COVID-19 Stay-At-Home Orders and Secondhand Smoke in Public Housing

Introduction: This study aimed to better understand the inequitable impact of the pandemic by examining the associations between stay-at-home orders and indoor smoking in public housing, mea-sured by ambient particulate matter at the 2.5-micron threshold, a marker for secondhand smoke.Methods: Particulate matter at the 2.5-micron threshold was measured in 6 public-housing build-ings in Norfolk, VA from 2018 to 2022. Multilevel regression was used to compare the 7-week period of the Virginia stay-at-home order in 2020 with that period in other years.Results: Indoor particulate matter at the 2.5-micron threshold was 10.29 mg/m3 higher in 2020 (95% CI=8.51, 12.07) than in the same period in 2019, a 72% increase. Although particulate matter at the 2.5-micron threshold improved in 2021 and 2022, it remained elevated relative to the level in 2019.Conclusions: Stay-at-home orders likely led to increased indoor secondhand smoke in public housing. In light of evidence linking air pollutants, including secondhand smoke, with COVID-19, these results also provide further evidence of the disproportionate impact of the pandemic on socio-economically disadvantaged communities. This consequence of the pandemic response is unlikely to be isolated and calls for a critical examination of the COVID-19 experience to avoid similar pol-icy failures in future public health crises. Am J Prev Med 2023;65(3):512-516.& COPY; 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.