Academic Journal
Safer inhalation devices: a rapid Health Impact Assessment of a harm reduction pilot for people who smoke crack cocaine.
| Τίτλος: | Safer inhalation devices: a rapid Health Impact Assessment of a harm reduction pilot for people who smoke crack cocaine. |
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| Συγγραφείς: | Ashton K; Wales Health Impact Assessment Support Unit (WHIASU), Policy and International Health Directorate, Public Health Wales NHS Trust, Cardiff, Wales, UK. kathryn.ashton2@wales.nhs.uk., Gray B; Health Protection Directorate, Communicable Disease Inclusion Health Programme (CDIHP), Public Health Wales NHS Trust, Cardiff, Wales, UK., Lines R; Health Protection Directorate, Communicable Disease Inclusion Health Programme (CDIHP), Public Health Wales NHS Trust, Cardiff, Wales, UK., Harman D; Health Protection Directorate, Communicable Disease Inclusion Health Programme (CDIHP), Public Health Wales NHS Trust, Cardiff, Wales, UK., Green L; Wales Health Impact Assessment Support Unit (WHIASU), Policy and International Health Directorate, Public Health Wales NHS Trust, Cardiff, Wales, UK. |
| Πηγή: | Harm reduction journal [Harm Reduct J] 2026 Jan 13; Vol. 23 (1), pp. 34. Date of Electronic Publication: 2026 Jan 13. |
| Τύπος έκδοσης: | Journal Article; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BioMed Central Country of Publication: England NLM ID: 101153624 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7517 (Electronic) Linking ISSN: 14777517 NLM ISO Abbreviation: Harm Reduct J Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BioMed Central, c2004- |
| Ιατρικοί όροι (MeSH): | Crack Cocaine*/adverse effects , Harm Reduction* , Cocaine-Related Disorders* , Nebulizers and Vaporizers*, Humans ; Wales ; Pilot Projects ; Female ; Male |
| Περίληψη: | Background: People who smoke crack cocaine face significant health risks, including communicable diseases and damage to respiratory health, particularly when using shared or homemade equipment. Despite this, there are currently no targeted harm reduction interventions in Wales for this population. This unique study demonstrates how Health Impact Assessment (HIA) can be used as a process to highlight the wider impacts of a proposed harm reduction pilot of the provision of safer inhalation devices (SIDs) in Wales, and how it has informed future actions and implementation of the scheme. Methods: A participatory HIA was conducted using a structured process facilitated by the Wales Health Impact Assessment Support Unit (WHIASU). Stakeholder engagement included a workshop involving service providers, public health professionals, and individuals with lived experience of crack cocaine use. The process utilised HIA checklists to systematically assess the potential health, social, and economic impacts of implementing a SIDs pilot, as well as unintended consequences. Results: The HIA identified a range of positive impacts associated with SIDs, including reduced risk of infections, decreased use of unsafe inhalation equipment, and increased service engagement. Participants emphasised the intervention's potential to reduce stigma and enhance trust, particularly for women, parents, and individuals with a history of adverse childhood experiences. Challenges were also recognised, including potential service strain, funding sustainability, and access barriers for rural populations. Suggested mitigations included mobile outreach and home delivery models. The HIA also highlighted the importance of including lived and living experience to inform future monitoring and service design. Conclusion: This HIA underscores the potential value of an SID pilot in Wales as a means of addressing a critical service gap and reducing health inequalities among people who smoke crack cocaine. It demonstrates the utility of HIA in identifying both potential positive and negative impacts, and in shaping harm reduction strategies that are inclusive, and evidence informed. The findings provide a foundation for pilot implementation and evaluation, as well as a model for integrating HIA into broader public health initiatives and holistic harm reduction services. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethical approval and consent to participate: Not applicable as the manuscript does not report on or involve the use of any animal or human data or tissue. Consent for publication: Not applicable Competing interests: The authors declare no competing interests. |
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| Contributed Indexing: | Keywords: Crack cocaine; Drug use; Equity; Harm reduction; Health and well-being; Health impact assessment |
| Substance Nomenclature: | 0 (Crack Cocaine) |
| Entry Date(s): | Date Created: 20260114 Date Completed: 20260626 Latest Revision: 20260705 |
| Update Code: | 20260706 |
| PubMed Central ID: | PMC12903636 |
| DOI: | 10.1186/s12954-025-01383-w |
| PMID: | 41530850 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1477-7517 |
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| DOI: | 10.1186/s12954-025-01383-w |