ArticleBMC public health2017
Declining rates of health problems associated with crack smoking during the expansion of crack pipe distribution in Vancouver, Canada.
Article in BMC public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of the Treatments in Crack Use Disorder: A Systematic Review.European addiction research · 2026Pooled it
- The utilization and delivery of safer smoking practices and services: a narrative synthesis of the literature.Harm reduction journal · 2023Pooled it
- Innovation, respiration and drug paraphernalia policy: a mixed methods study of crack pipe practice and respiratory harm in England.Harm reduction journal · 2026Article
- Crack-cocaine use practices, harms and respiratory problems: an analysis of gender differences using data from a cross-sectional survey in England.BMC public health · 2026Article
- A comprehensive review of state laws that govern the distribution and possession of drug use equipment in the United States.The International journal on drug policy · 2026Review
- Safer inhalation devices: a rapid Health Impact Assessment of a harm reduction pilot for people who smoke crack cocaine.Harm reduction journal · 2026Article
- A descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states.The International journal on drug policy · 2026Article
- Harm-Reduction Programs and Interventions for Equity-Deserving Populations Who Use Crack-Cocaine: A Scoping Review.European addiction research · 2026Article
- Association of safer smoking supply distribution with participant encounters and naloxone distribution from syringe services programs: Findings from the National Survey of Syringe Services Programs in the United States.Drug and alcohol dependence reports · 2025Article
- HIV prevention and crack harm reduction using projection mapping in Mexico City.Health education journal · 2024Article
- A qualitative study on perceptions and experiences of overdose among people who smoke drugs in Vancouver, British Columbia.Drug and alcohol dependence · 2024Article
- Safe inhalation pipe provision (SIPP): protocol for a mixed-method evaluation of an intervention to improve health outcomes and service engagement among people who use crack cocaine in England.Harm reduction journal · 2024Article
- Analysis of the UK Government's 10-Year Drugs Strategy-a resource for practitioners and policymakers.Journal of public health (Oxford, England) · 2023Article
- High levels of interest in access to free safer smoking equipment to reduce injection frequency among people who inject drugs in Seattle, Washington.Drug and alcohol dependence reports · 2023Article
- Not all screens are created equal: examination of surface features and other physical properties of commonly used screen materials for smoking drugs.Harm reduction journal · 2023Article
- "That Line Just Kept Moving": Motivations and Experiences of People Who Use Methamphetamine.The western journal of emergency medicine · 2023Article
- Heroin pipe distribution to reduce high-risk drug consumption behaviors among people who use heroin: a pilot quasi-experimental study.Harm reduction journal · 2022Article
- Transition from injecting opioids to smoking fentanyl in San Francisco, California.Drug and alcohol dependence · 2021Observational
- The impact of recent homelessness on the provision of injection drug use initiation assistance among persons who inject drugs in Tijuana, Mexico and Vancouver, Canada.Drug and alcohol dependence · 2021Article
- 'Resurgent', 'twin' or 'silent' epidemic? A select data overview and observations on increasing psycho-stimulant use and harms in North America.Substance abuse treatment, prevention, and policy · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundCrack cocaine smoking is associated with an array of negative health consequences, including cuts and burns from unsafe pipes, and infectious diseases such as HIV. Despite the well-established and researched harm reduction programs for injection drug users, little is known regarding the potential for harm reduction programs targeting crack smoking to reduce health problems from crack smoking. In the wake of recent crack pipe distribution services expansion, we utilized data from long running cohort studies to estimate the impact of crack pipe distribution services on the rates of health problems associated with crack smoking in Vancouver, Canada.
methodsData were derived from two prospective cohort studies of community-recruited people who inject drugs in Vancouver between December 2005 and November 2014. We employed multivariable generalized estimating equations to examine the relationship between crack pipe acquisition sources and self-reported health problems associated with crack smoking (e.g., cut fingers/sores, coughing blood) among people reported smoking crack.
resultsAmong 1718 eligible participants, proportions of those obtaining crack pipes only through health service points have significantly increased from 7.2% in 2005 to 62.3% in 2014 (p < 0.001), while the rates of reporting health problems associated with crack smoking have significantly declined (p < 0.001). In multivariable analysis, compared to those obtaining pipes only through other sources (e.g., on the street, self-made), those acquiring pipes through health service points only were significantly less likely to report health problems from smoking crack (adjusted odds ratio: 0.82; 95% confidence interval: 0.73-0.93).
conclusionsThese findings suggest that the expansion of crack pipe distribution services has likely served to reduce health problems from smoking crack in this setting. They provide evidence supporting crack pipe distribution programs as a harm reduction service for crack smokers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.