Helping smokers with adherence

Build success by helping smokers adhere to the policy. Some residents who smoke may not be ready or able to stop smoking, but you can work with them to help them adhere to the policy. Showing compassion to residents facing barriers to adherence may increase acceptance of the policy and willingness to adhere.

Planning for success

If possible, identify in advance any residents for whom policy adherence may be difficult due to a disability or other health issue, and consider possible accommodations (see Help address barriers, below).

“Some people have been smoking for 30 years. I don’t want my senior citizens going out on a busy road to smoke. I’m going to give them a covered gazebo area. That was our first step. We thought that that was fair. They’re not going to break the rules if they do have some place to go.”

• 
  

  Property manager

  
  

Smoking shelters

Smoking shelters protect people who smoke from the elements, making it easier for them to adhere to the policy. Smokers report that having a smoking shelter supports their sense of autonomy and helps them feel respected. Read more about smoking shelter considerations in Policy planning.

Helping smokers adhere

Due to climate, safety concerns, disability, caregiving responsibilities, or other reasons, residents may find it difficult to go outside to smoke at certain times. Having an alternative source of nicotine that they can use in their unit may help residents adhere to the policy. Provide residents with information about resources that may help them reduce the amount of their smoking in their units.

Nicotine gum

Although the main purpose of nicotine replacement products such as gum and lozenges is to help people quit smoking, they can also relieve nicotine cravings that may tempt residents to smoke at times when it is difficult for them to go outside. It is uncommon for people to have side effects from using nicotine gum while continuing to smoke. If it does occur, it almost always presents as acute symptoms of nausea, vomiting, and/or dizziness, rather than any more concerning symptoms. Residents should be advised to consult their health care providers to make sure there are no special concerns before starting to use nicotine replacement therapy (NRT). Health care providers can also recommend the correct dosage for each smoker’s situation.

Read more about NRT in Supporting smoking cessation.

E-cigarettes

E-cigarettes deliver nicotine through vapor rather than smoke. The health risks of e-cigarettes have not been clearly established, although it is generally accepted that e-cigarettes or vaping devices have lower health risks than smoking cigarettes. Even less is known about secondhand exposure to vapor.

Read more about e-cigarettes in Policy planning.

Define and maintain smoking areas

Post signage that clearly indicates where smoking is and is not allowed.

PHAs that have been able to provide a shelter for smokers report higher policy adherence rates. It is important to maintain designated smoking areas to ensure that they are safe and well-lit.

Help address barriers

Accessibility issues may present challenges to adherence for some residents, such as people with disabilities. PHAs are allowed to make reasonable accommodations to assist residents in adhering to the smoke-free policy, for example, by moving a resident with a disability to the first floor or to a building with an elevator so they can more easily access areas where smoking is allowed.

The HUD Rule does not allow residents to smoke in their units as a reasonable accommodation.

Resources

Download Helping smokers adhere as a PDF