In Mexico City, the prevalence of crack use in this population is alarmingly high. This is problematic as crack use has increased in the past decade in Latin America among poor urban populations in areas such as Guatemala City, São Paulo, and San Salvador ( Bastos, et al. Although harm reduction strategies have been developed to reduce drug users’ health risks, few interventions are specifically tailored for crack smokers ( Domanico and Malta 2012, Wechsberg, et al. Global literature has documented the health-related harms, including infectious disease transmissions, associated with crack use practices ( Dickson-Gomez, et al. Discussed are the policy and intervention implications associated with reducing crack related health consequences in Mexico and other Latin American countries. Results point towards a smoking process that is embedded in impoverished urban neighborhoods sustained by an accessible street-level crack market. Specifically, we identify essential paraphernalia items that make the smoking of crack possible describe the home- made construction of two categories of pipes and the sharing practices and physical harms associated with these paraphernalia. Findings reveal a complex, crack-smoking process in Mexico City that represents an interconnected structure of paraphernalia items and pipes that could contribute to detrimental health consequences. Data come from in-depth semi-structured interviews and observations with 156 current crack smokers in Mexico City.

Despite this increasing prevalence, little is known about the types of paraphernalia used and related sharing practices and physical harms. During the past decade, crack smoking has increased in Mexico among poor urban populations.

How to make a makeshift crack pipe