Harm Reduction Journal最新文献

{"title":"Perceived consequences of disseminating evidence on untreated recovery and moderate drinking after resolving alcohol concerns.","authors":"John A Cunningham","doi":"10.1186/s12954-026-01442-w","DOIUrl":"10.1186/s12954-026-01442-w","url":null,"abstract":"<p><strong>Aims: </strong>There is substantial evidence that many people recover from serious alcohol concerns without treatment and further, return to moderate alcohol consumption. The current study asks what people believe would happen if this evidence was widely disseminated.</p><p><strong>Design and methods: </strong>Participants (N = 3994), sampled to match the demographic characteristics of people in the UK, were recruited through the Prolific website. Participants were asked a series of questions about their current and past alcohol use. All participants were also asked their beliefs as to whether it would be problematic if evidence was disseminated regarding untreated and moderate drinking recoveries from serious alcohol problems.</p><p><strong>Results: </strong>Roughly half of the sample believed that it would make it harder for people to deal with their alcohol concerns if it was widely published that some people with serious alcohol problems can deal with their alcohol concerns without treatment and drink in a moderate/social manner after they have dealt with their concerns. Participants with prior to past year alcohol dependence were less likely to endorse that promulgating this information would be harmful compared to those who were never dependent or had lifetime alcohol dependence with past year symptoms.</p><p><strong>Discussion and conclusion: </strong>The results of this study contribute to the question of whether it is possible to promulgate the facts that untreated and moderate drinking recoveries are common without causing unanticipated consequences.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spike on a bike: mobile harm reduction in action.","authors":"Joseph Janes, Siân Roberts, Gareth Morgan","doi":"10.1186/s12954-025-01394-7","DOIUrl":"10.1186/s12954-025-01394-7","url":null,"abstract":"<p><strong>Background: </strong>Access to harm reduction services remains a significant challenge in rural areas, where geographic and structural barriers can prevent people who use drugs from engaging with fixed-site support. In response to declining service use during the COVID-19 pandemic, the Dyfed Drugs and Alcohol Service (DDAS), led by Barod, a Welsh harm reduction and treatment provider, developed a peer-led mobile intervention known as Spike on a Bike (SOAB), designed to deliver harm reduction equipment and relational support directly to service users in remote communities.</p><p><strong>Methods: </strong>This study draws on a mixed-methods evaluation of SOAB conducted between May 2022 and June 2024. Quantitative data on service uptake and demographics were analysed alongside qualitative data from semi-structured interviews, online surveys, and field observations. The evaluation was designed collaboratively with partners from Swansea University's Global Drug Policy Observatory, Public Health Wales, and local health boards.</p><p><strong>Results: </strong>SOAB significantly improved access to harm reduction support in rural West Wales, reaching individuals across diverse age groups and engaging a higher-than-typical proportion of female clients (36%). Service users reported positive experiences, particularly regarding ease of access and reduced stigma. However, uptake of blood-borne virus (BBV) testing and steroid harm reduction kits was low, indicating areas for targeted service development.</p><p><strong>Conclusion: </strong>Mobile harm reduction services like SOAB offer a promising model for addressing service exclusion in rural areas. By tailoring delivery to local contexts and reducing barriers linked to transport, stigma, and service visibility, such models have the potential to reach populations underserved by conventional approaches and inform future harm reduction strategies grounded in community knowledge and context-specific practice.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual violence at Australian universities: intersectionality in policy and practice.","authors":"Emma Gretgrix, Clare Farmer","doi":"10.1186/s12954-026-01430-0","DOIUrl":"10.1186/s12954-026-01430-0","url":null,"abstract":"<p><strong>Background: </strong>The diversity of student populations and the heightened risk/s for women students, sexuality and gender-diverse students, First Nations students, multicultural students, international students, and students with a disability, highlight the importance of intersectionality in university responses to sexual violence.</p><p><strong>Methods: </strong>This paper analyses policy guidance and explores the framing of sexual violence within policies from 35 Australian universities, with respect to considerations of intersectionality. It also examines student perceptions of the inclusiveness of university policies via an anonymous online survey.</p><p><strong>Results: </strong>Although 91% of the policies used language that is inclusive of specific identity attributes, policy guidance fails to acknowledge the importance of intersectionality in addressing sexual violence or to recognise the structural and systemic inequalities that underpin sexual violence. Policy guidance also lacks sufficient information about cultural responsiveness and intersectional support, and these gaps translate to the policies examined. Student victim-survivors perceived policies as inconsistent with respect to inclusivity and sought more specific acknowledgement of vulnerable populations and diverse student needs.</p><p><strong>Conclusions: </strong>Inclusive language broadens the framing of sexual violence, beyond a white, abled, heterosexual, cisgender norm, and can help all students to perceive their experiences as worthy of support. Failures to acknowledge and embed intersectionality and inclusivity within policy and practice can lead to harmful and enduring well-being, safety and human rights-based consequences, and compound systemic issues associated with sexual violence.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"No judgment, no preaching\": approaches to harm reduction service provision for people who use drugs in North Carolina.","authors":"David C Colston, Adams L Sibley, Elizabeth Joniak-Grant, Hillary L Mortensen, Monica E Swilley-Martinez, Brian W Pence, Vivian F Go, Shabbar I Ranapurwala","doi":"10.1186/s12954-026-01440-y","DOIUrl":"10.1186/s12954-026-01440-y","url":null,"abstract":"<p><strong>Background: </strong>Our study examines how harm reduction service providers (providers) throughout North Carolina (NC) provide services to people who use opioids (PWUO), how these service provision strategies align with PWUO preferences, and implications for care.</p><p><strong>Methods: </strong>We conducted semi-structured in-depth interviews and used a thematic analytic strategy to identify common approaches to service delivery among providers (n = 10), rationales for taking these approaches, and how approaches were received by PWUO (n = 30). To be included in the study, service providers had to provide direct care to PWUO, while PWUO had to be 18 + and be in active opioid use (not as prescribed by a doctor); providers and PWUO had to live in NC.</p><p><strong>Results: </strong>Providers often allowed PWUO to take the lead in service delivery interactions, asked limited questions about what/how participants use drugs, and rarely offered unsolicited information. Providers believed questioning could feel invasive or stigmatizing to PWUO. They also thought questions were unnecessary, assuming PWUO understood the risks that come with drug use. Providers reported that they would take the lead in interactions to correct PWUO's misconceptions that could make their use more dangerous, and would, occasionally, offer unsolicited information related to upcoming events or new services, or if PWUO appeared open to receiving more information. PWUO varied in desired approach by providers, based on the established rapport between providers and PWUO, and whether PWUO were in withdrawal during the interaction. Still, PWUO generally felt syringe service programs were a safe space, and many wanted to be asked more about their use so providers could provide tailored information about risks, trends, and safe use.</p><p><strong>Conclusion: </strong>Providers offer valuable services and safe spaces for PWUO in NC, but should ask program participants' preferences regarding interaction style to ensure the services provided are aligned with the desires of PWUO to have the maximum possible impact.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of COVID-19 vaccine uptake and preferences for service delivery among people who inject drugs accessing a syringe service program.","authors":"Marina Plesons, Ethan Steinberg, Sabrina Soto Sugar, Monica Faraldo, Hansel E Tookes, Tyler S Bartholomew","doi":"10.1186/s12954-026-01431-z","DOIUrl":"10.1186/s12954-026-01431-z","url":null,"abstract":"<p><strong>Introduction: </strong>Despite being disproportionately affected by the COVID-19 pandemic, people who inject drugs (PWID) have markedly lower and more variable rates of COVID-19 vaccine uptake-ranging from 10% to 81%-compared to 79% of all US adults. Multiple implementation adaptations have been proposed to address this gap, including offering the vaccines at syringe service programs (SSPs). To inform their implementation at an SSP in Miami, Florida, this study aimed to identify predictors of COVID-19 vaccine uptake and preferences for service delivery among PWID in our context.</p><p><strong>Methods: </strong>Between June 2022 and July 2023, we administered a cross-sectional survey based on the Health Belief Model with PWID accessing services at an SSP in Miami, FL (n = 135). Bivariate analysis was used to identify factors associated with COVID-19 vaccination status (vaccinated vs. not vaccinated).</p><p><strong>Results: </strong>Only 65% of participants had received at least one dose of the COVID-19 vaccine series. Factors associated with COVID-19 vaccination included older age (42 vs. 38 years, p = 0.0287), requiring medical care for previous COVID-19 infections (p = 0.0173), being confident in the US healthcare system (p = 0.0023), and not believing multiple COVID-19 misconceptions (p < 0.05). Among the Health Belief Model domains, perceived benefit, self-efficacy, and one cue to action item were significantly associated with COVID-19 vaccination status: vaccinated participants were more likely to believe in the vaccines' benefits (p = 0.0045-0.0213), report it was easy to get vaccinated (p = 0.0159), and know where to obtain accurate vaccine information (p = 0.0477). Most participants (86%) preferred to receive the COVID-19 vaccine at the SSP, and suggestions for increasing uptake included offering compensation, utilizing peer outreach systems, providing information and reminders, and allowing for accelerated vaccination schedules.</p><p><strong>Discussion: </strong>Our findings reiterate the potential of SSPs to increase COVID-19 and other vaccination rates among PWID and provide insight into implementation adaptations to optimize vaccine uptake, including emphasizing the benefit of vaccines in communication efforts, offering compensation, and leveraging the trusted relationship with SSP staff, particularly peer navigators. Together, this evidence reinforces SSPs' unique ability to increase engagement with and utilization of preventative care services among PWID, within and beyond the COVID-19 pandemic.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fentanyl use among people who inject drugs in two large Pacific Northwest metropolitan areas.","authors":"Lauren Lipira, Sara N Glick, Courtney Moreno, Lalaine Sevillano, Matthew A Town, Timothy W Menza","doi":"10.1186/s12954-025-01384-9","DOIUrl":"10.1186/s12954-025-01384-9","url":null,"abstract":"<p><strong>Background: </strong>We examined fentanyl use and outcomes among people who inject drugs (PWID) in the urban Pacific Northwest (PNW).</p><p><strong>Methods: </strong>We conducted secondary analysis of data from the 2022 National HIV Behavioral Surveillance PWID cycle from Seattle, WA and Portland, OR. We calculated proportions of any fentanyl, injection fentanyl, non-injection fentanyl, and street pill use. Next, we compared characteristics, behaviors, and outcomes by any fentanyl use. Finally, we estimated adjusted relative risk (aRR) of overdose outcomes associated with fentanyl use and injecting less associated with type of street pill use.</p><p><strong>Results: </strong>Among 830 PWID, 76% reported any fentanyl use, 47% specifically reported injection fentanyl use, 68% specifically reported non-injection fentanyl use, and 66% reported street pill use. Of those who used pills, 94% smoked them. Fentanyl use was crudely associated with age; race; housing; detainment; usual drug injected; injection frequency; syringe service programs, substance treatment, non-fatal overdose, and naloxone (p < 0.05). With adjustment, any fentanyl use (aRR = 3.20, 95% CI 1.58-6.47), injection fentanyl use (aRR = 3.51, 95% CI 1.63-7.58), and non-injection fentanyl use (aRR = 2.29, 95% CI 1.23-4.28) were associated with higher risk of overdose. Participants who smoked street pills were more likely to report injecting less because of pill use (aRR = 1.82, 95% CI 1.24-2.66).</p><p><strong>Conclusions: </strong>Fentanyl use was highly prevalent among PWID in the urban PNW. Non-injection fentanyl use was most common and street pills were frequently administered by smoking which was associated with injecting less. All fentanyl use was associated with increased risk for overdose. There is ongoing need for access to naloxone for PWID who use fentanyl.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on bloodborne viruses among people who inject drugs in South Asia.","authors":"Md Ferdous Rahman, Md Sharful Islam Khan, Muhammad J A Shiddiky, M Mamun Huda, Utpal K Mondal, Nusrat Jahan, Shakeel Mahmood, Allen G Ross","doi":"10.1186/s12954-026-01433-x","DOIUrl":"10.1186/s12954-026-01433-x","url":null,"abstract":"<p><p>Situated between two of the world's largest opium-producing regions, South Asia faces significant public health threats associated with drug trafficking and injecting drug use. People who inject drugs (PWID) in South Asia experience disproportionately high rates of bloodborne viruses (BBVs), including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). These high rates are driven by factors such as drug trafficking routes, socioeconomic marginalization, poor surveillance, and inadequate harm reduction services. Pakistan has the highest reported prevalence rates, with HIV and HCV rates exceeding 30% and 50%, respectively, while India, Bangladesh, and Afghanistan report localized epidemics in urban and border areas. Co-infections, particularly HIV/HCV, further complicate clinical management and public health responses. Despite the implementation of needle-syringe programs and opioid substitution therapy in several countries, service coverage remains below recommended levels due to legal, financial, and structural barriers. Marginalized subgroups, including women and incarcerated individuals, remain underserved and often overlooked. In this review, we discuss the burden of these infections among PWID in South Asia, current control strategies, and the precarious future given the recent instability to the USAID, PEPFAR, WHO, and the Global Fund by the Trump administration.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the role of overdose witnesses: responses and characteristics of people who inject drugs in Oakland and San Francisco.","authors":"Bow Suprasert, Raul Ruiz, Jose Francisco, Paavani Lella, Iris R O'Neal, Gueslyn Velasquez, Glenda N Baguso, Glenn-Milo Santos, Erin C Wilson, Eileen F Dunne, Willi McFarland","doi":"10.1186/s12954-026-01436-8","DOIUrl":"10.1186/s12954-026-01436-8","url":null,"abstract":"<p><strong>Background: </strong>Overdose is a significant cause of mortality in the United States. People who inject drugs (PWID) are uniquely positioned to witness and reverse overdoses. This study assesses overdose responses and factors associated with witnessing overdose among PWID.</p><p><strong>Methods: </strong>Data originate from baseline surveys for a longitudinal study of PWID in Oakland and San Francisco, California, collected between April 2024 and March 2025. Multivariable logistic regression identified factors associated with witnessing overdoses.</p><p><strong>Results: </strong>Of 597 PWID, 464 (77.7%) witnessed at least one overdose in the past 3 months, with an average of 13.4 (SD = 28.2) and a median of 6 (IQR = 3-15) overdoses. Among those, 30 (6.5%) reported only calling 911, 50 (10.8%) reported taking no action, 172 (37.2%) reported only using naloxone to reverse overdoses, and 210 (45.5%) used naloxone in conjunction with calling 911. The adjusted odds of witnessing overdoses were 2.2 times higher among unsheltered PWID (vs. sheltered, p < 0.001), 3.1 times higher among those in San Francisco (vs. Oakland, p < 0.001), 4.6 times higher among those who experienced non-fatal overdose themselves (vs. not, p = 0.002), 2.8 times higher among those sharing needles (vs. not, p = 0.015), and 1.9 times higher among those injecting fentanyl (vs. did not, p = 0.006) in the past 3 months.</p><p><strong>Conclusions: </strong>Nearly four in five PWID in Oakland and San Francisco recently witnessed an overdose. Witnesses are at greater risk of non-fatal overdose and may be the first to respond when those they inject with overdose. Targeting naloxone distributions to PWID who are characteristically more likely to witness overdoses may prevent additional drug-related deaths.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the Consolidated Framework for Implementation Research (CFIR) to understand college health administrator perceptions on adopting and implementing opioid overdose education and naloxone distribution (OEND) programs among universities nationally.","authors":"Savannah P Alexander, Elizabeth Shelton, Matthew Lee, G Tharp, Michael P McNeil, Melanie Bernitz, Kevin Graves, Lisa R Metsch, Rachel C Shelton","doi":"10.1186/s12954-025-01379-6","DOIUrl":"10.1186/s12954-025-01379-6","url":null,"abstract":"<p><strong>Background: </strong>The United States opioid epidemic's reach is expanding. Rapidly scaling opioid overdose education and naloxone distribution (OEND) programs is essential within a multipronged public health response. Universities offer infrastructure with potential to support routine, widespread OEND program implementation among adolescents and young adults nationally, a priority population who could disseminate to broader networks and geographic communities. This important setting is underutilized, and critical gaps remain in understanding university-based OEND program adoption/implementation.</p><p><strong>Methods: </strong>We conducted semi-structured, in-depth interviews (n = 21) among a purposively selected national sample of college health administrators to understand their perceptions of barriers/facilitators of implementing OEND programs at their universities and among universities nationally. The Consolidated Framework for Implementation Research guided data collection and inductive-deductive thematic analysis.</p><p><strong>Results: </strong>Unexpected student opioid overdoses and deaths catalyzed university administration to implement OEND programming. Absent the urgency induced by such events and in contrast to the incidental exposure they implicate, administrations perceived the prevalence of opioid misuse within their student population as too low to justify OEND program implementation. For some, this reluctance to proactively implement OEND programming was heightened by a desire to avoid political controversy, related to stigma surrounding harm reduction. Participants described the need for campus partners to collaboratively navigate university administrations' inaction/opposition, and ultimately, spearhead implementation, often with external collaborators. Key roles among campus and external collaborators were identified, including (a) allowing students to access existing OEND programming prior to obtaining administrative approval for university-based implementation; (b) compiling data and anecdotal evidence to understand the campus substance use environment and sharing that information with administration to establish program need; (c) overcoming stigma and legal complexity of harm reduction programming; (d) overcoming funding/resource constraints and building capacity to sustain OEND programming.</p><p><strong>Conclusions: </strong>Our findings underscore complexities of university-based OEND program implementation while providing actionable insights to support its national scale-up. Building on identified distinctions between universities in the process of implementing OEND programming and those without intention to implement, future research should identify OEND programming implementation phase among universities nationally, advance understanding of implementation determinants and strategies distinguishing each phase, and establish best practices for OEND program implementation.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-cigarette use and smoking-related disparities in England: an observational study using small area estimation and nonparametric regression.","authors":"James E Prieger, Samuel C Hampsher-Monk, Nima Shahidinia, Eliza R W Hunt","doi":"10.1186/s12954-026-01435-9","DOIUrl":"10.1186/s12954-026-01435-9","url":null,"abstract":"<p><strong>Background: </strong>The uptake of e-cigarettes has been associated with reduced smoking in the UK, and British public health policy has sought to leverage e-cigarettes' potential to encourage cessation. Smoking harms are concentrated in disadvantaged communities in the UK. If e-cigarette use were similarly concentrated in these groups, that could help redress the inequity. On the other hand, disadvantaged communities may be slower to adopt e-cigarettes, and this could perpetuate or exacerbate smoking-related disparities.</p><p><strong>Methods: </strong>This study examines the association between community-level e-cigarette prevalence and disparities in smoking between those employed in routine and manual occupations (R&M) and those employed in professional, managerial, intermediate, and other (PMI) occupations in England between 2013 and 2019. Using observational data, a small area estimation model is employed to form synthetic estimates of e-cigarette prevalence at the local level. The local socioeconomic gap in smoking (or smoking prevalence by occupation group) is then nonparametrically regressed on the estimated local e-cigarette prevalence.</p><p><strong>Results: </strong>The uptake of e-cigarettes is negatively associated with smoking rates in both occupational groups, affirming the role of e-cigarettes as an opportunity for harm reduction. However, the decrease in smoking is smaller for R&M workers. Thus, the uptake of e-cigarettes may have slightly increased the disparity between the two groups.</p><p><strong>Conclusions: </strong>Small area estimation provides a useful way to synthesize local estimates of e-cigarette use when direct estimation is impossible. The analysis suggests that the uptake of e-cigarettes, while associated with cessation from smoking for both types of workers, may not immediately reduce smoking-related disparities. Additional investigation should examine why the uptake of e-cigarettes may have a less marked effect on smoking cessation among R&M workers and whether these results change as the e-cigarette market matures. The analysis highlights the need to ensure that cessation interventions delivering net benefits reach the communities whose need is greatest.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}