Department of Community Health Sciences, Doctoral Program in Health Research, 150 Place Charles-Le Moyne, Room 200, Longueuil, Québec J4K 0A8, Canada.
Université de Sherbrooke, Addiction Research and Study Program, Faculty of Medicine and Health Sciences, 150 Place Charles-Le Moyne, Room 200, Longueuil, Québec J4K 0A8, Canada.
Int J Drug Policy. 2017 Oct;48:18-26. doi: 10.1016/j.drugpo.2017.05.059. Epub 2017 Jun 27.
The distribution of safer crack-smoking equipment has been implemented in several Canadian cities to reduce potential health risks such as transmission of blood borne viruses (BBV). Little is known about the perspectives of persons who smoke crack (PWSC) on sharing crack-smoking materials or using in settings where safer crack-smoking equipment is provided. This paper presents data from the perspective of PWSC in Montréal on their experiences of, and rationales for, sharing crack-smoking equipment, in light of the risks of BBV transmission.
This qualitative study is based on analyses of BBV risk behaviours among people who use cocaine. Thirty-two semi-structured interviews were conducted in low-threshold community centres for persons who use drugs. Twenty-six interviewees who used cocaine also smoked crack, and constitute a subsample for analyses. Interview transcripts were coded inductively and analyzed thematically from a symbolic interactionist perspective.
Participants demonstrated personal agency by adopting strategies to minimise sharing of smoking equipment. These included being firm in refusal to share, smoking alone, and keeping an extra pipe to give to others. Nonetheless, sharing seemed to be commonplace and was attributed to contextual and personal factors. These were linked to the social dynamics among smokers; economic reasons such as wanting to keep the accumulated crack resin; practical reasons such as lacking own smoking equipment; being ashamed to purchase or acquire crack pipes; fatalism; poor personal agency; and ambivalence or scepticism towards BBV transmission risks.
To reinforce harm reduction for PWSC, interventions aimed at reducing barriers to safer smoking practices should be developed at both structural and individual levels.
为了降低血液传播病毒（BBV）等潜在健康风险，加拿大的几个城市已经推出了更安全的吸食 crack 用具。关于吸食 crack 的人（PWSC）对共享吸食用具或在提供更安全吸食用具的环境中使用的看法，知之甚少。本文从蒙特利尔 PWSC 的角度介绍了他们在考虑 BBV 传播风险的情况下，共享吸食用具的经验和理由。
本定性研究基于对使用可卡因人群的 BBV 风险行为的分析。在为吸毒者提供的低门槛社区中心进行了 32 次半结构化访谈。26 名接受访谈的受访者使用可卡因，他们也是 crack 的使用者，构成了分析的一个子样本。访谈记录进行了归纳编码，并从符号互动主义的角度进行了主题分析。
参与者通过采取策略来尽量减少共享吸烟用具，表现出个人的能动性。这些策略包括坚决拒绝共享、独自吸烟以及保留额外的烟斗给他人。然而，共享似乎很普遍，并归因于情境和个人因素。这些因素与吸烟者之间的社会动态有关；经济原因，如想要保留积累的 crack 树脂；实际原因，如缺乏自己的吸烟用具；因购买或获得 crack 烟斗而感到羞耻；宿命论；个人能动性差；以及对 BBV 传播风险的矛盾或怀疑。
为了加强 PWSC 的减少伤害措施，应在结构和个人层面上制定旨在减少更安全吸烟做法障碍的干预措施。
