Safer Crack Kits and Smoking Practices: Effectiveness of a Harm Reduction Intervention among Active Crack Users in Mexico City

Subst Use Misuse. 2019;54(4):592-600. doi: 10.1080/10826084.2018.1528460. Epub 2019 Jan 17.


Background: Crack cocaine use has increased rapidly throughout Mexico, coinciding with rising HIV and HCV infections among vulnerable groups. Due to the increased risk of infection among crack users, harm reduction approaches have been identified to reduce the spread of disease. However, Mexico has yet to adopt these techniques for crack users.

Objectives: To evaluate the impact of a pilot crack kit distribution program on risky smoking behaviors of active crack users in an impoverished colonia of Mexico City, Mexico.

Methods: Fifty crack kits, containing safer smoking paraphernalia and related health items (i.e., condoms, alcohol wipes, etc.), were distributed to active crack users. A sample of 58 crack users were surveyed prior to the intervention and 35 were successfully relocated and surveyed three months after the intervention. Surveys assessed drug use, crack kit utilization, and smoking practices.

Results: Findings indicate that crack kit utilization was high throughout the sample. Use of risky or unsafe paraphernalia decreased, specifically the use of cans as pipes (Z = -2.653, p = .008). Similarly, Pyrex pipe use increased significantly (Z = -3.132, p = .002). Sharing of paraphernalia also decreased throughout the sample.

Conclusion: These findings identify the potential benefits in reducing risky smoking behaviors of crack kit distribution programs in Mexico City. This evidence supports expansion of crack kit programs in Mexico and similar impoverished regions.

Keywords: Crack cocaine; Mexico; crack pipe distribution; harm reduction; safer crack kits; smoking practices.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cocaine-Related Disorders / psychology*
  • Crack Cocaine*
  • Female
  • HIV Infections / prevention & control
  • Harm Reduction*
  • Hepatitis C / prevention & control
  • Humans
  • Male
  • Mexico
  • Risk Reduction Behavior
  • Risk-Taking*
  • Smoking / adverse effects
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires
  • Young Adult


  • Crack Cocaine