Safeworks is an Alberta Health Services program in Calgary that was distributing crack pipes as part of public health harm reduction. A survey was conducted with 179 respondents (131 male and 48 female) who received crack pipes from Safeworks. Fifty-six percent of females were Aboriginal and 70.2% of males were Caucasian. Forty-four percent were Hepatitis C positive and 4.4% were HIV positive. Sixty-three percent lived in homeless shelters. Sixty-six percent of respondents increased their access to other Safeworks services since commencement of pipe distribution. Seventy-one percent used a mouthpiece on their pipe, and, 78% in the past year had never burned or cracked their lips or had only done so once or twice. Ninety-five percent usually used glass or pyrex pipes. Fifty-four percent reported smoking more crack when they had their own pipe. Drug injecting frequency decreased for 28.4%. Sixty-six percent shared pipes. The public health implications of the findings are discussed.