- According to the U.S. surgeon general, non-smokers exposed to secondhand smoke see their chances of developing lung cancer or heart disease by at least 25 percent, making it a major public health concern. Smoking in nursing homes can be dangerous in other ways. Some seniors have fallen asleep while smoking in bed, which can lead to fires. Plus, the building's prolonged exposure to cigarette smoke can have a cumulative health effect.
- HUD's policies recognize the rights of the state, municipality or the nursing home owner to set its own policies when it comes to smoking. HUD stresses that nursing homes should follow whatever guidelines for smoking are set forth by the state or local government, but may also set its own policies to ensure the safety of their residents. Furthermore, HUD's own legal counsel in 2002 said that HUD recognizes the rights of nursing homes to make their buildings smoke-free, saying there is no policy prohibiting a property owner from setting such a policy.
- While HUD does not set forth rules on smoking in nursing homes, it does offer guidelines for implementing such a policy, should a nursing-home owner choose to do so. First, they should give residents plenty of time to adapt to the policy. HUD recommends at least six months. Next, they should seek to change the house rules and not the lease, because changing the lease would require more legal hoops. Tenants must know about a change in house rules for 30 days, and each must sign and date the new rules, making the policy an addendum to the lease. The nursing-home owner should also meet with residents to answer questions. The owner could also offer to "grandfather in" current smokers. HUD does not recommend trying to sneak the new rules by tenants.
- For nursing home owners who need guidelines in order to set non-smoking policies, HUD recommends the model policies created by the Center for Social Gerontology (TCSG). TCSG created several different types of model policies for nursing homes and other senior facilities such as senior centers and adult day care. TCSG's model guidelines for nursing homes focus on protecting tenants and employees from the dangers of second-hand smoke.
- TCSG says that 10 percent of seniors in nursing homes or assisted-living facilities are smokers. While their model guidelines are designed to create a smoke-free facility, they also have model guidelines to accommodate smokers, while also protecting non-smokers from second-hand smoke. The guidelines are designed to emphasize safety and respect for the rights of all persons in the facility.
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