Editor's Choice | This Week in BMJ | Press releases
BMJ No 7106 Volume 315 Press Releases Saturday 23 August 1997 Embargoed: 00.01 Hrs 22 August 1997 UK time
Tobacco - time for action at home and abroad
Banning tobacco advertising can only form part of our response to the tobacco industry's efforts to attract and retain customers, says an editorial in this week's BMJ. What is needed is a broader focus on the increasingly sophisticated business of tobacco marketing, and its appeal through branding, to the young. The editorial goes on to make three points: that young smokers are vital to the tobacco industry; that branding is the key tool they use to attract new smokers. It provides them with important social and psychological props that ease the process of starting to smoke; and that all aspects of marketing - product development, pricing strategy, promotion and distribution - are used to develop and hone brands, and all these activities therefore need to be controlled. "Perhaps the easiest way forward is to tell tobacco companies what they can do rather than what they can't," they suggest. "Ideally, they should be allowed simply to produce and sell plain packs of low tar cigarettes and communicate about these only by approved letter in response to specific inquiries from retailers or the public. Brand names in standard fonts could be permitted, but only on the pack. These should be the limits of tobacco marketing. Only with such stringent and wide ranging measures can we hope to limit seriously the tobacco marketers' ability to attract the young to smoking," they conclude.
Contact:
Strathclyde University
Tel: 0141 552 4400
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Beijing Continental Grand Hotel
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[The challenge for Beijing: the 10th World Conference on Tobacco and Health] Tobacco control must be seen as a global issue, not just a national concern, says an editorial in this week's BMJ. The proposed settlement in the US, negotiated by the tobacco industry and state attorney generals is problematic, says the author, with some leading figures in the health field arguing that the industry should be controlled by legislation and not negotiation. The US settlement will do nothing to help developing countries, argues the author. "If anything it will accelerate the global spread of smoking." In developing regions over half the men are current smokers and cigarette consumption is rising. With a quarter of the world's smokers smoking a third of the world's cigarettes, China has become the major tobacco control battleground. The Beijing conference on tobacco and health which takes place this month is concentrating on the themes of developing countries and women, and a record number of developing country delegates will attend. Developing countries are most vulnerable to the tobacco industry, says the author, who calls for a unified approach based on the best national strategies to accelerate the trend towards a smoke-free world.
Contact:
University of Auckland
Tel: 0064 9 373 7599
xtn 6722 [Test sales do not have impact on prevalence of smoking by children] A letter reports a survey carried out in two schools in Gateshead in May 1995 and May 1996. In 1995 in school A 39% of girls aged 14-15 were regular smokers and 26% of boys. In school B, 24% of girls and 14% of boys were regular smokers. Altogether 95% of children who were regular smokers bought cigarettes from shops at least once a week. Only 2.5% in 1995 and 6% in 1996 reported ever having had someone refuse to sell them cigarettes. The local trading standards office carried out test sales - in which a child attempts to purchase cigarettes while being observed by a trading standards officer - in shops around school A. No test sale purchases were made, and hence, there were no prosecutions, despite the ease with which the children were able to buy cigarettes in local shops. The study suggests that test sales may not be a useful measure of the availability of cigarettes to children, and it may not be justified to continue them in their current form, say the authors.
Contact: University of Newcastle
Tel: 0191 477 6000 The number of elderly people with dementia in the UK will increase steeply over the next few decades, predicts a paper in this week's BMJ. The prevalence of cognitive impairment increases with age, say the authors, and they predict that the increase in numbers of elderly people with such problems will outpace the increase in the elderly population as a whole. In 1996, 41% of elderly people with cognitive impairment were estimated to be aged 85 and over, but according to the authors' model this will rise to 45% by the year 2006 and 52% by 2036. Ageing has important consequences, since the risk of living in an institution rises sharply with age. This will have important implications for policymakers, say the authors, since "financing long term institutional care for elderly people is a contentious political issue".
Contact: University of Cambridge
Tel: 01223 330 332
The prevalence of obesity in many countries is now so high that it should be considered a pandemic. says a paper in this week's BMJ. One estimate suggests that over the past decade the average Australian adult has been adding one gram a day to his or her bodyweight. Although there is increasing knowledge and awareness about obesity, nutrition, and exercise, the inexorable rise has continued, say the authors, who suggest that a new way of tackling obesity is needed. Dietary fat and energy intake have not fallen as fast as energy output and the result is a large energy imbalance leading to obesity, they say. But large reductions in the fat content of the modern diet seem unlikely, as do large scale increases in high intensity exercise. Obesity has become a normal response to an abnormal environment, and the challenges this poses are not currently being met, say the authors; "Hence it is important to re-examine the paradigms on which treatment and prevention programmes are based." The driving force for the growing prevalence of obesity is environmental rather than an increase in metabolic defects of genetic mutations within individuals, they say, and this knowledge should inform a wider public health approach to the obesity pandemic. Contact:
Deakin University
Tel: 0061 2 9977 7753
Withdrawal of diuretics in elderly patients without heart problems or high blood pressure frequently leads to the emergence of heart failure symptoms or a rise in blood pressure, says a paper in this week's BMJ. Diuretics are among the most commonly prescribed drugs in Western society, say the authors, with about 20% of elderly patients using them long term. There is, however, doubt about the necessity of such large scale usage. The authors carried out a randomised trial to assess what proportion of elderly people could be withdrawn from diuretic therapy, and found that the potential adverse effects of stopping treatment were such that about 50% of patients needed to go back on the medication within six months. Withdrawal of diuretic therapy does more harm than good in most patients, they conclude, and extensive monitoring of attempts to withdraw from such treatment is essential.
Contact:
Erasmus University Medical School
Tel: 0031 10 408 7621
Embargoed: 00.01 Hrs 22 August 1997 UK time
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