Journal of Urban Health

, Volume 90, Issue 3, pp 542–551

Acute and Chronic Respiratory Symptoms among Primary Care Patients Who Smoke Crack Cocaine

  • Pamela Leece
  • Nikhil Rajaram
  • Susan Woolhouse
  • Margaret Millson
Article

DOI: 10.1007/s11524-012-9780-9

Cite this article as:
Leece, P., Rajaram, N., Woolhouse, S. et al. J Urban Health (2013) 90: 542. doi:10.1007/s11524-012-9780-9

Abstract

Among inner-city populations in Canada, the use of crack cocaine by inhalation is prevalent. Crack smoking is associated with acute respiratory symptoms and complications, but less is known about chronic respiratory problems related to crack smoking. There is also a gap in the literature addressing the management of respiratory disease in primary health care among people who smoke crack. The purpose of our study was to assess the prevalence of acute and chronic respiratory symptoms among patients who smoke crack and access primary care. We conducted a pilot study among 20 patients who currently smoke crack (used within the past 30 days) and who access the “drop-in clinic” at an inner-city primary health care center. Participants completed a 20- to 30-min interviewer-administered survey and provided consent for a chart review. We collected information on respiratory-related symptoms, diagnoses, tests, medications, and specialist visits. Data were analyzed using frequency tabulations in SPSS (version 19.0). In the survey, 95 % (19/20) of the participants reported having at least one respiratory symptom in the past week. Thirteen (13/19, 68.4 %) reported these symptoms as bothersome. Chart review indicated that 12/20 (60 %) had a diagnosis of either asthma or chronic obstructive pulmonary disease (COPD), and four participants (4/20, 20 %) had a diagnosis of both asthma and COPD. Majority of the participants had been prescribed an inhaled medication (survey 16/20, 80 %; chart 12/20, 60 %). We found that 100 % (20/20) of the participants currently smoked tobacco, and 16/20 (80 %) had smoked both tobacco and marijuana prior to smoking crack. Our study suggests that respiratory symptoms and diagnoses of asthma and COPD are prevalent among a group of patients attending an inner-city clinic in Toronto and who also smoke crack. The high prevalence of smoking tobacco and marijuana among our participants is a major confounder for attributing respiratory symptoms to crack smoking alone. This novel pilot study can inform future research evaluating the primary health care management of respiratory disease among crack smokers, with the aim of improving health and health care delivery.

Keywords

AddictionsCrack cocaineAsthmaCOPDPrimary care

Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • Pamela Leece
    • 1
  • Nikhil Rajaram
    • 1
  • Susan Woolhouse
    • 2
  • Margaret Millson
    • 3
  1. 1.Public Health and Preventive Medicine Residency ProgramUniversity of TorontoTorontoCanada
  2. 2.Department of Family MedicineUniversity of Western OntarioLondonCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada