Reducing Widespread Pipe Sharing and Risky Sex Among Crystal Methamphetamine Smokers in Toronto: Do Safer Smoking Kits Have a Potential Role to Play?

Many negative health consequences, including potential hepatitis transmission, are associated with smoking crystal methamphetamine. The authors of the current study set out to determine whether a crystal methamphetamine smoking kit might help reduce the negative health effects of this practice.

Community health agencies and youth shelters in Toronto recruited crystal methamphetamine smokers, who then took part in five focus groups. Those targeted for recruitment included "homeless/street-involved youth, sex workers, men who have sex with men, and youth in the party scene." The 32 participants answered questions about motivations for using crystal methamphetamine, the smoking process, experiences with health problems, sharing behavior, risky sex practices, and what the ideal harm-reduction kit would contain.

Pipe sharing, which was widespread, was viewed as an integral part of the social experience of smoking crystal methamphetamine. Though heated pipes were unlikely to cause direct injuries, many smokers reported having dry, cracked lips, "which may be a vector for disease transmission." Many smokers reported sex with multiple partners and being less likely to use condoms while taking the drug. There was mixed demand for harm-reduction kits.

"Changing pipe sharing behaviors may be difficult because many participants considered sharing to be integral to the social experience of smoking crystal methamphetamine," the researchers concluded. "Within the context of a broader health promotion and prevention program, pilot testing of safer smoking kits to initiate discussion and education on the risks associated with sharing pipes and unprotected sex for some communities (e.g., homeless/street-involved youth) is worth pursuing."