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Cohn AM, Zaring-Hinkle B, Catino JD, Ehlke SJ, Ware K, Alexander A, Smith MA, Jewell-Fleming S, Queimado L, Kendzor DE. Secondhand cannabis smoke exposure and respiratory symptoms among adults living in a state with legalized medical cannabis with limited smoke-free protections. Prev Med Rep 2024; 45:102835. [PMID: 39188973 PMCID: PMC11345892 DOI: 10.1016/j.pmedr.2024.102835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/19/2024] [Accepted: 07/20/2024] [Indexed: 08/28/2024] Open
Abstract
Background Little is known about the demographic and health correlates of secondhand cannabis smoke (SHCS) exposure, despite increased availability and use of cannabis across the U.S. This study examined the prevalence and correlates of SHCS exposure in a sample of N=5,410 adults living in Oklahoma and the association of SHCS exposure with self-reported respiratory problems. Methods Data were from a repeated cross-sectional online survey of adults ages 18 and older who completed measurements of past 30-day SHCS exposure in the respondent's home, in a vehicle, and/or in an indoor setting; harm perceptions of SHCS exposure; frequency of current respiratory symptoms; past 30-day use of cannabis, alcohol, and cigarettes. Results Almost half (42 %) reported past 30-day SHCS exposure. In bivariate tests, those exposed were male, younger, non-Hispanic (NH) black or Hispanic, reported lower educational and financial attainment, had lower harm perceptions of SHCS exposure, endorsed more respiratory symptoms, and reported past 30-day cannabis and cigarette use (all p's < 0.01). In an adjusted regression model, young adulthood (ages 18-24), NH black race (vs NH White), and past 30-day cigarette smoking and cannabis use emerged as the strongest correlates of SHCS exposure. In interaction models, respiratory symptoms were highest among those reporting past 30-day SHCS exposure and past 30-day cannabis use. Conclusion SHCS exposure is common and associated with more frequent respiratory symptoms, particularly among cannabis users. Those exposed were more socially and economically vulnerable.
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Affiliation(s)
- Amy M. Cohn
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 Children’s Aven, Suit 14000, Oklahoma City, OK, 73104, USA
| | - Brittany Zaring-Hinkle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
| | - Joshua D. Catino
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
- Social Sciences Department, Rose State College, 6420 S.E. 15 Street, Midwest City, OK 73110, USA
| | - Sarah J. Ehlke
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
| | - Kali Ware
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
- Social Sciences Department, Rose State College, 6420 S.E. 15 Street, Midwest City, OK 73110, USA
| | - Adam Alexander
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 80 Stanton L. Young Blvd, Oklahoma City, OK 73117, USA
| | - Michael A. Smith
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
| | - Sheri Jewell-Fleming
- Social Sciences Department, Rose State College, 6420 S.E. 15 Street, Midwest City, OK 73110, USA
| | - Lurdes Queimado
- Department of Otolaryngology Head and Neck Surgery, University of Oklahoma Health Sciences Center, 825 NE 10 Street, Suite 4c, Oklahoma City, OK 73104, USA
| | - Darla E. Kendzor
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, 655 Research Parkway, Suite 400, Oklahoma City, OK 73014, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 80 Stanton L. Young Blvd, Oklahoma City, OK 73117, USA
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Tripathi O, Bellettiere J, Liles S, Shi Y. Location and home rules of cannabis use - Findings from marijuana use and environmental survey 2020, a nationally representative survey in the United States. Prev Med Rep 2023; 35:102289. [PMID: 37408996 PMCID: PMC10319339 DOI: 10.1016/j.pmedr.2023.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/16/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
Cannabis combustion and aerosolization may be associated with adverse health for users and nonusers through secondhand and thirdhand exposure. As cannabis regulation becomes more lenient, understanding where cannabis is used and whether homes have rules restricting use is needed. This study aimed to identify locations, presence of other people, and in-home rules of cannabis use in the United States (U.S.). This secondary analysis of 3,464 inhalation-based (smoking, vaping, dabbing) cannabis users in past 12 months drew from a cross-sectional probability-based online panel of 21,903 U.S. adults in early 2020, providing nationally representative estimates. We describe presence of other people and location at most recent use (smoking, vaping, dabbing, respectively). We also describe household restrictions on in-home cannabis smoking by cannabis smokers vs non-smokers, and by presence of children in home. Cannabis smoking, vaping, and dabbing most often occurred at users' own homes (65.7%, 56.8%, and 46.9%, respectively). More than 60% of smoking, vaping, and dabbing occurred with someone else present. About 68% of inhalation-based cannabis users (70% and 55%, smokers and non-smokers, respectively) did not have complete restrictions on in-home cannabis smoking; among them, over a quarter lived with children under 18. In the U.S., inhalation-based cannabis use most commonly occurs at home, with others present and a substantial proportion of users lacking complete in-home cannabis smoking restrictions, raising risks of secondhand and thirdhand smoke exposure. These circumstances demand residential interventions for developing bans on indoor cannabis smoking, especially around vulnerable children.
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Affiliation(s)
- Osika Tripathi
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - John Bellettiere
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Sandy Liles
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Yuyan Shi
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Vijayaraghavan M, Hartman-Filson M, Vyas P, Katyal T, Nguyen T, Handley MA. Multi-Level Influences of Smoke-Free Policies in Subsidized Housing: Applying the COM-B Model and Neighborhood Assessments to Inform Smoke-Free Policies. Health Promot Pract 2023:15248399231174925. [PMID: 37209138 DOI: 10.1177/15248399231174925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents' ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.
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Affiliation(s)
| | | | - Priyanka Vyas
- California State University, East Bay, Hayward, CA, USA
| | - Toshali Katyal
- University of California, San Francisco, San Francisco, CA, USA
| | - Tram Nguyen
- University of California, San Francisco, San Francisco, CA, USA
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Yaskewich DM. Local Prohibitions on Marijuana Businesses With On-Site Consumption: Evidence from New York State. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221138229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
As several US states have legalized recreational marijuana over the past decade, local approval of commercial marijuana activities has faced opposition in a non-negligible share of communities. A common provision in state laws often grants local governments the authority to prohibit marijuana businesses from locating within their jurisdictions. This paper analyzed determinants of local government policies in New York State following the legalization of recreational marijuana in 2021. A key feature of New York’s law authorized municipal governments to pass an “opt-out” ordinance prohibiting marijuana retail stores, on-site consumption establishments, or both. Based on results from multilevel logistic regression models, the likelihood of allowing commercial marijuana activities was higher for local governments representing communities with larger Black populations, fewer evangelical Protestants, and lower levels of household income. While slightly more municipalities prohibited on-site consumption, determinants of opt-out decisions were similar for both retail and consumption businesses.
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Zajac L, Gallate X, Gu G, Liu B, Elaiho C, Lin E, Mogilner L, Oliver K, Vangeepuram N, Wilson K. Disparities in Marijuana and Tobacco Smoke Incursions Among New York City Families During Early Months of the COVID-19 Pandemic. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:248-257. [PMID: 34750327 PMCID: PMC8963431 DOI: 10.1097/phh.0000000000001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Once the COVID-19 pandemic arrived in New York City (NYC), stay-at-home orders led to more time spent indoors, potentially increasing exposure to secondhand marijuana and tobacco smoke via incursions from common areas or neighbors. The objective of this study was to characterize housing-based disparities in marijuana and tobacco incursions in NYC housing during the pandemic. DESIGN We surveyed a random sample of families from May to July 2020 and collected sociodemographic data, housing characteristics, and the presence, frequency, and pandemic-related change in incursions. SETTING Five pediatric practices affiliated with a large NYC health care system. PARTICIPANTS In total, 230 caregivers of children attending the practices. MAIN OUTCOME MEASURES Prevalence and change in tobacco and marijuana smoke incursions. RESULTS Tobacco and marijuana smoke incursions were reported by 22.9% and 30.7%, respectively. Twenty-two percent of families received financial housing support (public housing, Section-8). Compared with families in private housing, families with financial housing support had 3.8 times the odds of tobacco incursions (95% CI, 1.4-10.1) and 3.7 times the odds of worsening incursions during pandemic (95% CI, 1.1-12.5). Families with financially supported housing had 6.9 times the odds of marijuana incursions (95% CI, 2.4-19.5) and 5 times the odds of worsening incursions during pandemic (95% CI, 1.9-12.8). Children in financially supported housing spent more time inside the home during pandemic (median 24 hours vs 21.6 hours, P = .02) and were more likely to have asthma (37% vs 12.9%, P = .001) than children in private housing. CONCLUSIONS Incursions were higher among families with financially supported housing. Better enforcement of existing regulations (eg, Smoke-Free Public Housing Rule) and implementation of additional policies to limit secondhand tobacco and marijuana exposure in children are needed. Such actions should prioritize equitable access to cessation and mental health services and consider structural systems leading to poverty and health disparities.
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Affiliation(s)
- Lauren Zajac
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Xanthe Gallate
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Gregory Gu
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Bian Liu
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Cordelia Elaiho
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Elaine Lin
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Leora Mogilner
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Kristin Oliver
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Nita Vangeepuram
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
| | - Karen Wilson
- Department of Environmental Medicine and Public Health (Drs Zajac and Oliver), Department of Pediatrics, and Kravis Children's Hospital (Ms Elaiho and Drs Lin, Mogilner, Vangeepuram, and Wilson), Medical Education (Ms Gallate), and Department of Population Health Science and Policy, and Institute for Translational Epidemiology (Dr Liu), Icahn School of Medicine at Mount Sinai, New York City, New York; and Columbia University Post-Baccalaureate Program, New York City, New York (Mr Gu)
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Driezen P, Kaufman P, Chaiton M, Goodman S, Hammond D. Prevalence and factors associated with self-reported exposure to secondhand cannabis smoke in the United States and Canada in 2019. Prev Med 2022; 157:107006. [PMID: 35240141 DOI: 10.1016/j.ypmed.2022.107006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/10/2022] [Accepted: 02/23/2022] [Indexed: 10/19/2022]
Abstract
Little is known about exposure to secondhand cannabis smoke (SHCS) among residents of detached single-family homes and multiunit housing (MUH). Using data from the 2019 International Cannabis Policy Study, the prevalence of (a) self-reported exposure to SHCS at home (n = 33,024) and (b) self-reported SHCS incursions into MUH (defined as SHCS from another unit/the outdoors, n = 15,634) was estimated in (1) Canada; (2) US states where non-medical cannabis use was legal, and (3) US states where it remained illegal. Factors associated with exposures and incursions were assessed using weighted logistic regression. Overall, 16.9% of residents in Canada, 20.6% in US legal states, and 15.5% in US illegal states reported exposure to SHCS in their homes at least once in the previous month. One quarter (25.7%) of Canadian MUH residents, 26.6% from US legal states, and 20.1% from US illegal states reported at least monthly incursions. Sociodemographic factors associated with incursions suggested MUH residents reporting incursions lived in qualitatively different MUH than those not reporting incursions. Irrespective of the legality of non-medical cannabis use, smoke-free policies in MUH should protect residents from involuntary exposure to all types of secondhand smoke.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
| | - Pamela Kaufman
- Ontario Tobacco Research Unit, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Michael Chaiton
- Ontario Tobacco Research Unit, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
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Wade NE, McCabe CJ, Wallace AL, Gonzalez MR, Hoh E, Infante MA, Mejia MH, Haist F. Clouding up cognition?: Secondhand cannabis and tobacco exposure related to cognitive functioning in youth. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:233-242. [PMID: 37124351 PMCID: PMC10140452 DOI: 10.1016/j.bpsgos.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background Increasing legalization of cannabis, in addition to longstanding rates of tobacco use, raises concerns for possible cognitive decrements from secondhand smoke or environmental exposure, although little research exists. We investigate the relation between cognition and secondhand and environmental cannabis and tobacco exposure in youth. Methods The Adolescent Brain Cognitive Development (ABCD) Study year 2 follow-up (N = 5580; 48% female) cognitive performance and secondhand or environmental cannabis or tobacco exposure data were used. Principal components analysis identified a global cognition factor. Linear mixed-effects models assessed global cognition and individual cognitive task performance by cannabis and/or tobacco environmental exposure. Sociodemographics and other potential confounds were examined. p values were adjusted using the false discovery rate method. Results Global cognition was not related to any exposure group after testing corrections and considering confounds. Beyond covariates and family- and site-level factors, secondhand tobacco was related to poorer visual memory (p = .02), and environmental tobacco was associated with poorer visuospatial (p = .02) and language (p = .008) skills. Secondhand cannabis was related to cognition, but not after controlling for potential confounders (p > .05). Environmental cannabis was related to better oral reading (p = .01). Including covariates attenuated effect sizes. Conclusions Secondhand tobacco exposure was associated with poorer visual memory, while environmental tobacco exposure was related to poorer language and visuospatial skills. Secondhand cannabis was not related to cognition after controlling for sociodemographic factors, but environmental cannabis exposure was related to better reading. Because, to our knowledge, this is the first known study of its kind and thus preliminary, secondhand cannabis should continue to be investigated to confirm results.
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Affiliation(s)
- Natasha E. Wade
- Department of Psychiatry, University of California San Diego, San Diego, California
- Address correspondence to Natasha E. Wade, Ph.D.
| | - Connor J. McCabe
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Alexander L. Wallace
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Marybel R. Gonzalez
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, California
| | - M. Alejandra Infante
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Margie Hernandez Mejia
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Frank Haist
- Department of Psychiatry, University of California San Diego, San Diego, California
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Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312565. [PMID: 34886292 PMCID: PMC8656672 DOI: 10.3390/ijerph182312565] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
Abstract
In 2018, the U.S. Department of Housing and Urban Development required public housing authorities to implement a smoke-free housing (SFH) policy that included individual apartments. We analyzed the policy implementation process in the New York City Public Housing Authority (NYCHA). From June-November 2019, we conducted 9 focus groups with 64 NYCHA residents (smokers and nonsmokers), 8 key informant interviews with NYCHA staff and resident association leaders, and repeated surveys with a cohort of 130 nonsmoking households pre- and 12-month post policy. One year post policy implementation, participants reported widespread smoking violations and multi-level factors impeding policy implementation. These included the shared belief among residents and staff that the policy overreached by "telling people what to do in their own apartments". This hindered compliance and enforcement efforts. Inconsistent enforcement of illegal marijuana use, staff smoking violations, and a lack of accountability for other pressing housing issues created the perception that smokers were being unfairly targeted, as did the lack of smoking cessation resources. Resident support for the policy remained unchanged but satisfaction with enforcement declined (60.1% vs. 48.8%, p = 0.047). We identified multilevel contextual factors that are influencing SFH policy implementation. Findings can inform the design of strategies to optimize policy implementation.
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Sangmo L, Liu B, Elaiho C, Boguski L, Yaker M, Resnick M, Malbari A, Wilson KM. Reported Marijuana and Tobacco Smoke Incursions Among Families Living in Multiunit Housing in New York City. Acad Pediatr 2021; 21:670-676. [PMID: 33460815 DOI: 10.1016/j.acap.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/05/2021] [Accepted: 01/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND While public knowledge on the prevalence and adverse health effects of secondhand tobacco smoke exposure is well established, information on the prevalence of secondhand marijuana smoke (SHMS) exposure is limited. METHODS A convenience sample of parents of children attending 1 of 4 pediatric practices in the Mount Sinai Health System completed an anonymous questionnaire assessing demographics, housing characteristics, and the child's health status, as well as smoke incursions and household smoking behaviors. RESULTS About 450 parents completed the survey between 2018 and 2019; those with incomplete data were excluded, and 382 surveys were included in the analysis. Approximately 40% of the children were white; the median age was 15 months (interquartile range: 5-40 months). About 30.9% (n = 118) of participants reported marijuana incursions in their home while with their child, while 33.5% (n = 122) reported tobacco smoke incursions. SHMS exposure differed by race (P = .0043); and by housing types (P < .0001). Participants in New York City Housing Authority (NYCHA) developments were more likely to report smelling SHMS (adjusted odds ratio = 3.45, 95% confidence interval = 1.18, 10.10], P = .02). Those in Section 8 housing were also more likely to report smelling SHMS, but the association was not significant (adjusted odds ratio = 3.29, 95% confidence interval = 0.94, 11.55, P = .06). Approximately two thirds of the participants reported viewing marijuana smoke as being harmful to their child. CONCLUSIONS About one third of the families enrolled in the study reported smelling SHMS while at home with their child. Reported marijuana smoke exposure was associated with living in NYCHA housing. Policies that limit all smoke in multiunit housing should be supported.
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Affiliation(s)
- Lodoe Sangmo
- Icahn School of Medicine at Mount Sinai (L Sangmo), New York City, NY
| | - Bian Liu
- Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai (B Liu), New York City, NY
| | - Cordelia Elaiho
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY
| | - Lisa Boguski
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY
| | - Michael Yaker
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY
| | - Micah Resnick
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY
| | - Alefiyah Malbari
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY
| | - Karen M Wilson
- Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai (C Elaiho, L Boguski, M Yaker, M Resnick, A Malbari, and KM Wilson), New York City, NY.
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Lozinsky CH, Touchie MF. Inter-zonal airflow in multi-unit residential buildings: A review of the magnitude and interaction of driving forces, measurement techniques and magnitudes, and its impact on building performance. INDOOR AIR 2020; 30:1083-1108. [PMID: 32643179 DOI: 10.1111/ina.12712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/15/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Inter-zonal airflows within multi-unit residential buildings (MURBs) have profound impacts on an array of building performance metrics, including energy, indoor air quality (IAQ), fire and acoustical separations, and distribution of ventilation air. Although there are wide-ranging implications, most building codes/standards have yet to incorporate airtightness requirements for interior partitions in large, multi-zone structures, and instead focus primarily on exterior envelope airtightness. Despite the multi-disciplinary nature of the topic, previous reviews have been limited to one domain (eg, energy performance, IAQ, specific test methods). This paper presents a comprehensive summary of the literature on inter-zonal airflow in MURBs including the magnitude and interaction of driving forces; its relevance to/effect on building performance; current code requirements; testing methods; and previous measurements. While considerable efforts have been made in recent years to quantify and control inter-zonal airflows, most measurement techniques are still labor-intensive and disruptive, and there is no framework for how to implement performance-based requirements into building codes and standards. Further research efforts should be focused on refining testing methods and preparing the construction industry for code changes.
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Affiliation(s)
- Cara H Lozinsky
- Department of Civil and Mineral Engineering, University of Toronto, Toronto, ON, Canada
| | - Marianne F Touchie
- Department of Civil and Mineral Engineering, University of Toronto, Toronto, ON, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
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