International Journal of Drug Policy最新文献

{"title":"Comparing drug policies: An assessment of the validity and reliability of the global drug policy index","authors":"David Bewley-Taylor ,&nbsp;Matthew Wall ,&nbsp;Jack Tudor ,&nbsp;Alison Ritter","doi":"10.1016/j.drugpo.2025.104908","DOIUrl":"10.1016/j.drugpo.2025.104908","url":null,"abstract":"<div><h3>Background</h3><div>The Global Drug Policy Index (GDPI) is an instrument that attempts to comparatively evaluate national drug policies at a global scale. This paper assesses the validity and reliability of this new Index, speaking to the wider question of whether such a comparative evaluation can be achieved in a methodologically robust manner.</div></div><div><h3>Method</h3><div>We review the validity of the Index through analysis of the conceptual logic of the GDPI. Construct validity is assessed using Cronbach’s alpha statistics alongside exploratory factor analysis (EFA). The reliability of the Index is assessed using uncertainty analysis where we systematically analyse how Index rankings vary across simulations with randomly perturbed weighting schemes. In addition, we explore the reliability of experts’ assessment of policy implementation, reporting on a common vignette undertaken by all country-expert evaluators.</div></div><div><h3>Results</h3><div>The analysis of conceptual validity is a reproduction of the logic supporting the contention that the project’s underpinning normative document (a report produced by the UN system coordination Task Team on the Implementation of the UN System Common Position on drug-related matters) represents a solid starting point of what will be a sustained, iterative research process to develop a valid conceptual and operational basis for comparative evaluation of national drug policies. The empirical analysis of construct validity reveals that operationalising the Common Position creates a set of variables with a coherent multidimensional structure that is amenable to aggregation into an overall index. While the performance of states under simulations of different weighting schemes was highly consistent, country expert evaluation in developing state codes on policy implementation can be inconsistent, even when they are provided with a common description designed to capture variance on their rating scale. Cronbach’s alpha indicates that the variables encompassed by the GDPI measure a coherent construct, while EFA results provide support for three of the <em>a priori</em> dimensions used in the creation of the Index.</div></div><div><h3>Conclusions</h3><div>We conclude that the GDPI project demonstrates that robust comparative evaluation of drug policy at a global scale is possible. However, we also reveal that this project will necessarily be subject to continuous refinement – especially when it comes to standardising expert country evaluations. We outline practical challenges and suggestions for future work in this direction.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104908"},"PeriodicalIF":4.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of the introduction of generic methadone to the Ontario public drug formulary","authors":"Bisola Hamzat ,&nbsp;Tianru Wang ,&nbsp;Ria Garg ,&nbsp;Anita Iacono ,&nbsp;Mina Tadrous ,&nbsp;Fangyun Wu ,&nbsp;Jennifer Wyman ,&nbsp;Zoë Dodd ,&nbsp;Shauna Pinkerton ,&nbsp;Ashley Smoke ,&nbsp;Tara Gomes","doi":"10.1016/j.drugpo.2025.104918","DOIUrl":"10.1016/j.drugpo.2025.104918","url":null,"abstract":"<div><h3>Background</h3><div>Two new generic methadone products—Jamp-methadone and Odan-methadone—were added to Ontario’s public drug formulary in August 2022 and listed as interchangeable with the brand-name product, Methadose®. Concerns have been raised by people receiving methadone and their prescribers about potential risks of treatment destabilization as a result of switching between methadone-containing products.</div></div><div><h3>Methods</h3><div>We conducted a retrospective population-based time series analysis of weekly methadone claims in Ontario, Canada between January 5, 2017, and March 31, 2023. Using interventional autoregressive integrated moving average models, we assessed the impact of the formulary listing on product market-share, maximum dose dispensed, methadone discontinuation, and opioid toxicities.</div></div><div><h3>Results</h3><div>The market share of Methadose® declined from 99.7 % to 52.3 % between the listing of generic methadone and March 2023, whereas generic products increased from 0.27 % to 40.0 % (Jamp-methadone) and 0.0 % to 7.7 % (Odan-methadone). We observed a significant short-term increase in the percentage of individuals dispensed methadone doses ≥130 mg (+1.30 %; 95 % CI: 0.85 %, 1.76 %) following formulary listing; however the introduction of generic methadone did not result in a significant change in methadone discontinuation among those stabilized (<em>p</em> &gt; 0.5) and not yet stabilized on treatment (<em>p</em> &gt; 0.7) or opioid-related toxicity events (<em>p</em> &gt; 0.1).</div></div><div><h3>Conclusion</h3><div>Our findings did not indicate broad treatment destabilization or increased opioid-related toxicity among methadone recipients in the months following the introduction of generic products. Early notification of formulary changes, phased implementation of the policy, as well as information resources developed for patients and clinicians may have played a role in mitigating potential disruptions for this population.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104918"},"PeriodicalIF":4.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the estimation of unrecorded alcohol consumption in Chile: a multi-methods study","authors":"Carolina Cornejo ,&nbsp;Deirdre M. Gilmore ,&nbsp;Mariel Mateo Pinones ,&nbsp;Pablo Norambuena Cardenas ,&nbsp;Dirk W. Lachenmeier ,&nbsp;Jürgen Rehm ,&nbsp;Maristela Monteiro ,&nbsp;Alvaro Castillo-Carniglia","doi":"10.1016/j.drugpo.2025.104907","DOIUrl":"10.1016/j.drugpo.2025.104907","url":null,"abstract":"<div><h3>Background</h3><div>Reports of unrecorded alcohol consumption have relied on aggregated and regional information rather than empirical research on national characteristics. This study aims to inform about the Chilean unrecorded alcohol market and the magnitude of unrecorded consumption.</div></div><div><h3>Methods</h3><div>We employed a multi-methods approach with four components: a Delphi panel among experts (<em>n</em> = 21), a survey of people at increased risk of problematic alcohol consumption (<em>n</em> = 138), semi-structured interviews with key stakeholders and alcohol industry informants (<em>n</em> = 12), and chemical analysis of 10 unrecorded alcohol samples.</div></div><div><h3>Results</h3><div>After two rounds of consultations, experts challenged prior estimates of unrecorded alcohol consumption and set per capita levels between 0.05 and 0.5 liters of pure alcohol (0.7 %-8 % of total per capita alcohol consumption), with homemade alcohol as the primary source (31 %). Homemade alcohol consumption was prevalent among individuals at high risk of problematic alcohol use, where clandestine or unlicensed establishments and artisanal producers were primary sources. Informants identified regulatory controls, production traceability, and the affordability of recorded alcohol as factors that limit the unrecorded alcohol market in Chile. Conversely, the availability of raw materials and alcohol taxation were seen as potential threats. Finally, while chemical analyses revealed that some unrecorded alcohol samples exceeded regulatory parameters (e.g., acidity, impurities), all 10 samples were safe for human consumption.</div></div><div><h3>Conclusions</h3><div>Unrecorded alcohol consumption in Chile appears to be lower than previous estimates. A robust surveillance system of the alcohol market will strengthen the institutional capacity to monitor and take actions to prevent harm from recorded and unrecorded alcohol use.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104907"},"PeriodicalIF":4.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Having naloxone when you need it: Factors associated with owning and carrying naloxone among people who use opioids","authors":"Carl A. Latkin ,&nbsp;Lauren Dayton ,&nbsp;Haley Bonneau ,&nbsp;Melissa A. Davey-Rothwell ,&nbsp;Andrew Gaddis ,&nbsp;Oluwaseun Falade-Nwulia","doi":"10.1016/j.drugpo.2025.104914","DOIUrl":"10.1016/j.drugpo.2025.104914","url":null,"abstract":"<div><div>It is critical to have naloxone readily available in the event of an opioid overdose. This study examines the prevalence of owning and carrying naloxone and factors associated with ownership and carriage among people who use opioids in Baltimore, Maryland, from December 2022 to January 2025. Among the 780 community-recruited study participants who were aged 18 years or older and currently used non-prescription opioids, most (78.2 %) reported owning naloxone, with the majority (69.4 %) keeping it at their residence. While 41.8 % of participants reported always having naloxone available when using drugs, 13.5 % never did. Only 27.0 % were carrying it with them at the time of the interview. Frequent heroin/fentanyl use (aOR: 2.07; 95 % CI: 1.36–3.16) and reporting lower difficulty accessing naloxone (aOR: 2.37; 95 % CI: 1.85–3.05) significantly increased the likelihood of owning naloxone. Experiencing homelessness in the past six months (aOR: 2.09; 95 % CI: 1.40–3.12) and perceiving poor neighborhood treatment due to drug use (aOR: 1.27, 95 % CI: 0.1.08–1.49) increased odds of currently carrying naloxone. Although naloxone distribution programs have successfully improved access, substantial gaps remain in consistent naloxone carriage, necessitating targeted interventions addressing barriers to carriage, including drug use stigma.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104914"},"PeriodicalIF":4.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scapegoated communities, shared struggles: A call for solidarity with people who use drugs and queer and trans people","authors":"Kira London-Nadeau ,&nbsp;Christian Barborini ,&nbsp;Rebecca Haines-Saah ,&nbsp;Misha Bazarov ,&nbsp;Sean Bristowe ,&nbsp;Misha Khorkhordina ,&nbsp;Mélodie Lemay-Gaulin ,&nbsp;Catherine Gorka ,&nbsp;Robert-Paul Juster ,&nbsp;Heath D’Alessio ,&nbsp;Nicholas Chadi","doi":"10.1016/j.drugpo.2025.104915","DOIUrl":"10.1016/j.drugpo.2025.104915","url":null,"abstract":"<div><div>Efforts to control, repress, and punish drug use and queer and trans existence are rising as right-wing extremism becomes increasingly mainstream. These connected efforts are seen through the stifling of bodily autonomy and agency using criminal-legal, biomedical and political apparatuses, and have been executed similarly for people who use drugs and queer and trans people alike. This is most notable for those who exist at the intersection of these communities. Both groups have withstood attempts at manufacturing internal hierarchies – always at the expense of those who are already most marginalized – and eradication and erasure from public existence altogether. In this editorial, we argue that these mechanisms of oppression link not only the struggles of queer and trans people and people who use drugs, but also threaten those outside of these groups. As such, this paper is an urgent call to cultivate shared solidarity and action based in theorizing developed by people who use drugs and queer and trans communities. These tools support resistance against oppression not only through the reclamation of bodily autonomy and agency, but also by centering pleasures, desires, dreams, and the ability to imagine ‘utopian’ futures and versions of ourselves.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104915"},"PeriodicalIF":4.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis legalization in Canada: Implications for research","authors":"Patricia Di Ciano ,&nbsp;Christine M. Wickens ,&nbsp;Bernard Le Foll","doi":"10.1016/j.drugpo.2025.104917","DOIUrl":"10.1016/j.drugpo.2025.104917","url":null,"abstract":"","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104917"},"PeriodicalIF":4.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“A huge, unwieldy barrier to push through on a daily basis”: The effects of stigma on AOD workers and workplaces","authors":"Theresa Caruana ,&nbsp;Loren Brener ,&nbsp;Courtney von Hippel ,&nbsp;Elena Cama ,&nbsp;Candice Gilford ,&nbsp;Joanne Bryant","doi":"10.1016/j.drugpo.2025.104916","DOIUrl":"10.1016/j.drugpo.2025.104916","url":null,"abstract":"<div><h3>Background</h3><div>Stigma is known to impact the experiences of people who use drugs, hampering the realisation of better health and social justice outcomes, but much less is understood about how it impacts people who work in alcohol and other drug (AOD) services.</div></div><div><h3>Methods</h3><div>Within an online survey, Australian AOD workers provided text responses to questions about their perceptions and experiences of stigma, job satisfaction, and workplace wellbeing (<em>n</em> = 190). Data were analysed using iterative categorisation, and themes outlining two stigma manifestations and one intervention were generated with reference to the Health Stigma and Discrimination Framework.</div></div><div><h3>Findings</h3><div>AOD workers observed and were affected by stigma directed at people who use substances, whether personally as individuals with living/lived experience or indirectly through their professional role. Identifying and addressing stigma comprised essential but under-acknowledged work, best performed in a supportive organisational context. Contending with the structural drivers of stigma, which reinforce negative perceptions of service users and limit the effectiveness of health and wellbeing interventions, was described as both stressful and motivating. Workers also derived a sense of moral responsibility and experienced pride or personal fulfillment in providing compassionate care and contributing to progressive social change.</div></div><div><h3>Conclusions</h3><div>Understanding, responding to, and mitigating stigma need recognition as core aspects of AOD professional roles. To support worker retention and wellbeing, we suggest AOD services prioritise the development of strategies for working within a stigmatised context, while continuing to advocate against the injustices that stigma creates for people who use drugs.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104916"},"PeriodicalIF":4.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of cannabis use for medical reasons in Brazil: An exploratory latent class analysis study","authors":"Heloísa Scattone ,&nbsp;Luís Eduardo Gauer ,&nbsp;Julia Valle Pezzini ,&nbsp;Luís Fernando Tófoli","doi":"10.1016/j.drugpo.2025.104906","DOIUrl":"10.1016/j.drugpo.2025.104906","url":null,"abstract":"<div><h3>Background</h3><div>Although cannabis has a long history of therapeutic use, it has been subject to prohibition and stigma, including in Brazil. Recent social movements and legislative changes have enabled legal access to medical cannabis, yet bureaucratic and financial barriers restrict its availability. Understanding patterns of medical cannabis use – based on treated conditions, usage behavior, access routes, and product types – may help overcome these barriers and improve patient care. This exploratory study aims to identify distinct patient typologies based on these indicators among individuals legally accessing medical cannabis in Brazil.</div></div><div><h3>Methods</h3><div>We conducted an anonymous online survey among individuals using medically prescribed cannabis, including patients and caregivers. Data were collected between March and April 2023 via social media and online groups. Latent Class Analysis (LCA) was performed using indicators that captured key aspects of medical cannabis use: prior cannabis experience, symptom categories (mental health, neurological, and pain-related), evidence-based cannabis use, access pathways (associations, importation, pharmacy, court-authorized cultivation), administration routes, treatment costs, and duration of use. Multinomial logistic regression was used to examine associations between class membership and participant characteristics, including sociodemographic factors (age, gender, ethnicity, religion, education, income, region, and marital status) and survey informant (patient vs. relative or caregiver).</div></div><div><h3>Results</h3><div>A total of 1335 individuals participated. Among the solutions generated by the LCA, the five-class model was selected as optimal, reflecting specific clinical conditions, usage patterns, and access characteristics: (1) Mental Health Patient Class (36 %); (2) Pain Relief Patient Class (24.3 %); (3) Neurological Patient Class (17.8 %); (4) Prior-Use Multi-Symptom Patient Class (11.6 %); and (5) Recently Initiated Multi-Symptom Patient Class (10.3 %). Significant associations were found between class membership and gender, religion or spiritual affiliation, and monthly household income.</div></div><div><h3>Conclusions</h3><div>The study revealed heterogeneity among Brazilian medical cannabis patients, identifying distinct typologies with specific needs. Findings highlight how sociodemographic factors shape use patterns and inform ongoing reflections on access and care within a shifting regulatory context.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104906"},"PeriodicalIF":4.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of drug-related mortality among people receiving opioid-agonist treatment during the COVID-19 pandemic in Scotland","authors":"Megan Glancy ,&nbsp;Andrew McAuley ,&nbsp;Norah Palmateer ,&nbsp;Kirsten Trayner ,&nbsp;Alan Yeung ,&nbsp;Lee Barnsdale ,&nbsp;Saket Priyadarshi ,&nbsp;Kirsten Horsburgh ,&nbsp;Matthew Hickman ,&nbsp;Sharon Hutchinson","doi":"10.1016/j.drugpo.2025.104912","DOIUrl":"10.1016/j.drugpo.2025.104912","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic led to changes in delivery of opioid-agonist treatment (OAT) and risk of drug-related harm in Scotland. This study aimed to (i) examine changes in drug-related death (DRD) rates and the protective effect of OAT during the COVID-19 pandemic in Scotland (2020–2022) compared with the previous decade (2011–2019); and (ii) describe trends in OAT prescribing over the same period.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from the Scottish national Prescribing Information System linked to healthcare and administrative data from Public Health Scotland. The cohort included individuals prescribed OAT (methadone or buprenorphine). We examined trends in OAT prescribing, calculated crude DRD rates per 1000 person-years, and used multivariable quasi-Poisson regression to estimate adjusted incidence rate ratios (aIRR) for DRD risk across four time periods (2011–2013, 2014–2016, 2017–2019, and 2020–2022).</div></div><div><h3>Results</h3><div>Between 2011 and 2022, 49,000 individuals accessed OAT, contributing 366,344 person years of follow-up, during which 5255 DRDs occurred. In the COVID-19 pandemic period (2020–2022), 34,241 people received OAT and there were 1825 DRDs. DRD rates increased steadily prior to 2020, but remained stable during the pandemic: the observed DRD rate during 2020–2022 was comparable to 2017–2019 (aIRR=0.96, 95 % CI=0.80, 1.15). Across all periods, being on OAT was consistently associated with a lower risk of DRD compared to being off treatment (aIRR=3.47, 95 % CI=2.98, 4.05).</div></div><div><h3>Conclusions</h3><div>During the COVID-19 pandemic in Scotland, DRD rates remained stable following a three-fold rise since 2011–13. The protective effect of OAT was sustained during the pandemic, which highlights the importance of maintaining access to OAT during public health crises.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104912"},"PeriodicalIF":4.4,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring how an e-cigarette intervention influenced tobacco smoking behaviour in people accessing homelessness services: Findings from the SCeTCH trial process evaluation","authors":"Allison Ford ,&nbsp;Lauren McMillan ,&nbsp;Kirstie Soar ,&nbsp;Francesca Pesola ,&nbsp;Caitlin Notley ,&nbsp;Rachel Brown ,&nbsp;Emma Ward ,&nbsp;Bethany Gardner ,&nbsp;Anna Varley ,&nbsp;Charlotte Mair ,&nbsp;Jessica Lennon ,&nbsp;Janine Brierley ,&nbsp;Amy Edwards ,&nbsp;Danielle Mitchell ,&nbsp;Debbie Robson ,&nbsp;Peter Hajek ,&nbsp;Allan Tyler ,&nbsp;Steve Parrott ,&nbsp;Jinshuo Li ,&nbsp;Linda Bauld ,&nbsp;Sharon Cox","doi":"10.1016/j.drugpo.2025.104901","DOIUrl":"10.1016/j.drugpo.2025.104901","url":null,"abstract":"<div><h3>Background</h3><div>Smoking prevalence among people experiencing homelessness is high. This study explored the factors which influenced potential smoking abstinence among participants receiving an e-cigarette (EC) intervention within the Smoking Cessation Trial in Centres for Homelessness (SCeTCH) across Great Britian.</div></div><div><h3>Methods</h3><div>Using the Capability Opportunity Motivation – Behaviour (COM-B) model, hypothesised and emerging mediators were explored quantitatively via measures in baseline and follow-up questionnaires (n=239) and qualitatively via interviews with homelessness centre staff (n=16) and participants (n=31) who received an EC starter pack and 4-week e-liquid supply. We purposively sampled 8 centres for interviews, representing varied regions and participant vaping/smoking and sociodemographic status. Quantitative measures were analysed descriptively. Qualitative data were analysed thematically. Data from the two approaches were mapped onto the COM-B for combined analysis and reporting.</div></div><div><h3>Results</h3><div>After receiving the intervention, participants demonstrated high capability to use EC and appreciation of EC for harm reduction. Some participants reported dissatisfaction with vaping. Opportunity for behaviour change was strengthened by perceived acceptability to vape and social support beyond the centre but hindered by a smoking culture and perceived lack of staff support. Motivation was enhanced by EC efficacy belief, pride from cutting down, and financial benefits of vaping, but negatively impacted by challenging personal circumstances.</div></div><div><h3>Conclusion</h3><div>For people accessing homelessness support centres, smoking abstinence remains challenging. More intensive support and a variety of approaches to support smoking cessation, particularly those which address the psychosocial factors which hinder smoking abstinence, may be required. Future research should focus on how this can be achieved.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"143 ","pages":"Article 104901"},"PeriodicalIF":4.4,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}