannie, and Freddie do the right thing and eliminate those hazards before children are poisoned.

As part of our new national infrastructure initiative, let’s include solving the lead problem. We urge the new president and Congress to protect our children. Let’s not wait for another Flint or another poisoned child. Get Fannie, Freddie, and FHA to do the right thing. Get rid of those old lead-contaminated windows and old lead pipes and put our people back to work to protect our children and our future.

_______________

1 Tresande, L., & Liu, Y. (2011, May). Reducing the staggering costs of environmental disease in children. Health Affairs 30(5), 863. Retrieved February 21, 2017,
from http://content.healthaffairs.org/content/30/5/863.long
2 Cox, D. C., Dewalt, G., O'Haver, R., Salatino, B. (2011, April). American healthy homes survey: Lead and arsenic findings. Washington, DC: U.S. Department of Housing and Urban Development. Retrieved February 21, 2017, from  https://portal.hud.gov/hudportal/documents/huddoc?id=AHHS_Report.pdf
3 Jacobs, D. E., Tobin, M.,Targos, L., Clarkson, D., Dixon, S. L. Breysse, J., et al. (2016, September-October). Replacing windows reduces childhood lead exposure: Results from a state-funded program. Journal of Public Health Management & Practice, 22(5), 482-491. Retrieved February 21, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/26910871
4 Nevin, R., Jacobs, D. E., Berg, M., & Cohen, J. (2008, March). Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement, Environmental Research, 106(3), 410-419. Retrieved February 21, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/17961540
5 Gould, E. (2009, July). Childhood lead poisoning: Conservative estimates of the social and economic benefits of lead hazard control. Environmental Health Perspectives, 117(7), 1162-1167. Retrieved February 21, 2017, from https://ehp.niehs.nih.gov/wp-content/uploads/117/7/ehp.0800408.pdf
6 Nevin, R., Jacobs, D. E., Berg, M., & Cohen, J. (2008, March). Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement, Environmental Research, 106(3), 410-419. Retrieved February 21, 2017, from http://www.ncbi.nlm.nih.gov/pubmed/17961540



 
Dr. David Jacobs, former Director of the Lead Poisoning Prevention Program at the U.S. Department of Housing and Urban Development, is the Chief Scientist for the National Center for Healthy Housing and an adjunct professor at the University of Illinois at Chicago School of Public Health

Anita Weinberg is the Clinical Professor and Director of the ChildLaw Policy Institute at Loyola University Chicago School of Law.

Alternative Financing Mechanisms: Exploring Options for Healthy Homes Services



The National Center for Healthy Housing (NCHH) is a “go-to” resource for practitioners in the housing as healthcare industry. We get inquiries regularly: “Where is this being done? By whom and how?” We also look at the industry landscape ourselves and ask the same questions.

As we looked at the landscape in 2015, we closely reviewed the robust evidence base about the potential for transforming health outcomes and reducing healthcare costs by incorporating home-based interventions into patient care. Such interventions target social determinants of health, and investing in them has the potential to reduce the burden of preventable housing-related illness dramatically. The investing bit caught our attention, because we heard two conflicting scenarios.

On the one hand were states or individual managed care organizations providing Medicaid coverage for services delivered in the home environment related to asthma and lead exposure. On the other hand were states that indicated an interest in delivering home environment services but had not yet achieved Medicaid coverage. It seemed like their only option was to wait for Medicaid expansion coverage. But was it? As these conversations continued, we were aware of some states utilizing other financing mechanisms as either a complement or alternative to healthcare financing. The inevitable a-ha moment happened, and a series of questions followed: “What if more people know about these alternative financing mechanisms being used by certain states?” “Can someone, somewhere adopt an existing model as-is or with some modification?” “Is there a chance to increase the number of people receiving home environment services around the country?” We liked all the positive answers to these questions, and what followed was the alternative financing mechanism information project – after we secured funding from the W.K. Kellogg Foundation, of course. (Yes, our ideas depend on funding to be actualized.)

In 2016, NCHH interviewed several states providing one or more home-based asthma services, childhood lead services, or healthy home services using funding other than Medicaid or grants. The interviews provided information on the funding mechanism and how it operates, the program being funded and how it operates, outcome and evaluation information (where available), and lessons learned. We are pleased to share our findings of 12 different financing mechanisms.

This project does several things, but I would like to highlight one major feature—the “behind-the-scenes” information that the interviews provide.

The Montana Asthma Home Visiting Program (MAP) website tells us about the program. It is the interview that lets us know that not only does the program receive funding from the Master Settlement Agreement (MSA), it began to receive funding in 2007, nine years after the MSA accord was reached! This implies that even if MSA funds have not been a source for home-based asthma services or lead-based follow-up services, it is a potential source. Who else can begin to receive funding from their state’s MSA for home environment services?

One of the Massachusetts program interviews tells us how a trade-off was instrumental to raising funds for the program. The state amended the lead law to remove liability from organizations, and as a trade-off they accepted “surcharge on fees assessed by certain boards of registration, or state agencies for the licensure or certification of certain professionals, and on fees assessed for the renewal of such licensure or certification.” These surcharges raise about $2.5 million annually for Massachusetts Lead Education Trust Fund, income that would otherwise have been unavailable to support lead education services in the state!

The Maine interviewee spoke about the need to make the distinction between primary and secondary prevention. Just like several other states, Maine had a secondary prevention program. But secondary prevention only reacts after the fact. With the Lead Poisoning Prevention Fund, Maine now tests homes not just after a child has been poisoned in it, but before poisoning can happen to prevent poisoning.

Here are two things that stand out from the New Jersey’s project ReHEET interview: One, you can start where you are: Although they have received funding as high as $480,000, they have also worked with funding as low as $80,707! They began work with a few units. Two, the interviewee also pointed out how addressing more than one issue when intervening in a home lowers cost. They are committed to promoting energy and weatherization services to be incorporated with healthy homes services as a total package. Was someone thinking this might be a good idea? It is. They are working with it in New Jersey.

The page includes many more insights from our interviewees. For practitioners, we hope you are thinking “If them, why not us?” That’s what we are thinking too. Unhealthy homes are costing our nation too much in lost school and work days, medical expenses, and reduced quality of life. We encourage states and nonprofits to continue exploring alternate financing mechanisms that can support implementing evidence-based interventions for healthy homes.


Visit NCHH's Alternative Financing Mechanisms page here. Visit NCHH's Healthcare Financing page here.


Dr. Lillian Agbeyegbe is a public health practitioner with over a decade of experience in program development, implementation, and evaluation. As a project manager, she leads and supports NCHH’s Housing as Healthcare portfolio by developing resources, training, and providing technical assistance to support states in providing healthy home services.

The Silent Killer


No one heard the door open or a window shatter. Nobody saw a figure enter the small, darkened one-story home at the corner of Antioch Avenue in a slumbering Maryland neighborhood. There were no shouts, screams, or cries for help; the killer was silent, efficient, and dispassionate. And after the deed was done, the faceless killer simply vanished, virtually into thin air. By the time the sun rose the following morning, a single father and seven children were dead. There were no signs of entry and no fingerprints, footprints, or tire marks to assist the police. But there was one critical piece of evidence that helped the authorities to identify the killer: A portable gas-powered generator was discovered inside the home, its gas tank now empty....

And who did it? Carbon monoxide, often called "the silent killer."

It almost sounds like the premise for a horror movie, but that was a true story. The tragedy occurred in April 2015 in a small community on Maryland’s Eastern Shore, roughly 20 minutes from Salisbury University. Rodney Todd had separated from his wife a few years back, and the now-single dad was trying his best to keep the lights on and the food on the table for his seven children. He was committed to keeping his children, ranging in age from six to 15 years, happy, healthy, and safe. But his income from a dining services job at the University of Maryland Eastern Shore campus wasn’t enough to cover their living expenses. With no electrical service to his home, Mr. Todd installed a portable gas-powered generator to keep the lights and heat functioning through the cold nights.

What Mr. Todd didn’t know or understand was that he’d installed a combustion device in his home, and any stove, heater, lantern, or lamp that burns gas or oil fuel releases carbon monoxide (CO) into the air. Carbon monoxide is colorless, tasteless, and odorless, and it can kill you. You can breathe it in while sleeping or while talking to a friend or family member without realizing that you’re being poisoned, and it only takes a few minutes of exposure to be affected. If you’re awake, you may feel light-headed or weak, eventually experience flu-like symptoms, such as weakness, vertigo or dizziness, stomach upset or vomiting, or chest pain. If you’re asleep (or even inebriated, for that matter), you may not even notice these symptoms at all; you simply don’t wake up the next morning for work or school. Or anything ever again. Just like that.

Unfortunately, Rodney Todd’s story is not an isolated incident. On February 21 of last year, Leonard and Heather Quasarano and their four children, ranging in age from 23 months to 11 years, perished inside their two-story home in Fenton Township, Michigan. Their power went out, so the Quasaranos set up his gas-powered generator in the basement to keep the family comfortable as they slept, a fatal mistake. Said Genesee County Sheriff Robert Pickell, "It's very difficult just talking to the undersheriff who was in the house and saw all the bodies in the different rooms," he said. "No matter how long, how many investigations we conduct, seeing young children, an entire family wiped out, is just a very, very sad thing."

According to the U.S. Centers for Disease Control and Prevention (CDC), unintentional CO poisoning (non-fire-related) results in 20,000 emergency room visits, 4,000 hospitalizations, and roughly 300 fatalities every year in the U.S. The U.S. Consumer Product Safety Commission’s estimate (200 non-fire-related fatalities yearly) is more conservative but still tragic, especially when it happens to someone you know.

But you don’t have to die from CO poisoning to be affected by it. Even what some might describe as a “low-level,” nonfatal CO exposure may still result in permanent organ or brain damage. You may also suffer other side effects, such as headaches, amnesia, loss of muscle control, incontinence, and personality changes. These are usually short-term problems for most victims, but they can be permanent in some cases.

So how do you defend yourself and your family against a villain who can’t be seen, heard, smelled, or touched? What extra steps could Rodney Todd have taken to protect himself and the seven children who occupied that small house on Antioch Avenue? Are you making the same mistakes? How long before your luck runs out?

While there are many things you can do to reduce the likelihood of CO poisoning, let's focus on two solutions that might’ve saved Mr. Todd and his family.

First, avoid running any kind of combustion device inside your home. Read the instructions and heed the warning labels. If you must use a combustion device indoors, make sure that you have adequate ventilation. “Adequate ventilation” means that there must be some source of fresh air nearby, usually an open window or door. The window can be open only a few inches, but you must provide a way for fresh air to enter your home so that oxygen binds with the CO molecules, which creates carbon dioxide (CO2) instead.

Second, install CO alarms (also “monitor” or “detector”) in your home, if they aren’t there already. According to NCHH's National Healthy Housing Standard, a CO alarm is “an electronic device that measures the level of carbon monoxide gas… [and] … activates an audible alarm when an amount … above the device’s threshold level accumulates in the area in which the alarm is located.” The alarms look very much like a smoke detector and work similarly. The International Fire Code requires (and the Consumer Product Safety Commission also recommends) smoke and CO alarm models that include a voice notification system. There should be one CO alarm on each floor and outside each sleeping area, near the bedroom. NCHH is promoting CO alarm requirements as a safety provision in the National Healthy Housing Standard. Maryland (where NCHH is located) requires that homes constructed after January 1, 2008, have a hardwired CO alarm; some states have similar laws. Last year, NCHH proposed an amendment before the International Code Council that would require CO alarms in all properties governed under the International Property Maintenance Code (IPMC). ICC codes currently require only that CO alarms be installed in new structures and in existing properties where a building permit has been requested for renovations. Such an amendment would result in CO alarms being as prevalent in properties as smoke detectors, which we feel is extremely important for public safety.

Since most older homes have no CO alarms, that’s where you come in. If your budget is tight, you can buy a CO alarm for under $20; units with more bells and whistles, such as models that also detect smoke or explosive gases, cost more but are still affordable; and they’re a small price to pay for peace of mind. You can even buy a “travel alarm,” which is not a bad thing to have with you on a trip, because you’ll never know when you’ll need one.

If your CO detector runs on batteries, be sure to replace them twice per year. You should install new batteries when you change the time on your clocks each spring and fall, just as you do with your smoke alarms. You were already doing that, right?

Great, you've installed the CO detector! That's your best tool for protecting your family and yourself, although there are several other ways to minimize the threat of CO poisoning. For example, when shopping for appliances or equipment, be sure to look for products that have been approved by a nationally recognized testing lab, such as UL or NSF International. Make sure that any gas appliances are vented properly, with horizontal vent pipes angling slightly upward. Have a qualified service technician inspect your heating system and combustion appliances annually, and, if you have a fireplace, get your chimney checked for blockages every year. Also, don't burn charcoal or use a portable gas camp stove or inside.

Now, let’s say your power's on, your furnace works just fine, and you don’t have a gas generator in your kitchen or living room. Are you still at risk for CO poisoning?

Yes, you may still be in danger. Here's another story: It was two days after Christmas when Melissa and Jorge were killed. They left their home in New Jersey on a frosty night to celebrate their anniversary at a charming little bed and breakfast in Stroudsburg, Pennsylvania, laughing and joking flirtatiously. The happy couple pulled off the road and parked for a moment in front of a strip of storage garages. Melissa had a key. Should they or shouldn't they? Melissa opened the door to garage 55. They backed in, and Jorge shut the door. They needed a little privacy, just for a few minutes; then they'd be back on the road. But they never saw the killer that entered the garage with them...

Most CO exposures occur inside the home, but there are far too many incidences of accidental exposures and deaths relating to car exhaust fumes wafting into the living areas of homes and poisoning families. Some are unusual, such as the case of the man who committed suicide in his garage but inadvertently killed his wife and two daughters as they tried to rescue him, that tale of the amorous New Jersey couple who lingered in their car too long, or the tale of heroic father who realized that his car had been idling and opened the garage door, preventing the deaths of his family and their neighbors but not his own—he collapsed and died before he could shut off the car’s ignition, a shocking reminder of how quickly carbon monoxide can overcome a person; but most of the stories are just sad. And all of these tragedies could have been avoided if only the victims had known that about the silent killer that is carbon monoxide.

Now that you know what to do and what not to do, be safe and sleep peacefully.

Decorating for the Holidays: How to Hang Your Lights Safely This Year



Jingle all the way...to the ER? According to the Consumer Product Safety Commission, there are about 12,000 or more reported emergencies involving holiday lighting each year. But that’s certainly not what you want to be thinking about when you’re gathered round the tree.

The best present you can give yourself this year is a little peace of mind. And that’s not too hard to do when you follow best practices for seasonal lighting. With the proper equipment and lighting techniques, you can avoid a holiday disaster, and still get the most beautiful lights on the block.


Replace Incandescent String Lights with LEDs

LED lights usually get promoted solely for their energy efficiency—but they also run much cooler than incandescent lights, as well. In consumer testing, LEDs ran over 200 degrees cooler than comparable incandescent lights, a trend that translates over to your seasonal decorations, as well. Cooler lights means less danger for combustion, so LEDs are typically considered safer than their incandescent counterparts.

Of course, simply purchasing LED lights can’t root out every problem. You also need to make sure you use safe practices with extension cords and outlets, as well. But they can certainly eliminate some of the risks associated with decorating—which is definitely one way to make things merry and bright!


Use Caution When Hanging Exterior Lights


We’ve all seen the damage that can come from improper lighting techniques (if not, stop reading this article, watch National Lampoon’s Christmas Vacation, and come back). However, unlike in the realm of fiction, accidents here can result in serious injuries that are nothing to laugh about.

If you’re hanging lights high, make sure that you have a sturdy ladder, and stand it on even ground. Move the ladder as you go instead of reaching too far to your left or your right. Invest in a set of light holders rather than using nails or a staple gun—and give yourself some extra cookies for being smarter than Clark Griswold.


Look Your Lights Over


A lot can happen in a year while lights are stored away in the attic. Make sure to give every strand a visual inspection—and don’t chance it with frayed or damaged lights.

Plug string lights in before hanging them. If they don’t light up, then they’re no good to you anyway, and it will save you the hassle of hanging your lights, only to have to take them all down again. And who needs that wasted time during this busy season?


Use the Proper Lights, Cords, and Outlets


Minus the right equipment, even the most magical light display can go sour fast. If you’re putting lights outdoors this year, make sure both the lights and any extension cords you use are rated for exterior use. Lights should be waterproof, as well, to protect them from wintry weather. Also, check that your cords are UL-approved—this independent consumer safety group tests commercial electrical products to verify their safety.

Outlets, too, need to be chosen with safety in mind. Install lights on a ground fault circuit interrupter (GFCI) outlet. As the name suggests, this kind of outlet will interrupt the electrical circuit if the outlet becomes overloaded. Obviously, you should avoid plugging too many different lights into the same outlet, as well, but this will help you avoid sparks if you happen to go overboard.

With some lighting smarts, the only fires you’ll be seeing this year will be for those roasting chestnuts! Wishing you and your family a happy and safe holiday!










 

Erin Vaughan is a blogger, gardener, and aspiring homeowner. She currently resides in Austin, TX, where she writes full time for Modernize with the goal of empowering homeowners with the expert guidance and educational tools they need to take on big home projects with confidence.

The Family that Smokes Together (Expanded)

Before Dad was a physician, he was a smoker. And, because we lived in his house, we were smokers too.

Throughout my life, people have thought it odd that a doctor could also smoke, but it’s not really so strange because Dad started his habit at 14. Smoking was one of the things people did back then, all the time—at home, at work, at parties. Millions of soldiers received free cigarettes during World War II, and when they returned home from the war, they were hailed as heroes, role models for kids everywhere. And our heroes smoked.

My father was already a veteran of smoking before he ever set foot in med school, and any doctor will tell you that med school is incredibly stressful—it’s not the best environment for quitting anything, except maybe sleep. Plus, he enjoyed it. These were the days before the Surgeon General’s package warnings, the terrifying ads, and the lawsuits. By 1966, when the warnings started appearing on cigarette packaging, he’d already spent half of his time on Earth as a smoker.

As kids, my sister and I waged a failing war against the cigarettes: We begged and pleaded, we pinched our noses and complained about the horrible smell. We hid the packs and the ashtrays. I’ll bet many of you did the same things to your parents. One time I even “loaded” a cigarette, which resulted in a small explosion that angered Dad, not because he was surprised by it but because the cinders nearly burned his shirt. But every time we tried, he proved that his love of smoking was somehow stronger than we were.

Our success—such as it was—was comparable to everyone else who battled smoking at that time. Public policy (most notably, the 1964 Surgeon General’s report, which linked smoking to lung cancer) managed to curb smoking’s stratospheric popularity, but it didn’t result in a massive reduction in the overall quantity of smokers. By the mid-1970s, the anti-smoking movement was highly visible, and the number of smokers fell incrementally.

Dad eventually responded to our protests smoked by switching to a pipe for a year or so. He looked very distinguished, and the pipe smoke smelled better than that of the cigarettes; but it was still smoke that wafted through the halls.

So we grew up with smoke in the house every morning before, during, and after breakfast. Some people wake up to the aroma of eggs or bacon, but we woke to the acrid odor of cigarettes. The other thing I woke up to almost without fail was a lump in the back of my throat—an actual lump of gunk that accumulated there while I slept. Part of my morning routine was to get up and expel a gob of phlegm into the sink. It didn’t end there, either—several times a day I repeated this ritual, right up until bedtime. Every day, for years.

My mother thought it was disgusting, and she told me so. I agreed, but what was I supposed to do about it? “I gotta get it out somehow,” I muttered grimly as I continued to hack away.

Now, you’d think from this description that my house was absolutely hazy with smoke all the time, but it wasn’t. Dad had very long hours throughout the week and when he was away, we didn’t notice any lingering smell.

Something unexpected happened when I left for college. Within a few weeks, my coughing subsided. A few more, and it ended altogether. Honestly, I hadn’t noticed it happening, probably because it was so gradual and because I hadn’t made any conscious changes to my lifestyle. I only noticed it when I woke up on the first full day of my fall break. The lump in my throat was back, which must’ve meant that it had stopped sometime while I was away. My mother heard me and commented again about the horrible noise and what a disgusting habit it was. I told her that no one was more disgusted by it than I, but it was funny because this morning was the first time I’d done it in a long time—there must be something in the house that was making me sick.

It wasn’t long after that I started hearing about the dangers of secondhand smoke. Secondhand smoke is the smoke that the other people in the presence of a smoker breathe, the smoke that my father expelled from his lungs after every drag from his cigarettes or puff from his pipe as well as the smoke that rises from these tobacco products as they burn. In short, it’s what my sister and I complained about for roughly 20 years. All the things that can happen to a person as a result of smoking can happen to a nonsmoker too if they’re exposed to secondhand smoke. Secondhand smoke is a known trigger for people with asthma and can lead to lung cancer, too.

You may not have heard of it, but there’s also a thing called “third hand smoke,” which is the chemical residue left behind on surfaces that we take into our bodies by touching contaminated surfaces, ingest from hand-to-mouth contact (or possibly via our food), or breathe in as dust after the actual smoking stops. These would be the chemicals trapped in curtains, on wallpaper or painted surfaces, or the foul odor you detect in a smoker’s car. Whatever you smell in the car is the particulate residue of various chemicals including carbon monoxide, arsenic, butane, lead, toluene, and hydrogen cyanide. If you’ve spent any time on our website at all, you may already know how dangerous carbon monoxide and lead are. Butane is used in lighter fluid and  fuel for camping stoves, and toluene is found in paint thinner. Anything with a name like “hydrogen cyanide” can’t possibly be good for you; this substance is used in chemical weapons. If that’s not frightening enough, polonium-210 is a radioactive carcinogen (meaning it can cause cancer). And arsenic is, well, arsenic. That’s what you’re taking into your lungs when you’re breathing second- and third hand smoke. And before you say anything about air fresheners, forget it: They’re masking the chemical smell, not removing it; you’re still breathing smoke residue and to it you’ve added other chemicals blended to smell like pine or vanilla.

Despite our efforts, our family was never able to convince Dad to quit, although he did smoke less in his later years—a minor victory that may have actually had more to do with changes in public policy. State and federal government have raised taxes substantially over the last twenty years, and laws now prohibit smoking inside or near entrances to almost all public buildings and many public parks, on planes, or on buses. Smoking is now a very expensive habit, and it’s hard to find anywhere to do it outside of your own personal property. As if to follow their lead, my mother—herself a former smoker—insisted that our father’s was no longer allowed to smoke in the house. In the winter, he was allowed to use the garage. Stubbornly, he persisted through the rain and the snow. After all, it was his life, and he wasn’t going to quit just because someone said he should.

And that’s what I say to you: Sure, it’s your life—you can do what you like with it, but what about your family and your friends? Are their lives yours too? And what about your pets? Does old Rufus have to suffer because you don’t feel like quitting? He might be “man’s best friend” to you, but if he knew what you were doing to him, he might not hold you in the same regard. So, if you're a smoker, why not quit? If not for yourself, then how about for your family? And if you’re not willing, or haven’t been able to break the habit, at least take it outside.

As for my own Dad, well, he finally did stop. It happened after he spent a month on the ventilator after a surgery, a procedure that followed angioplasty and an open-heart bypass. His lungs were really weak. When he finally left the hospital, roughly 20 days later than expected, he realized that he was never going to wake up from the next surgery at all if he kept smoking. All of the surgeries he'd endured might've been avoided had he not smoked or even if he’d quit sooner. Suddenly, smoking seemed to be a lot less enjoyable to him, and so he quit—at age 60—but he’d done too much damage to his body. He was already suffering from emphysema by then and often used an oxygen pump to assist his breathing. Still, I think quitting did allow him to live a longer life, and he got to meet his first grandchild before he passed.


This is an expanded version of a blog post that first appeared on NCHH.org in September 2016.

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