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MOSAIC: The news that didn’t make it
Taxing tobacco “TAMBAKU noshi sehat key liye...” This warning has to tag on to every cigarette advertisement, be it TV, billboards or newspapers, in Pakistan. Cigarette ads are not allowed on PTV primetime. There are no-smoking zones in aeroplanes, several restaurants, offices, shops. On World Health Day (past April 7) the President of Pakistan promulgated an ordinance to prohibit smoking in public work places and vehicles. Effective May 31, 2003, tobacco is not to be sold to under-18 and within a radius of 50 meters from schools. All this, is to discourage smoking, and to protect non-smokers. But has warnings, ordinances and restrictions ever made a difference to tobacco prices, sales and consumption? According to a study by the World Health Organisation, tobacco products in developing countries are cheaper now than they were a decade ago. The study looked at tobacco price trends between 1990 and 2000 in over 80 countries, and indicated that cigarettes have become more expensive in several industrialized countries while becoming more affordable in many developing countries. Who warns that cheaper tobacco products will fuel tobacco-related diseases and deaths in developing countries. In spite of overwhelming support for increases in tobacco taxes from past studies conducted by the Who, the World Bank, the IMF and leading economists, the study shows that the price of tobacco products has not kept pace with inflation, and that there is room to increase tobacco taxes in developing countries. “Increasing the price of tobacco products remains one of the most effective methods of curbing the consumption of tobacco products and thereby reducing the global deaths caused by tobacco,” said Derek Yach, Who Executive Director of Noncommunicable Diseases and Mental Health and co-author of the study. “Higher prices may assist non-users in continuing to keep away from tobacco or even persuade them to quit, or prevent ex-users from starting again. Governments receive more revenue from increased taxation. It’s a win-win situation, “ he added. According to the World Bank, a price increase of 10 per cent can reduce demand for tobacco products by about four per cent in high-income countries and by the about eight per cent in low-and middle-income countries.—Samina Iqbal Source of all headaches THE lifetime prevalence of headache is more than 90 per cent, states a recent issue of the Journal of American Medical Association. Headache may arise from conditions that range from benign to catastrophic. Secondary headaches need thorough screening. A detailed history with a general and focussed neurological examination is mandatory. Once the secondary headache has been excluded, the primary ones can be episodic or chronic. The latter fall into the category of migraine or tension headaches. The cause of chronic headaches is not well understood. Physical or emotional trauma, major life change, surgery and female hormone changes can act as catalysts. Often these patients overuse acute pain killers, decongestants, muscle relaxants, sedatives or anxiolytics, which can perpetuate the headache. Tension headache is mild to moderate pain, generally bilateral and nonpulsatile. It typically remains unchanged or improves with physical activity. Stress is the most common trigger. Migraine is characterized usually by unilateral throbbing headache. It can be bilateral also and triggered by barometric pressure changes or stress. Treatment of migraine comprises of acute therapy with non-steroidal anti-inflammatory drugs and preventive strategies with certain beta-blockers or tricyclic antidepressants. Relaxation training, cognitive behavioural therapy, regulation of sleep, dietary and exercise patterns and trigger avoidance are all very helpful. Patient education and a vigorous therapeutic partnership between patient and doctor give successful outcomes.—Dr Fatema Jawad | ||
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