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Rapid Responses: Rapid Responses published:
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Role of Education
- Ritika Mangal (12 August 2005)
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Comprehensive enforced legislation is desperately needed.
- Kelechi E Nnoaham (12 August 2005)
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Systematic Education and Comprehensive Measures are Essential
- Desmond A. Gale (15 August 2005)
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Education is the vital shield
- Ranjit K Dhelaria (18 August 2005)
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Information about drugs of abuse
- Magi Farre, Jimena Fiz, Marta Torrens (27 August 2005)
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Ritika Mangal, SHO Psychiatry Ormskirk District General Hospital, Ormskirk L39 2AZ
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Editor: This is a very useful article which reiterates our role not just as treating clinicians but as those involved with the society in promoting health. We can restrict the availability of these habit-forming substances like alcohol, tobacco and various drugs by declaring them illegal or by increasing their price as in tobacco. These measures can improve the statistics on total consumption. However, as noted in the article, adolescents have easy access to these substances. They are first exposed to the addiction on an experimental basis for which they do not even have to pay. Subsequently, depending on their drug dependence, they use all means to obtain them. My schooling was in India during the time when narcotics abuse was at its height and the government was trying hard to crack down on supply of drugs, even bringing death penalty for possessing a certain quantity of narcotics. I spent a lot of time in the Indian state of Gujarat, where alcohol consumption is illegal. However, both drugs and alcohol are freely available at a slightly extra cost anywhere in India. Therefore I am not surprised by the author's findings about the free availability of drugs to the teenagers in the UK. What I learnt from my Indian experience is that although alcohol consumption in the "dry" state of Gujarat is still high, the problem of drug abuse was at least controlled in India. The main reason for this was the extensive education and awareness campaign by the government and various other organisations. I remember participating in many street plays, poster campaigns and seminars that were organized in almost all the schools. It is true that adolescence is the most vulnerable time of life when people get hooked to these substances on an experimental basis. But it is also true that most of them go to schools where they can be educated so that they can make a rational choice. Like adults even school children have middle, upper and lower classes in terms of affluence (financial or intellectual). The middle class forms the majority and it is this middle class which can be more easily swayed away from drugs by education. I and all my friends never tried drugs because of education. Obviously this education cannot be given in formal text books. Popular media like TV, sports stars and media stars can convey it better and more convincingly to them. Even we doctors should organise workshops and talks for teenagers. I am sure education will provide a long term "active immunity" against substances of abuse. Restricting their sale can only provide short term "passive immunity”. Competing interests: None declared |
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Kelechi E Nnoaham, Public Health Specialist Registrar North Oxfordshire PCT Partnership, Banbury Business Park, Adderbury, Oxon, OX17 3NS
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Editor, I enjoyed reading the article by Ogilvie et al. They aptly identified that it is relatively easy for young people in the UK to obtain alcohol, cigarettes and other illicit drugs. They also establish the effectiveness of tax policies and enforced national legislation on the use of tobacco and alcohol. There is paucity of evidence that customs enforcement of laws against tobacco smuggling affect overall consumption. The authors did not however identify that the proliferation of counterfeit tobacco, which the Chief Medical Officer refers to in his recent report on the state of public health in England, might easily blunt the effect of a reduced market share of smuggled tobacco. Simple economic theory assumes that an increase in supply will control demand and the argument that lower taxes might reduce smuggling seems to be founded partly on this theory. The theory however appears to hold true when non-addictive human behaviour is concerned. The addictive nature of smoking and alcohol use mean that increases in supply are followed by increased or, at least, sustained demand. This fact is very clearly demonstrated in the study by Joossens et al, cited in the article. It is not very surprising to know that established evidence supports the role of comprehensive legislation in the control of tobacco and alcohol use. What is rather surprising is how conflicting messages are ever so often sent out to the public. It should not surprise anyone that cannabis is declassified and the use of the drug increased. What should have been surprising is a decrease in its use in spite of the declassification. In the years to come following the recent institution of 24 hour operating licenses to pubs in England, one would be surprised if irresponsible drinking decreased. There is a desperate need for national policies to create enabling environments for local promotion of health-enhancing behaviours if we must achieve the vision of making healthier choices easier. Competing interests: None declared |
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Desmond A. Gale, Retired G.P. No 9. Dayrells Court, Rockley, Christ Church, Barbados BB 15148
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Dear Sir/Madam. As Ritika Mangal and Kelechi E Nnoaham point out in their responses to this article systematic education and comprehensive measures appllied to all sections of society,young and old, rich and poor are indispensable. Systematic education should precede comprehensive social,economic,and legislative measures and would help both the public and Governmental as well as Non- Governmental policy makers to understand and fully accept the urgent necessity of preventing and eliminating or reducing to a minimum the abuse of alchohol, and the use of tobacco and drugs legal or illegal that not only cause intoxication and addiction but endanger or destroy the freedom and wreck the health of all who use them habitually and kill more than 50% prematurely. Nearly all of the measures required to achieve this are mandated by the Framework Convention on Tobacco Control and the fact that 168 members of WHO have signed this treaty and 74 m of these have ratified it are reasons to be optimistic about the future. Yours truly, D.A. Gale Competing interests: Honorary Director Tobacco Control Program Barbados Cancer Society |
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Ranjit K Dhelaria, Senior Medical House Officer South Tyneside District Hospital, Harton Lane, South Shields NE34 0PL
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I enjoyed reading this article and was tempted to put my view about the teenager accessibility to tobacco, alohol and illicit drugs. The accessibility is a major issue, but there are other factors which make the adolescent vulnerable to abuse these harmful substances and these mainly include the friends and peer pressure, family circumstances-socio- economic, and the psychological beliefs. We all read, hear and see about the addictive and harmful effects from the abuse of these substances but few of us take the message onboard and the rest don’t bother. Education is the vital shield and hence systematic education should precede comprehensive social, economic and legislative measures. The education should begin in home from the parents, which will then have a strong foundation. Competing interests: None declared |
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Magi Farre, Associate professor and Researcher Institut Municipal d'Investigacio Medica, HMAR-IAPS,UAB. Doctor Aiguader, 80. Barcelona 08003, Jimena Fiz, Marta Torrens
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As Ogilvie et al affirm, availability is one of the many factors that may influence substance use. Other important factors are perception of risk associated to consumption and information provided to consumers by drug information resources (1,2). In recent years, Internet seems to have a relevant increasing paper as information resource about drugs for European young people. Use of Internet for that purpose has risen significantly, from 28% in 2002 to 34% in 2004 (1,2) in the European Union. Although the type and quality of the information provided varies widely from page to page, an important number of web pages are clearly “pro drugs” and actively promote the use of substances (3). Recent papers have found a large amount of information that could not be adequate to young people surfing on the web, and that these materials could influence drug use behaviour (4,5) In addition, Internet is not only a source to obtain illicit substances, but also marketed medicines that need medical prescription (e.g. benzodiazepines or opiates). Government and society should increase efforts to design web sites to inform and prevent the initiation and use of substances. 1.European Comission. Young People and Drugs. Flash Eurobarometer 158, 2004. 2.European Opinion Research Group. Attitudes and opinions of young people in the European Union on drugs. Special Eurobarometer 172, 2002. 3.Schifano F, Leoni M, Martinotti G, Rawaf S, Rovetto F. Importance of cyberspace for the assessment of the drug abuse market: preliminary results from the Psychonaut 2002 project. Cyberpsychol Behav 2003;6:405- 10. 4. Wax, PM. Just a Click Away: Recreational Drug Web Sites on the Internet. Pediatrics 2002;109:96. 5.Boyer EW, Shannon M, Hibberd PL. The Internet and psychoactive substance use among innovative drug users. Pediatrics 2005;115:302-5. Competing interests: None declared |
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