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Potential uptake and correlates of willingness to use a supervised smoking facility for noninjection illicit drug use

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Abstract

Many cities are experiencing infectious disease epidemics and substantial community harms as a result of illicit drug use. Although medically supervised smoking facilities (SSFs) remain untested in North America, local health officials in Vancouver are considering to prepare a submission to Health Canada for an exemption to open Canada’s first SSF for evaluation. Reluctance of health policymakers to initiate a pilot study of SSFs may be due in part to outstanding questions regarding the potential uptake and community impacts of the intervention. This study was conducted to evaluate the prevalence and correlates of willingness to use an SSF among illicit drug smokers who are enrolled in the Vancouver Injection Drug Users Study. Participants who reported actively smoking cocaine, heroin, or methamphetamine who returned for follow-up between June 2002 and December 2002 were eligible for these analyses. Those who reported willingness to use an SSF were compared with those who were unwilling to use an SSF by using logistic regression analyses. Four hundred and forty-three participants were eligible for this study. Among respondents, 124 (27,99%) expressed willingness to attend an SSF. Variables that were independently associated with willingness to attend an SSF in multivariate analyses included sex-trade work (adjusted odds ratio [AOR]=1.85), crack pipe sharing (AOR=2.24), and residing in the city’s HIV epicentre (AOR=1.64). We found that participants who demonstrated a willingness to attend an SSF were more likely to be involved in the sex trade and share crack pipes. Although the impact of SSFs in North America can only be quantified by scientific evaluation, these data indicate a potential for public health and community benefits if SSFs were to become available.

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References

  1. Strathdee SA, Galai N, Safaeian M, et al. Sex differences in risk factors for HIV seroconversion among injection drug users: a ten year perspective. Arch Intern Med. 2001;161:1281–1288.

    Article  CAS  PubMed  Google Scholar 

  2. Craib KJ, Spittal PM, Wood E, et al. Risk factors for elevated HIV incidence among Aboriginal injection drug users in Vancouver. CMAJ. 2003;168:19–24.

    PubMed Central  PubMed  Google Scholar 

  3. van Beek I, Dwyer R, Dore GJ, Luo K, Kaldor JM. Infection with HIV and hepatitis C virus among injecting drug users in a prevention setting: retrospective cohort study. BMJ. 1998;317:433–437.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Thorpe LE, Oueller LJ, Levy JR, Williams IT, Monterroso ER. Hepatitis C virus infection: prevalence, risk factors, and prevention opportunities among young injection drug users in Chicago, 1997–99. J Infect Dis. 2000;182:1588–1594.

    Article  CAS  PubMed  Google Scholar 

  5. Thorpe LE, Oueller LJ, Hershow R, et al. Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. Am J Epidemiol. 2002;155:645–653.

    Article  PubMed  Google Scholar 

  6. Selvey LA, Denton M, Plant AJ. Incidence and prevalence of hepatitis C among clients of a Brisbane methadone clinic: factors influencing hepatitis C serostatus Aust N Z J Public Health. 1997;21:102–104.

    Article  CAS  PubMed  Google Scholar 

  7. Hahn JA, Page-Shafer K, Lum PJ, Ochoa K, Moss AR. Hepatitis C virus infection and needle exchange use among young injection drug users in San Francisco. Hepatology. 2001;34:180–187.

    Article  CAS  PubMed  Google Scholar 

  8. Hagan H, Thiede H, Weiss NS, Hopkins SG, Duchin JS, Alexander ER. Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health. 2001;91:42–46.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Villano SA, Vlahov D, Nelson KE, Lyles CM, Cohn S, Thomas DL. Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland. J Clin Microbiol. 1997;35:3274–3277.

    CAS  PubMed Central  PubMed  Google Scholar 

  10. Tortu S, Neaigus A, McMahon J, Hagen D. Hepatitis C among noninjecting drug users: a report. Subst Use Misuse. 2001;36:523–534.

    Article  CAS  PubMed  Google Scholar 

  11. Flamm SL, Parker RA, Chopra S. Risk factors associated with chronic hepatitis C virus infection. Limited frequency of an unidentified source of transmission. Am J Gastroenterol. 1998;93:597–600.

    Article  CAS  PubMed  Google Scholar 

  12. Tortu S, McMahon JM, Pouget ER, Hamid R. Sharing of noninjection drug-use implements as a risk factor for hepatitis C. Subst Use Misuse. 2004;39:211–224.

    Article  PubMed  Google Scholar 

  13. Conry-Cantilena C, VanRaden M, Gibble J, et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med. 1996;334:1691–1696.

    Article  CAS  PubMed  Google Scholar 

  14. Alter HJ, Conry-Cantilena C, Melpolder J, et al. Hepatitis C in asymptomatic blood donors. Hepatology. 1997;26:29S-33S.

    Article  CAS  PubMed  Google Scholar 

  15. Broadhead RS, van Hulst Y, Heckathorn DD. The impact of a needle exchange’s closure. Public Health Rep. 1999;114:439–447.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Haemmig R. Beyond safe injecting rooms: next steps in hard reduction incl. safe smoking rooms. Paper presented at: International Conference on the Reduction of Drug Related Harm; April 20–24, 2004; Melbourne, Australia.

  17. Wood E, Kerr T, Small W, Li K, Marsh DC, Montaner JS, Tyndall MW. Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users. CMAJ. 2004 Sep 28;171(7):731–734.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Kerr TH, Wood E, Palepu A, Wilson D, Schechter MT, Tyndall MW. Responding to explosive HIV epidemics driven by frequent cocaine injection: is there a role for safer injecting facilities? Journal of Drug Issues. In press.

  19. Kerr T, Palepu A. Safe injection facilities in Canada: is it time? CMAJ. 2001;165:436–437.

    CAS  PubMed Central  PubMed  Google Scholar 

  20. Wood E, Kerr T, Spittal PM, et al. The potential public health and community impacts of safer injecting facilities: evidence from a cohort of injection drug users. J Acquir Immune Defic Syndr. 2003;32:2–8.

    Article  PubMed  Google Scholar 

  21. Wood E, Spittal PM, Small W, et al. Displacement of Canada’s largest public illicit drug market in response to a police crackdown. CMAJ. 2004;170:1551–1556.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Campbell L. Four Pillars—the Vancouver experience. Paper presented at: 15th International Conference on the Reduction of Drug Related Harms; April 22, 2004; Melbourne, Australia.

  23. Wood E, Schechter MT, Tyndall MW, Montaner JS, O’Shaughnessy MV, Hogg RS. Antiretroviral medication use among injection drug users: two potential futures. AIDS. 2000;14:1229–1235.

    Article  CAS  PubMed  Google Scholar 

  24. Wood E, Tyndall MW, Spittal PM, et al. Unsafe injection practices in a cohort of injection drug users in Vancouver: could safer injecting rooms help? CMAJ. 2001;165:405–410.

    CAS  PubMed Central  PubMed  Google Scholar 

  25. Spittal PM, Craib KJ, Wood E, et al. Risk factors for elevated HIV incidence rates among female injection drug users in Vancouver. CMAJ. 2002;166:894–899.

    PubMed Central  PubMed  Google Scholar 

  26. Wood E, Tyndall MW, Spittal PM, et al. Factors associated with persistent high-risk syringe sharing in the presence of an established needle exchange programme. AIDS. 2002;16:941–943.

    Article  PubMed  Google Scholar 

  27. Miller CL, Johnston C, Spittal PM, et al. Opportunities for prevention: hepatitis C prevalence and incidence in a cohort of young injection drug users. Hepatology. 2002;36: 737–742.

    Article  PubMed  Google Scholar 

  28. Spittal PM, Bruneau J, Craib KJ, et al. Surviving the sex trade: a comparison of HIV risk behaviours among street-involved women in two Canadian cities who inject drugs. AIDS Care. 2003;15:187–195.

    Article  CAS  PubMed  Google Scholar 

  29. Sterk CE, Theall KP, Elifson KW. Who’s getting the message? Intervention response rates among women who inject drugs and/or smoke crack cocaine. Prev Med. 2003; 37:119–128.

    Article  PubMed  Google Scholar 

  30. Rosse RB, Collins JP Jr, Fay-McCarthy M, Alim TN, Wyatt RJ, Deutsch SI. Phenomenologic comparison of the idiopathic psychosis of schizophrenia and drug-induced cocaine and phencyclidine psychoses: a retrospective study. Clin Neuropharmacol. 1994;17: 359–369.

    Article  CAS  PubMed  Google Scholar 

  31. Colliver JD, Kopstein AN. Trends in cocaine abuse reflected in emergency room episodes reported to DAWN. Drug abuse warning network. Public Health Rep. 1991;106:59–68.

    CAS  PubMed Central  PubMed  Google Scholar 

  32. Bailey I. Pickton accused in 4 more deaths: this is now the largest serial killer investigation in Canadian history. National Post. October 3, 2002:A1.

    Google Scholar 

  33. Astemborski J, Vlahov D, Warren D, Solomon L, Nelson KE. The trading of sex for drugs or money and HIV seropositivity among female intravenous drug users. Am J Public Health. 1994;84:382–387.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Kral AH, Bluthenthal RN, Lorvick J, Gee L, Bacchetti P, Edlin BR. Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001;357:1397–1401.

    Article  CAS  PubMed  Google Scholar 

  35. Kilbourne AM, Herndon B, Andersen RM, Wenzel SL, Gelberg L. Psychiatric symptoms, health services, and HIV risk factors among homeless women. J Health Care Poor Underserved. 2002;13:49–65.

    PubMed  Google Scholar 

  36. Faruque S, Edlin BR, McCoy CB, et al. Crack cocaine smoking and oral sores in three inner-city neighborhoods. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;13:87–92.

    Article  CAS  PubMed  Google Scholar 

  37. Mitchell-Lewis DA, Phelan JA, Kelly RB, Bradley JJ, Lamster IB. Identifying oral lesions associated with crack cocaine use. J Am Dent Assoc. 1994;125:1104–1108, 1110.

    CAS  PubMed  Google Scholar 

  38. Porter J, Bonilla L. Crack users’ cracked lips: an additional HIV risk factor. Am J Public Health. 1993;83:1490–1491.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  39. Centers for Disease Control and Prevention. Top 11 most frequently asked questions about viral hepatitis. Available at: http://www.cdc.gov/ncidod/diseases/hepatitis/common_faqs.htm. Accessed June 15, 2004.

  40. From the Centers for Disease Control and Prevention. 1993 revised classification system for HIV, infection and expanded surveillance case definition for AIDS, among adolescents and adults. JAMA. 1993;269:729–730.

    Google Scholar 

  41. Barr CE, Lopez MR, Rua-Dobles A, Miller LK, Mathur-Wagh U, Turgeon LR. HIV-associated oral lesions; immunologic, virologic and salivary parameters. J Oral Pathol Med. 1992;21:295–298.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, British Columbia, Canada

    Courtney L. C. Collins, Thomas Kerr, Laura M. Kuyper, Kathy Li, Mark W. Tyndall & David C. Marsh

  2. Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada

    Evan Wood

  3. Canadian HIV/AIDS Legal Network, 417 Saint-Pierre Street, Suite 408, H2Y 2M4, Montréal, Québec

    Thomas Kerr

  4. Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Mark W. Tyndall & Julio S. Montaner

Authors
  1. Courtney L. C. Collins
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  2. Thomas Kerr
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  3. Laura M. Kuyper
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  4. Kathy Li
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  5. Mark W. Tyndall
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  6. David C. Marsh
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  7. Julio S. Montaner
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  8. Evan Wood
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Correspondence to Evan Wood.

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Collins, C.L.C., Kerr, T., Kuyper, L.M. et al. Potential uptake and correlates of willingness to use a supervised smoking facility for noninjection illicit drug use. J Urban Health 82, 276–284 (2005). https://doi.org/10.1093/jurban/jti051

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  • DOI: https://doi.org/10.1093/jurban/jti051

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