title: Do crack smoking practices change with the introduction of safer crack kits?
abstract: OBJECTIVE
  Crack smoking has increased in Vancouver despite the harms associated with its use. Many people who smoke crack share their equipment, thereby increasing their risk for infectious disease. This project explored the effects of outreach distribution of "safer crack kits" on smoking practices.
  
  
  METHODS
  Two cross-sectional surveys were conducted, the first prior to kit distribution and the second a year later. Participants were individuals who smoked crack and lived in Vancouver's inner city. Crack smoking practices and use of items in the crack kit were documented.
  
  
  RESULTS
  The results of the second survey (i.e., following 12 months of kit distribution) showed an increase in availability and use of safer use items; mouthpieces and condoms provided in the kit were used by 79% and 59% of recipients, respectively. Unsafe practices were reported post distribution: although 42% used brass screens, the majority reported that they usually used Brillo; over 40% of respondents reported using syringe plungers to scrape crack resin; and participants reported sharing crack-use paraphernalia.
  
  
  CONCLUSIONS
  While kit distribution made safer use items more accessible, its impact on safer use practice was limited. Our findings highlight the need for targeted distribution of safer use items. Future research should explore the dynamics of unsafe crack smoking practices and ways to leverage safer use messaging.
authors.affiliation: Nursing and Health Behaviour Research Unit, School of Nursing, 302-6190 Agronomy Rd., University of British Columbia, Vancouver, BC V6T 1Z3. 44leslie@telus.net
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Malchy
authors.forename: Vicky
authors.initials: V
authors.lastname: Bungay
authors.forename: Joy L
authors.initials: JL
authors.lastname: Johnson
authors.forename: Jane
authors.initials: J
authors.lastname: Buxton
mesh_terms: D000328:Adult; D001955:British Columbia; D019970:Cocaine-Related Disorders; D003140:Communicable Disease Control / Q000379:methods*; D016578:Crack Cocaine; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior
chemical_list: D016578:Crack Cocaine