• Sarah Gehlert, Vaughan W Rees, Kelvin Choi, Peter D Jackson, Brynn E Sheehan, Richard A Grucza, Amy C Paulson, and Andrew D Plunk.
• Brown School, Washington University in St. Louis, St. Louis, Missouri; Institute for Addiction Science, University of Southern California, Los Angeles, California.
• Am J Prev Med. 2023 Sep 1; 65 (3): 512516512-516.

IntroductionThis 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, measured by ambient particulate matter at the 2.5-micron threshold, a marker for secondhand smoke.MethodsParticulate matter at the 2.5-micron threshold was measured in 6 public-housing buildings 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.ResultsIndoor particulate matter at the 2.5-micron threshold was 10.29 μg/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.ConclusionsStay-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 socioeconomically 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 policy failures in future public health crises.Copyright © 2023 American Journal of Preventive Medicine. All rights reserved.

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