Table 1 Kit contents and rationale for inclusion

Pyrex Stems

• Compared to conventional glass, they are stronger and less brittle.

• They are less likely to explode, break, or chip and last longer than do glass stems.

• Their inclusion reduces likelihood of the use of other, less safe options.

Mouthpieces (a four-inch rubber tube)

• For use at one end of a stem to prevent direct contact with broken or hot pipes.

• A personal mouthpiece minimizes exposure to communicable disease when a pipe is shared.

Wooden Push Sticks (chopstick)

• For the purpose of packing and positioning the filter or screen inside the stem.

• Wooden push sticks do not chip stems, unlike metal counterparts that are used frequently (e.g., coat hangers, car antenna).

• Given that plungers of syringes were also being used for this purpose, providing a wooden push stick decreased the use of syringes and subsequent littering of needles and syringes.

Condoms

• Since crack use is associated with high-risk sexual behaviors (i.e., buying and selling sex), condoms are integral to promoting safer sex.

• Many women in the DTES who use crack support themselves through sex work; women need easy access to condoms.

Bandages:

• These were included to protect broken skin, promote healing, and minimize exposure to infection (self and others).

Alcohol Swabs

• Promoted the use of clean equipment (e.g., pipes, mouthpieces) and a means of cleaning wounds.

Screens (Brass tobacco pipe screens)

• They are less likely to break apart than steel wool or "Brillo.¹"

• Unlike Brillo, brass filters are not coated with potentially toxic substances.

Lighter

• Smoking crack requires applying consistent heat to the pipe.

• Using matches is more likely to result in burns and the inhalation of sulphur.

Information cards

• Two cards were included in the kits: 1) The Tip card covered harm reduction information for people who use crack, and 2) The Resource card outlined information on health and drug services in the DTES for people who use drugs.