An evaluation of the effectiveness of tobacco-control legislative policies in European Community countries

The purpose of this paper was to assess the effectiveness of anti-tobacco smoking legislation from 1948 onwards in reducing actual per capita tobacco consumption in the twelve countries of the European Economic Community (EEC). In order to undertake these assessments a score was assigned to every legislative measure, indicating the a priori likely impact of this measure on tobacco consumption. Two approaches were then utilized. In the first, it was found that the cumulative anti-tobacco legislative score correlates well in time with a reduction of tobacco consumption. In the second, cross-sectional data from the EEC countries and multiple regression modelling were used to estimate the elasticities of tobacco price, per capita income and cumulative anti-tobacco legislation score; it was found that legislation has an impact on tobacco consumption which, although considerably smaller than the corresponding impact of tobacco price levels, is nominally significant and potentially important. The evaluative approaches utilized in this paper are based on observational data of ecologic nature and can provide only weak evidence about the causal nature of the reported associations. Nevertheless, this limited evidence suggests that legislative measures may be effective both by affecting price levels and through other mechanisms, including health education and the formation of a more general anti-smoking ethos.     

PSEUDOHYPERPHOSPHATAEMIA AND MONOCLONAL GAMMOPATHY

SUMMARY A case is reported of pseudohyperphosphataemia in association with a monoclonal gammopathy of undetermined significance.     

Comparative efficacy of Hanifin and Rajka''s criteria and the UK working party''s diagnostic criteria in diagnosis of atopic dermatitis in a hospital setting in North India

BACKGROUND: Diagnosis of atopic dermatitis (AD) depends on clinical features because no definitive diagnostic test exists. Criteria proposed by Hanifin and Rajka (Acta Derm Venereol (Stockh) 1980; Suppl 92: 44-47) were acceptable for hospital-based studies but were found not to be suitable for field studies. A UK working party formulated clinical diagnostic criteria that could be used in both hospital and epidemiological settings. Validation studies of the criteria showed widely variable results, probably due to different clinical settings and ethnicity. AIM AND OBJECTIVE: This study was undertaken to validate Hanifin and Rajka's criteria and to assess the comparative efficacy of their criteria and the UK working party's diagnostic criteria in the diagnosis of AD in a hospital setting in North India. SUBJECTS AND METHODS: This study serially included 101 patients with AD and 48 controls of paediatric age group. The study period was from July 2003 to December 2004. RESULTS: Hanifin and Rajka's criteria (sensitivity 96%, specificity 93.75%, positive predictive value 97% (PPV) and negative predictive value (NPV) 91.84%) had a statistical advantage over the UK working party's diagnostic criteria (sensitivity 86%, specificity 95.83%, PPV 97.75% and NPV 76.67%), with a P-value < 0.005.     

IMPOTENCE AND ITS NON-SURGICAL MANAGEMENT

SUMMARY Impotence is a common symptom which can cause considerable distress to both the sufferer and his partner. The use of pharmacotherapy to improve erectile function will continue to increase as safe and effective drugs are developed. However, restoring erectile function should not be the only treatment objective. It is also essential to address personal and emotional factors in the sufferer, conflicts in his relationship with his partner, and sexual problems in his partner, all of which may be instrumental in causing or maintaining the presenting impotence. We advocate a combined approach with appropriate medical treatment and sex and couple therapy     

Tobacco and cancer: how to react to the evidence.

Tobacco is a remarkable product when considering the number of diseases to which it can reliably be linked as a causal agent or at least as a factor which is partially responsible for the occurrence of disease. If we only look at cancer, tobacco is responsible for the vast majority of cancers of the lung, trachea and bronchus; a proportion of cancers of the bladder and of the renal pelvis; a considerable proportion of cancers of the oral cavity, lip, pharynx, larynx and oesophagus with, for these sites, a large potentiation of risk when associated with the drinking of alcohol; a proportion of cancers of the pancreas and possibly of renal adenocarcinoma. In addition, among women, tobacco use has been linked with an increased risk of cervical cancer. In order to evaluate the present burden of tobacco-related cancers in the world precisely, one needs to be able to consult precise statistics of cancer occurrence, tobacco use and the relationship between the two. The availability of such data varies greatly across countries. Although mortality, and to a lesser extent, morbidity cancer statistics are collected in many parts of the world, the coverage is far from exhaustive and of uniform quality. Commercial or governmental sources of data on tobacco also exist, but the most important missing link is knowledge of the population-specific risk attributable to tobacco use in various countries for all tobacco-related diseases. Despite imperfect knowledge, the link between tobacco use and cancer is clear enough to demand strong action.(ABSTRACT TRUNCATED AT 250 WORDS)