Post on 18-Aug-2015
A Critical Review of an Interdisciplinary Solution Authored by: Samantha Cochran
An analytical review of the article “National and State Cost Savings Associated With
Prohibiting Smoking in Subsidized and Public Housing in the United States” by Brian A.
King, PhD, MPH; Richard M. Peck, PhD; and Stephen D. Babb, MPH.
November 30, 2014
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Introduction
The Problem
The effects of tobacco on the body have been studied extensively by independent
and government scientists. The CDC has defined secondhand smoke as any smoke from a
burning tobacco product or any smoke that has been exhaled by a person smoking a
tobacco product (2)(6). Smoking is estimated to cause 440,000 deaths per year in the US
(3). Secondhand smoke is estimated to cause 7,330 deaths from lung cancer and 33,950
deaths from heart disease among US adult nonsmokers (1). A separate source from the CDC
states that since 1964, 2.5 million nonsmokers have died from the effects of secondhand
smoke (2). In the article, “National and State Cost Savings Associated With Prohibiting
Smoking in Subsidized and Public Housing in the United States,” the authors cite the US
Surgeon General’s assessment that there is no risk-free level of secondhand smoke
exposure (1)(6). A separate study concluded the overall cost of health care and premature
loss of life attributed to secondhand smoke for the US was estimated to be $53.9 million in
2000(7). In the US, smoking tobacco products is legal, and thus the personal choice of
smokers. However, this choice does not only affect the smoker, but rather affects the people
around the secondhand smoke the smoker produces.
In the US there have been measures undertaken to reduce the public presence of
secondhand smoke, such as prohibiting smoking in all indoor public places and worksites
(1). However, these measures have not extended into the homes of smokers. The article,
“National and State Cost Savings Associated With Prohibiting Smoking in Subsidized and
Public Housing in the United States” has identified a portion of the American people that
are at risk of developing health problems from exposure to secondhand smoke. The article
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states that people in multiunit housing are particularly vulnerable to secondhand smoke
because the smoke can permeate into adjacent units of non-smokers (1). These multiunit
houses will be the focus of the potential first step towards reducing the cost of secondhand
smoke in America.
The Solution
In America, there are approximately 80 million multiunit housing residents that could
be at an increased risk of secondhand smoke exposure. Of the 80 million residents of
multiunit housing, 7 million live in subsidized or public housing (1)(7). The article by King,
Peck, and Babb states a possible first step towards reducing the health impact of
secondhand smoke. By prohibiting smoking in subsidized housing, the authors propose “an
annual cost savings of $496.82 million (range, $258.96–$843.50 million), including $310.48
million ($154.14–$552.34 million) in secondhand smoke-related health care, $133.77
million ($75.24–$209.01 million) in renovation expenses, and $52.57 million ($29.57–
$82.15 million) in smoking-attributable fire losses (1).” Statistical analysis instructs that if
the range includes the number “0”, the results are not statistically significant. Because the
range includes only positive numbers, the results are statistically significant and provide a
numerical representation of the cost benefit of prohibiting smoking in subsidized housing.
Research
Key Aspects of Article
The article by King, Peck, and Babb considers the topic of implementing a "smoke-
free" environment in subsidized and public housing for both a cost and health benefit using
an interdisciplinary approach. The threats of second hand smoke and national debt seem
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unrelated, but the authors believe they can be tackled together with an interdisciplinary
approach. Through analytical research of data collected on smoke-related costs, the article
determines correlation between allowing smoking in subsidized housing and $496.82
million (range, $258.96–$843.50 million) in economic impact on the US. The authors Brian
A. King, PhD, MPH; Richard M. Peck, PhD; and Stephen D. Babb, MPH are all highly educated
key thinkers in their field.
The authors make the assumption that the impact of secondhand smoke-related
healthcare costs could be reduced with the decrease in secondhand smoke exposure. This,
however, would not immediately reduce all of the secondhand smoke-related health costs
of the people currently exposed in multiunit subsidized housing. There are already health
problems in the people exposed that will cause them to need health care throughout their
lives, thus reducing the initial impact of their solution. The authors do try to limit the
assumptions made in order to reduce the bias and error of their study.
Key Elements of Interdisciplinary Research
Augsburg states that an interdisciplinary approach must include a broad interest
and competence in one’s field (4). The authors displays competency in their respective
fields and uses their information to create a solution that covers a broad selection of
disciplines. Although the authors include multiple disciplines in their approach, Augsburg
defines interdisciplinary as, “combining or involving two or more disciplines or fields of
study (4).” To be truly interdisciplinary, one must successfully combine the discipline, not
just refer to them separately.
Identifying the key elements of interdisciplinary research as stated by Augsburg in
Becoming Interdisciplinary provides a framework for which to analyze an article’s
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interdisciplinary approach. A few of the most important items to identify are the discipline
subject matter, research method, and key concept (4). The value of identifying these
characteristics allows the reader to justify the interdisciplinarity of the article. Multiple
disciplines must be identified by the author and successfully integrated into a cohesive
argument for change.
Disciplines in Article Conclusion
These sources of this article come from multiple disciplines, including economic
policy, statistical analysis, physics, public policy, behavioral studies, architecture,
economics, housing and urban development, and medicine. Each discipline plays an
integral role in determining the factors that affect the possibly solution presented in the
article. The authors integrate the statistical analysis and economic impacts to determine
the quality of their potential results. While determining the fields the solution would affect,
and the fields that are involved in the problem itself, they include fire safety, architecture,
air flow, air quality, and medicine. To determine a solution, they bridge the disciplines of
public policy, behavioral studies, and economic policy. Each step of their research and
conclusions has a specific set of disciplines that combine to form their integrated approach
to a complex problem facing America. Additional disciplines could be considered as the
solution is carried out, such as communication (to enact the plans) and law (to successfully
write the federal documents that would enact the new policy).
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Discussion
Integrity of Sources in the Article
In the article, “National and State Cost Savings Associated With Prohibiting Smoking
in Subsidized and Public Housing in the United States,” the author uses thirty sources for
supporting his thesis. These sources come from multiple areas of study, including economic
policy and impact of smoking on Americans, the CDC analysis of health impact of smoking,
air quality studies on secondhand smoke transfer in multiunit housing, public policy of
non-smoking in public housing, behavioral studies of tenants, home structure fire analysis,
the economic impact of fire in the US, housing and urban development, analysis of human
activity patterns, and medical research of smoking and treatments (1). These varied
sources, combined with the reputable nature of the sources, give the article’s research
integrity and value.
Rebuttal
Despite the overall validity of the article’s findings, there is another perspective that
could influence how the findings are carried out. The American people are strongly against
the illegalization of smoking. When asked if smoking should be made totally illegal, 79%
said “no” in 2014. However, 56% said “yes” to the question of whether smoking should be
made illegal in public places (5). While American support still favors the idea of smoking
being permitted, it will be hard to implement new policies of smoking bans.
Additionally, it is important to mention that, as the author of this paper, I am subject to my
history, allowing for bias. While my mother was pregnant with my brother and myself she
decided to continue smoking. Her choice caused my brother to be born with Asthma and
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me to be born with an allergy to smoke. Every time I inhale smoke I become dizzy,
nauseous, and find it difficult to breathe. I live in an apartment unit that is frequently
permeated by tobacco and cannabis smoke from neighbors. Their blatant disrespect for the
health of others forces me to be exposed to secondhand smoke daily, despite choosing to
inhabit a smoke-free household. The topic of reducing secondhand smoke exposure to
people who choose to live smoke-free is important to me, but also makes me biased. My
bias could have an effect on my position taken throughout this analysis. However, I
endeavored to use my disciplines of Computational Sciences, Biological Sciences, and
Health Sciences alongside reputable sources and logic to form an impartial analysis of the
research and assertions made by the authors of "National and State Cost Savings Associated
With Prohibiting Smoking in Subsidized and Public Housing in the United States."
Conclusion
Based on the interdisciplinary text we have been reading in this class, I believe the
article’s solution is an interdisciplinary approach. The authors use data and studies from
multiple disciplines to develop their thesis, then further integrate multiple disciplines into
a solution that would require professionals in many different fields to work together. In
order to draft the bill that would make their proposal a reality, people from the fields of
law, medicine, public policy, physics, architecture, behavioral studies, and housing and
urban development would have to work together to determine the best way to successfully
solve the problem established in the article. The US is currently becoming more educated
and health conscious, giving way to a new era where this article could actually have a
chance to become a reality. The people of the US want less health costs and more clean air.
Even the University of Central Florida recognized the trend and went “smoke-free” in 2012.
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With help from multiple disciplines working together, this interdisciplinary approach could
save millions of dollars, and more importantly millions of lives.
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Annotated Bibliography
1. King, Brian A., Richard M. Peck, and Stephen D. Babb. "National and State Cost
Savings Associated With Prohibiting Smoking in Subsidized and Public Housing in
the United States." Preventing Chronic Disease 11.E171 (2014): n. pag. Centers for
Disease Control and Prevention, Oct. 2014. Web. 25 Oct. 2014.
<http://www.cdc.gov/pcd/issues/2014/14_0222.htm>.
This article details a potential interdisciplinary approach to alleviating the negative
role smoking plays in the American healthcare system. The article will be analyzed
based on its sources, ideas, assumptions, and interdisciplinarity.
2. "Secondhand Smoke (SHS) Facts." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 11 Apr. 2014. Web. 15 Nov. 2014.
<cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/ind
ex.htm?mobile=nocontent>.
This article will be as a sources for reliable information concerning secondhand
smoke and its health impacts on the human body. It is used to define secondhand
smoke and examine the negative effect secondhand smoke has on the human body.
It is published by the Center for Disease Control and cites reliable government and
medical sources.
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3. "Toll of Tobacco in the United States." Centers for Disease Control and Prevention.
Penn State University, 18 Mar. 2009. Web. 17 Nov. 2014.
<http://www.med.upenn.edu/cirna/pdf/USA_Figures.pdf>.
This source is a compilation of facts to verify the validity of the figures presented in
the article I am analyzing. This source provided the data of how many deaths were
recorded concerning smoking as a whole. The article is published by the Penn State
University, with sources from the CDC and SAMHSA. It is a reliable source of data.
4. Augsburg, Tanya. Becoming Interdisciplinary: An Introduction to Interdisciplinary
Studies. Dubuque, IA: Kendall/Hunt Pub., 2006. Print.
This text provided the key aspects of interdisciplinary research. Additionally, it was
used to define the term “interdisciplinary”. It is the text assigned to this class and is
therefore a reliable source of information.
5. Riffkin, Rebecca. "Americans Favor Ban on Smoking in Public, but Not Total Ban."
Americans Favor Ban on Smoking in Public, but Not Total Ban. GALLUP, 30 July
2014. Web. 21 Nov. 2014. <http://www.gallup.com/poll/174203/americans-favor-
ban-smoking-public-not-total-ban.aspx>
This website displays the graphical representation of the polls given to Americans
concerning their opinion on the illegalization of smoking. The source conducted the
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GALLUP poll, which is used by many reputable scholarly journal articles as evidence.
This website is the source of the figures at the end of this paper.
6. "Secondhand Smoke and Cancer." National Institute of Health. National Cancer
Institute, Jan. 2011. Web. 29 Oct. 2014.
<http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS>.
This source details a fact sheet about secondhand smoke and its effect on cancer. It
is published by the National Cancer Institute at the National Institute of Health. This
is a credible source of information on public health. The article is an informative list
of facts about secondhand smoke. It is the authority on the effects of secondhand
smoke. This source will provide valuable background knowledge on a main topic in
my analysis of the article I have chosen. It will provide detailed information about
secondhand smoke from the discipline of Biological Health.
7. Zollinger, T. W., R. M. Saywell, Jr., A. D. Overgaard, S. J. Jay, A. M. Holloway, and S. F.
Cummings. "Estimating the Economic Impact of Secondhand Smoke on the Health of
a Community." American Journal of Health Promotion 18.3 (2004): 232-38. National
Center for Biotechnology Information. U.S. National Library of Medicine, Jan. 2004.
Web. 1 Nov. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/14748313>.
This journal article details an analysis of the economic impact of secondhand smoke
on the health community. It is published in the American Journal of Health
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Promotion, a reliable source of scholarly articles. Additionally, it is electronically
accessible through the U.S. National Library of Medicine. The information provided
supports the main argument in the article I have chosen to analyze. There is use of
statistical analysis and detailed demographic studies. The information is based in
economic analysis from the discipline of Statistics and Public Policy. I will use this
source to support the arguments made in the article I have chosen to analyze.
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Figures
Figure 1
Figure 2
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Interdisciplinary Statement
While progressing through my degree in Biological Sciences, I realized that my approach to
Public Health had become one-sided and biased. My degree in Interdisciplinary Studies
allowed me the opportunity to learn how to approach problems from multiple
perspectives, integrating all of the pertinent information for a fair and effective solution.
This analysis of a large scale problem with a focus of Interdisciplinary intervention
enlightened me in the true path I want to take in life. Until now, I couldn't verbalize what I
felt I needed to contribute to our society's public health system. I would like to apply my
new tools of analysis to the large scale problems facing the healthcare system in the CDC. I
hope to use this project as a justification of my abilities for admission to Graduate School
and as a basis for my skills. It will allow my future advisors to focus on areas where I need
improvement and help me to become a contribution to the field.