Academic Journal
Innovation, respiration and drug paraphernalia policy: a mixed methods study of crack pipe practice and respiratory harm in England.
| Τίτλος: | Innovation, respiration and drug paraphernalia policy: a mixed methods study of crack pipe practice and respiratory harm in England. |
|---|---|
| Συγγραφείς: | Harris M; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK. magdalena.harris@lshtm.ac.uk., Vuckovic C; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK., McGaff C; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK., Sharpe C; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK., Rathod S; Department of Population Health, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK., Piot A; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK., Southwell M; Coact, Bath, UK., Scott J; Centre for Academic Primary Care, Bristol Medical School, Canynge Hall, University of Bristol, Bristol, BS8 2PS, UK., Hope V; Public Health Institute / School of Public and Allied Health, Liverpool John Moores University, 3rd Floor Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK., Platt L; Department for Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK. |
| Πηγή: | Harm reduction journal [Harm Reduct J] 2026 May 09; Vol. 23 (1). Date of Electronic Publication: 2026 May 09. |
| 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 , Crack Cocaine*/administration & dosage , Cocaine-Related Disorders*/epidemiology , Cocaine-Related Disorders*/complications , Respiration Disorders*/epidemiology, England/epidemiology ; Humans ; Harm Reduction ; Female ; Male ; Adult ; Administration, Inhalation |
| Περίληψη: | Background: Provision of equipment for the purpose of stimulant inhalation is prohibited under UK law. Crack cocaine use is prevalent and rising in England, where the SIPP (safer inhalation pipe provision) study piloted and evaluated a crack equipment and workforce training intervention. We report mixed method findings from the baseline component of the study, prior to intervention implementation. The aim of this paper is to situate quantitative findings regarding respiratory risk through qualitative exploration of crack inhalation practice in a context of stimulant equipment prohibition. Methods: In this paper we report descriptive findings from baseline survey data (n = 727) with a focus on thematic analysis of interview data (n = 33). Participants were recruited through drug treatment services and peer networks in six geographical locations in England, with survey eligibility criteria including crack use (injecting or smoking) in the past 28 days. Findings: Of the 733 participants who completed the baseline questionnaire, 727 (99%) smoked crack in the past month and were included for further analysis. A minority reported crack injection (28%). Over half (55%) used crack daily in the past month. Many (60%) reported respiratory symptoms, with one third experiencing a respiratory-related hospitalisation. Qualitative data illustrate ingenuity of crack equipment practice, with participants fashioning pipes out of materials ranging from umbrella handles, through to tin cans and plastic inhaler cases. Ash and stainless-steel scourer were primarily used as suspension materials. Accounts of practice illustrate connections between materials used and respiratory harms, the latter exacerbated by poor living conditions and limited availability of supports. Conclusion: We evidence a high burden of respiratory harm among people who smoke crack in England. Stimulant inhalation equipment prohibition contributes to a constellation of respiratory risk, with use of unsafe materials and impoverished living environments exacerbating health harms among a highly marginalised population. There is a need to reorientate drug services to support safer crack inhalation practice and reduce respiratory risk. Legislative change can facilitate this process. Trial Registration: ISRCTN12541454 https://doi.org/10.1186/ISRCTN12541454 . (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: Ethics approval was awarded by the London School of Hygiene & Tropical Medicine (UK) Observational/Intervention Research Ethics Committee [28102]. All participants provided signed consent to participate. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests. |
| References: | Am J Public Health. 1993 Oct;83(10):1490-1. (PMID: 8214248) Cureus. 2021 Feb 10;13(2):e13267. (PMID: 33728203) Subst Use Misuse. 2012 Apr;47(5):535-46. (PMID: 22428821) Int J Drug Policy. 2008 Aug;19(4):339-41. (PMID: 18638705) Drug Alcohol Rev. 2015 May;34(3):259-66. (PMID: 25066509) Am Surg. 2007 Nov;73(11):1144-6. (PMID: 18092651) J Med Libr Assoc. 2022 Apr 1;110(2):270-272. (PMID: 35440911) Subst Use Misuse. 2019;54(4):592-600. (PMID: 30654689) J Urban Health. 2013 Jun;90(3):542-51. (PMID: 23188552) Harm Reduct J. 2020 Oct 7;17(1):72. (PMID: 33028363) CMAJ. 2000 Jun 13;162(12):1697-700. (PMID: 10870502) Harm Reduct J. 2017 May 12;14(1):17. (PMID: 28494810) Subst Use Misuse. 2021;56(1):1-10. (PMID: 33086934) Int J Drug Policy. 2011 Jul;22(4):292-300. (PMID: 21700443) Am J Public Health. 2019 Nov;109(11):1564-1567. (PMID: 31536408) Int J Drug Policy. 2021 Dec;98:103386. (PMID: 34419321) Respiration. 2004 Jan-Feb;71(1):91. (PMID: 14872118) BMC Public Health. 2017 Feb 3;17(1):163. (PMID: 28158995) Harm Reduct J. 2023 May 23;20(1):68. (PMID: 37221542) Gastroenterology. 2015 Jul;149(1):e3-4. (PMID: 26043819) Harm Reduct J. 2008 Nov 17;5:34. (PMID: 19014696) Eur J Gastroenterol Hepatol. 2008 Jan;20(1):29-32. (PMID: 18090987) BMJ Med. 2022 Sep 28;1(1):e000215. (PMID: 36568709) Int J Drug Policy. 2020 Sep;83:102829. (PMID: 32595070) Int J Drug Policy. 2017 Oct;48:18-26. (PMID: 28666203) Int J Drug Policy. 2007 Mar;18(2):107-17. (PMID: 17689353) Can J Public Health. 2005 May-Jun;96(3):185-8. (PMID: 15913081) CMAJ. 2009 Oct 27;181(9):585-9. (PMID: 19841052) Subst Abuse Treat Prev Policy. 2011 Dec 30;6:34. (PMID: 22208877) J Emerg Med. 1998 Nov-Dec;16(6):861-3. (PMID: 9848701) Harm Reduct J. 2024 Jan 23;21(1):19. (PMID: 38263202) Int J Drug Policy. 2008 Jun;19(3):255-64. (PMID: 18502378) |
| Grant Information: | NIHR133118 National Institute for Health and Care Research |
| Contributed Indexing: | Keywords: Crack cocaine; Drug legislation; Drug paraphernalia; Harm reduction; Respiratory diseases |
| Molecular Sequence: | ISRCTN ISRCTN12541454 10.1186/ISRCTN12541454 |
| Substance Nomenclature: | 0 (Crack Cocaine) |
| Entry Date(s): | Date Created: 20260509 Date Completed: 20260707 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13340102 |
| DOI: | 10.1186/s12954-026-01470-6 |
| PMID: | 42106855 |
| Βάση Δεδομένων: | MEDLINE |
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