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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.

Both House and Senate Move to Increase HUD Lead Hazard Control Funding

Thanks to all of you who called your senators last week to urge them to pass the HUD funding bill! The bill did pass the Senate, with $50 million in funding increases for lead hazard control, half of which will go to HUD’s Office of Lead Hazard Control and Healthy Homes (OLHCHH) – raising their budget to $135 million – and half for lead hazard control in public housing.  

Similarly, the House appropriations committee just passed a House funding bill that also increases HUD’s OLHCHH budget – to $130 million, an increase of $20 million. Both bills also provide level funding for CDBG and HOME and allow continued assistance to all households currently served by HUD programs, with some targeted increases. We'll need your help over the summer and fall to ensure that these lead hazard control funding increases are enacted at the Senate level.

Of course, this is only a fraction of the funding needed to eliminate lead poisoning, but it's a strong step forward in an austere budget environment. To help us press for more funding, sign up for the Find It, Fix It, Fund It campaign and/or register for our Find it, Fix it, Fund It webinar rollout meeting tomorrow (1 p.m. EDT).

We thank Chairman Mario Diaz-Balart (R-FL-25) of the HUD appropriations subcommittee for working closely with ranking members Representative Nita Lowey (D-NY-17) and Representative David Price (D-NC-4) to increase spending on lead hazard control. All three brought the issue up as a key success of the bill at the markup hearing today.

I was able to thank them personally and urge you to thank you them too by tweeting:

@MarioDB thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!
@NitaLowey thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!
@RepDavidEPrice thank you for increasing @HUDgov #lead hazard control funding and protecting America's children!


Here are additional highlights from the Senate bill in which Chairman Susan Collins (R-ME) and Ranking Member Jack Reed (D-RI) crafted numerous policy changes to improve lead poisoning prevention! The new bill will accomplish the following:
  • Provides more resources to the Office of Lead Hazard Control and Healthy Homes ($25 million) and lead hazard control in public housing ($25 million). 
  • Allows lead hazard control grants to serve zero-bedroom units for the first time.
  • Requires HUD to align its blood lead level standard with CDC’s (changing the standard from 20 μg/dL to 5 μg/dL).
  • Doubles the staffing at the Office of Lead Hazard Control and Healthy Homes’ Enforcement Division.
  • Also: Increases funding for Section 202 Housing for the Elderly program and the Section 811 Housing for People with Disabilities program, and homeless assistance programs.
Thanks for all you do, and don’t forget to join the next full National Safe and Healthy Housing Coalition webinar on June 7, which will include a panel on Healthy Housing for Older Adults!

Appropriations Update and Take Action: Funding for Healthy Housing and Lead Poisoning Prevention

It has been a busy few weeks on the appropriations front for healthy housing.

The good news is that the Senate appropriations committee voted on June 25 for level funding for HUD and CDC healthy homes, lead poisoning prevention, and lead hazard control programs! THANK YOU to all of you for your sign-ons and phone calls to make this happen! This is all the more remarkable given the very severe budget caps!

Unfortunately, both Housing and Urban Development (HUD) and Health and Human Services (HHS) suffered billions of dollars in funding cuts overall. The cuts harmed several critical environmental health and housing programs that impact healthy housing, including the National Housing Trust Fund, HOME, and CDBG. We will continue advocacy to lift the onerous budget caps and increase HUD and CDC funding levels.


Please Take Action Today:

Call Senator Susan Collins (R-ME) and Senator Jack Reed (D-RI), the top Republican and Democrat on the Senate HUD appropriations subcommittee:

  1. Call Senator Collins at 202.224.2523 and say: "I'm calling to thank Senator Collins for maintaining level funding for HUD's Office of Healthy Homes and Lead Hazard Control. I greatly appreciate her standing up again for the health and well-being of America's children and communities."
  2. Call Senator Jack Reed at 202.224.4642 and say: "I'm calling to thank Senator Reed for maintaining level funding for HUD's Office of Healthy Homes and Lead Hazard Control and for offering an amendment to increase that funding. I greatly appreciate him standing up again for the health and well-being of America's children and communities."

Also, please forward this email to any friends and colleagues in Maine and Rhode Island, and ask them to make the phone call too!

Join the National Safe and Healthy Housing Coalition.


Updates:

  1. HUD Office of Lead Hazard Control and Healthy Homes (OLHCHH):
    • On June 9, the House of Representatives passed its HUD appropriations bill cutting HUD’s OLHCHH funding by $35 million to $75 million in 2016.
    • On June 25, the Senate appropriations committee voted in a bipartisan effort to maintain level funding for HUD's OLHCHH at $110 million in 2016.
  2. CDC Healthy Homes and Lead Poisoning Prevention Program:
    • On June 24, the House Appropriations Committee voted to cut this program by $1/2 million to $15 million in 2016.
    • On June 25, the Senate Appropriations Committee voted to maintain level funding for CDC's Healthy Homes and Lead Poisoning Prevention program at $15.5 million in 2016.
Several representatives and senators spoke out and offered amendments in favor of the HUD Office of Healthy Homes and Lead Poisoning Prevention programs, and Representative David Price (D-NC) mentioned the Partnership Effort for the Advancement of Children's Health (PEACH) of Durham, North Carolina, by name. Go PEACH!


Next Steps:

The National Center for Healthy Housing and the National Safe and Healthy Housing Coalition will work to increase the overall budget caps to allow for funding increases to HUD and CDC, and continue to advocate for level or increased funding to healthy homes programs. The House and Senate will continue to deliberate and negotiate final appropriations levels throughout the summer and fall, but the bills passed this week will provide a likely baseline.

Join the National Safe and Healthy Housing Coalition.


Quotes from Capitol Hill:

From the June 25, 2015, Senate Appropriations Committee hearing:

"[This amendment] provides additional resources to protect Americans and ensure their safety. For example, it would add 10 million dollars to lead hazard reduction. This has been a curse, particularly in low-income, older neighborhoods, and we have them all across the county. And once a child is infected by lead, that child's cognitive ability, that child's ability to succeed in school and to contribute to this community, is devastated. And it’s completely avoidable. You simply have to get the lead out."

‎        –Senator Jack Reed (D-RI), Ranking Member, HUD appropriations subcommittee


"I do want to address just one point, specific point that the senator made, and that has to do with lead hazards, which we have worked on for years. For 18 years we've worked on this, we've had hearings in our home states, and I would say that, first of all, the House bill slashed this program to only 75 million. We have funded it at 110 million dollars, which is the same level as last year. So I don't want anyone to leave this room under this mistaken impression that we had slashed the program for lead hazard removal out of old housing stock, because that just would be inaccurate. "

‎       –Senator Susan Collins (R-ME), Chair, HUD appropriations subcommittee


"This bill would be better if we had a bipartisan agreement to lift the onerous sequester funding levels and with the resources in the amendment Ranking Member Reed will offer. His amendment would allow us to meet more of our country's infrastructure and community needs by providing $3.9 billion for aviation and rail safety, housing, lead paint abatement, and transportation infrastructure."

‎      –Senator Barbara Mikulski (D-MD), Vice-Chair, HUD appropriations committee

Tell Congress: No More Cuts to Lead Poisoning Prevention!

“When my son was poisoned by lead, I had to act. But how?”

This was the question posed by Thomas Beller, a New Orleans resident and father whose story of lead poisoning was published yesterday in a New York Times op-ed. Despite Beller’s efforts to avoid his child’s exposure to lead, his son was poisoned by remodeling on his neighbor’s home. Through rapid intervention – received only because his son had routine blood lead screening at age one – his son has since reduced his blood lead levels. Yet like millions of other parents of lead-poisoned children, Thomas is left with the difficult question: What is my next step?

Millions of children living in urban areas of the United States are at a disproportionally higher risk of being lead poisoned. An article in The Washington Post last week identifies lead poisoning as one of the most ignored factors affecting the educational outcomes of poor children.

With blood lead levels playing such a major role in the development and well-being of children, the job of addressing this issue must not be left only to those who are affected by it. Yet Congress has failed to prioritize this issue: Just last week, the House of Representatives cut the HUD’s Office of Lead Hazard Control and Healthy Homes’ funding by 31%.

The Center for Disease Control’s (CDC’s) Healthy Homes and Lead Poisoning Prevention could potentially face similar cuts; the House will release its proposed CDC funding levels tomorrow.

Let’s hope the House is not as short-sighted in its CDC funding as it was with its HUD funding and restores funding for the Healthy Homes and Lead Poisoning Prevention Program to $29 million – or, at a bare minimum, retains the current $15 million funding level. This program provides surveillance for lead-poisoned kids and education to families so that perhaps other parents like Beller can help their kids in time, and so that communities can find the homes making children sick and repair them to be lead-safe.  

Tell your members of Congress that funding levels for these programs cannot be cut further. We must end the scourge of lead poisoning once and for all – and help those kids who have already been poisoned. If you haven’t yet, sign the letter to Congress demanding full funding – and email it to five of your colleagues today!

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