Reported Marijuana and Tobacco Smoke Incursions Among Families Living in Multiunit Housing in New York City.

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.

Secondhand marijuana exposure in a convenience sample of young children in New York City.

BACKGROUND: Biomarkers of exposure to marijuana smoke can be detected in the urine of children with exposure to secondhand marijuana smoke, but the prevalence is unclear. METHODS: We studied children between the ages of 0 to 3 years who were coming in for well-child visits or hospitalized on the inpatient general pediatric unit between 2017 and 2018 at Kravis Children's Hospital at Mount Sinai. Parents completed an anonymous survey, and urine samples were analyzed for cotinine and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (COOH-THC), a metabolite of Δ9-tetrahydrocannabinol. RESULTS: Fifty-three children had urine samples available for analysis. COOH-THC was detectable in 20.8% of the samples analyzed and urinary cotinine was detectable in 90.2%. High levels of tobacco exposure (defined as cotinine ≥2.0 ng/ml) were significantly associated with COOH-THC detection (p < 0.01). We found that 34.8% of children who lived in attached housing where smoking was allowed within the property had detectable COOH-THC compared to 13.0% of children who lived in housing where smoking was not allowed at all. CONCLUSIONS: This study adds to the growing evidence that children are being exposed to marijuana smoke, even in places where recreational marijuana use is illegal. It is critical that more research be done on the impact of marijuana smoke exposure on children's health and development. IMPACT: We found that 20.8% of the 53 children recruited from Mount Sinai Hospital had detectable marijuana metabolites in their urine. Children with household tobacco smoke exposure and children who lived in attached housing where smoking was allowed on the premises were more likely to have detectable marijuana smoke metabolites. This study adds to the growing evidence that children are being exposed to marijuana smoke, even in places where marijuana remains illegal by state law. As states consider marijuana legalization, it is critical that the potential adverse health effects from marijuana exposure in children be taken into account.

The Experiences of Minors Seeking Asylum in the United States: A Modified Consensual Qualitative Research Analysis.

Minors fleeing violence in their countries of origin constitute a significant portion of asylum seekers in the United States. Medical and mental health professionals provide continuity care services and offer pro bono forensic evaluations for this population to document evidence of human rights abuses and torture. The present study included a retrospective, qualitative chart review of deidentified personal declarations and clinician medico-legal affidavits associated with 36 asylum seekers under 21 years of age. Data were analyzed through a modified consensual qualified research (CQR-M) approach to identify patterns in these individuals' reports of persecution and assess health outcomes. Among the cases studied, violence by organized criminal groups (47.2%), family-based violence (44.4%), and gender-based violence (44.4%) were the most commonly cited reasons minors sought asylum. Evaluators documented a wide range of psychological sequelae: 80.5% of minors presented with clinically significant symptoms associated with trauma- and stressor-related disorders, depression, and/or anxiety at the time of their applications for asylum. Of note, almost three-quarters of the minors reported current enrollment in school and two-thirds reported factors related to adaptive functioning. Despite reported exposure to premigratory and migratory trauma, postmigratory stressors, and psychological sequelae related to their experiences of violence, these young asylum seekers exhibited signs of resilience and a range of health-promoting strengths.