Levy Douglas E, Adamkiewicz Gary, Rigotti Nancy A, Fang Shona C, Winickoff Jonathan P
Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, United States of America; Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2015 Sep 11;10(9):e0137740. doi: 10.1371/journal.pone.0137740. eCollection 2015.
To protect residents from tobacco smoke exposure (TSE), the Boston Housing Authority (BHA) prohibited smoking in BHA-owned apartments beginning in 2012. Our goal was to determine if the smoke-free policy reduced TSE for non-smoking BHA residents.
We compared TSE before the smoke-free policy (2012) and one year later among BHA residents as well as residents of the neighboring Cambridge Housing Authority (CHA) where no such policy was in place. Participants were a convenience sample of adult non-smoking BHA and CHA residents cohabitating with only non-smokers. Main outcomes were 7-day airborne nicotine in participants' apartments; residents' saliva cotinine; and residents' self-reported TSE.
We enrolled 287 confirmed non-smokers (192 BHA, 95 CHA). Seventy-nine percent (229) were assessed at follow-up. At baseline, apartment and resident TSE were high in both housing authorities (detectable airborne nicotine: 46% BHA, 48% CHA; detectable saliva cotinine: 49% BHA, 70% CHA). At follow-up there were significant but similar declines in nicotine in both sites (detectable: -33% BHA, -39% CHA, p = 0.40). Detectable cotinine rose among BHA residents while declining among CHA participants (+17% BHA vs. -13% CHA, p = 0.002). Resident self-reported TSE within and outside of the housing environment decreased similarly for both BHA and CHA residents.
Apartment air nicotine decreased after the introduction of the smoke-free policy, though the decline may not have resulted from the policy. The BHA policy did not result in reduced individual-level TSE. Unmeasured sources of non-residential TSE may have contributed to BHA residents' cotinine levels.
为保护居民免受烟草烟雾暴露（TSE），波士顿住房管理局（BHA）自2012年起禁止在其所属公寓内吸烟。我们的目标是确定无烟政策是否降低了非吸烟BHA居民的烟草烟雾暴露。
我们比较了无烟政策实施前（2012年）以及一年后的BHA居民和邻近未实施此类政策的剑桥住房管理局（CHA）居民的烟草烟雾暴露情况。参与者是与非吸烟者同居的成年非吸烟BHA和CHA居民的便利样本。主要结果是参与者公寓内7天的空气中尼古丁含量；居民的唾液可替宁；以及居民自我报告的烟草烟雾暴露情况。
我们招募了287名经确认的非吸烟者（192名BHA居民，95名CHA居民）。79%（229名）在随访时接受了评估。在基线时，两个住房管理局的公寓和居民烟草烟雾暴露水平都很高（可检测到的空气中尼古丁：BHA为46%，CHA为48%；可检测到的唾液可替宁：BHA为49%，CHA为70%）。在随访时，两个地点的尼古丁含量都有显著但相似的下降（可检测到的：BHA下降33%，CHA下降39%，p = 0.40）。BHA居民中可检测到的可替宁上升，而CHA参与者中则下降（BHA上升17%，CHA下降13%，p = 0.002）。BHA和CHA居民在住房环境内外自我报告的烟草烟雾暴露情况下降相似。
无烟政策实施后，公寓空气中的尼古丁含量有所下降，尽管这种下降可能并非该政策所致。BHA政策并未导致个人层面的烟草烟雾暴露减少。未测量的非居住性烟草烟雾暴露来源可能导致了BHA居民的可替宁水平升高。
