Academic Journal
Crack-cocaine use practices, harms and respiratory problems: an analysis of gender differences using data from a cross-sectional survey in England.
| Τίτλος: | Crack-cocaine use practices, harms and respiratory problems: an analysis of gender differences using data from a cross-sectional survey in England. |
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| Συγγραφείς: | Hope VD; Public Health Institute and School of Public and Allied Health, Liverpool John Moores University, 3rd Floor Tithebarn Building, 79 Tithebarn Street, Liverpool, L2 2ER, UK. v.d.hope@ljmu.ac.uk., McGaff C; Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK., Sharpe C; Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK., Rathod SD; Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK., Platt L; Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK., Scott J; Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK., Harris M; Department for Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. |
| Συλλογικό Έργο: | SIPP Project Team |
| Πηγή: | BMC public health [BMC Public Health] 2026 Apr 02; Vol. 26 (1). Date of Electronic Publication: 2026 Apr 02. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| Ιατρικοί όροι (MeSH): | Crack Cocaine*/adverse effects , Cocaine-Related Disorders*/epidemiology , Respiratory Tract Diseases*/epidemiology , Respiratory Tract Diseases*/chemically induced, England/epidemiology ; Humans ; Male ; Adult ; Female ; Cross-Sectional Studies ; Sex Factors ; Middle Aged ; Young Adult |
| Περίληψη: | BACKGROUND: The use of stimulants, such as crack-cocaine, is a global public health concern. Crack-cocaine use is increasing in the UK, but available data is focused on those who inject or also use opioids. To address this gap, characteristics of people using crack-cocaine in England, including respiratory problems among those who smoke, and variation in these by gender are described. METHODS: Adults self-reporting crack-cocaine use in the past 28 days, recruited by specialist services and peer networks in six sites during 2023, completed a self-report survey about demographic characteristics, drug use, crack use practices, health problems and service use. Bivariable analyses and logistic regression were used to explore gender-related differences in crack-cocaine use and crack-related respiratory problems. RESULTS: The participants’ (n = 731) median age was 42 years and 71% were men. Overall, 54% were stably housed, 71% had ever been imprisoned and 28% reported emergency department attendance in past 6 months. In the past 28 days, 99% had smoked crack-cocaine (44% shared pipes), with 30% injecting crack. Poly-sedative use was common including heroin (78%), pregabalin/gabapentin (41%), and benzodiazepines (28%), with 62% receiving opioid substitution therapy. Use of drugs normally smoked was common (90% tobacco, 62% cannabis and 25% spice). Women reported less polydrug use but more often vaped nicotine. Crack-related respiratory symptoms among those smoking crack were reported by 67% of women and 58% of men. In both men and women these symptoms were associated with increasing time since first crack-cocaine use and pregabalin/gabapentin use. In men they were also associated with food insecurity; smoking tobacco; temporary employment; and use in abandoned buildings or at friend’s place; reduced odds were associated with current heroin use and using with a close friend. Among women, having a respiratory symptom was also associated with sharing pipes. CONCLUSIONS: Respiratory health problems are common among those smoking crack-cocaine, particularly among women. In combination with high poly-sedative use, this poses a mortality risk from respiratory depression. UK service provision is focused on prevention of opiate and injection-related risks. Services for people who use crack-cocaine and low-threshold respiratory care pathways require prioritisation to reduce avoidable morbidity and mortality. |
| Competing Interests: | Declarations. Ethics approval and consent to participate: All protocols and research implements were approved by the London School of Hygiene and Tropical Medicine’s Research Ethics Committee (ref: 28102). All participants provided informed consent. Consent for publication: Not applicable. Competing interests: JS is paid by the College of Mental Health Pharmacy twice a year for 1.5 hours CPD teaching; work for Turning Point (a UK provider of service to people who use drugs); and is co-investigator on a grant funded by Gilead. VH none LP none SR none CM none CS none MH none |
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| Grant Information: | NIHR133118 National Institute for Health and Care Research |
| Contributed Indexing: | Investigator: J Busza; S Sweeney; L Guinness; C Vuckovic; I Yoon; A Piot; A Preston; N Eastwood; L Wilkins; S Ram; C Lord; P Bonnet; P Furlong Keywords: Crack-cocaine; Gender; Respiratory problems; Smoking |
| Substance Nomenclature: | 0 (Crack Cocaine) |
| Entry Date(s): | Date Created: 20260402 Date Completed: 20260627 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13169751 |
| DOI: | 10.1186/s12889-026-27073-1 |
| PMID: | 41923056 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1471-2458 |
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| DOI: | 10.1186/s12889-026-27073-1 |