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Attachment 1 3#/0% /& 4(% )335% Secondhand smoke exposure is a leading cause of preventable disease and death in the United States. Secondhand smoke, classified by the Environmental Protection Agency as a Group A 1 carcinogen, contains more than 7,000 chemicals. Over 58 million nonsmoking Americans are exposed to secondhand smoke, with smoke exposure contributing to approximately 41,000 2 deaths among nonsmoking adults and 400 deaths of infants each year. Since the 1964 Surgeon 1 caused or exacerbated by exposure to secondhand smoke. Secondhand smoke causes stroke, asthma, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung 2 growth. One quarter of US residents- approximately 79 million people- live in multi-unit properties. Although the majority of people do not allow smoking in their homes, 36 percent 3 are regularly exposed to secondhand smoke.Secondhand smoke travels easily from unit-to- unit within multi-unit housing and the home is the predominant location for the exposure of 6 children and adults to secondhand smoke. Prohibiting smoking indoors is the only way to eliminate secondhand smoke from the indoor environment. Ventilation and filtration 7 techniques can reduce, but not eliminate, secondhand smoke exposure. 2!-3%9 #/5.49 02/&),% Ramsey County is the county seat and capital city of Minnesota located in the Twin Cities metropolitan area. With a population of 540,649 as of July 1, 2016, it is the most fully- developed and densely populated county in the state, as well as one of the most diverse. About 56 percent of county residents reside in Saint Paul. The suburban area includes communities that range in size from Gem Lake (500 people) to Maplewood (40,000 people). The largest minority populations are Asians (13 percent) and African American (11.1 percent). About 7.3 percent of residents have a Hispanic or Latino ethnic background. 21.9 4 ages five years and older live in homes where a language other than English is spoken.Ramsey 5 County is estimated to contain 220,680 housing units, 59.3% of which are owner occupied. METHODOLOGY Staff from the Live Smoke Free program and Saint Paul - Ramsey County Public Health met in December 2018 to determine criteria for whom to survey and to refine survey questions. Live Smoke Free maintains a comprehensive list of multi-unit properties in Ramsey County which includes information about their smoking policies, number of units and if available, the number of residents residing in those properties. A map was created to visualize the geographic distribution of multi-unit properties with a smoke-free policy and those without a smoke-free policy throughout Ramsey County. The project team then prioritized 30 multi-unit properties based on their geographic distribution, smoking policy type, housing type (market rate versus subsidized), and building size to provide the best representation of the county and then narrowed the selection to ten. The property managers of the ten properties were contacted to solicit their interest in participating in the survey process. Property managers distributed paper Page 2 of 2 Qbhf!91!pg!33: