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75 % of cigarettes sold loose in India: Study

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Shimla: Nearly 75 percent of all cigarettes in India are sold as single sticks valued at close to 30 percent of the Rs.35,000 crore (over $5 billion) Indian market, an international journal says. The sale of single cigarettes, which is not in the interest of public health, is an important factor for early experimentation, initiation and persistence of tobacco use, says the study.

“Based on the data collected from 10 jurisdictions, we estimate that nearly 75 percent (59-87 percent) of all cigarettes are sold as single sticks,” says the study, published in the Asian Pacific Journal of Cancer Prevention. The study was conducted under the International Union Against Tuberculosis and Lung Disease across 10 cities – Agartala, Baroda, Chennai, Delhi, Goa, Indore, Jaipur, Jorhat, Patna and Shimla. It recommends that the Indian government ban the sale of single cigarettes and eliminate “kiddy packs”. (The ban does exist but is observed more in breach than in practice.)

Under the tobacco control legislation in India, each tobacco product has to bear a specified pictorial health warning. But the single cigarette sales defy the overall purpose.The single cigarette sale is a win-win game for the tobacco industry, but not in the interest of public health,” said Kumar, a consultant with the World Health Organization’s tuberculosis programme and based in Shimla. It says single or loose cigarettes also promote the sale of illicit cigarettes and neutralise the effect of pack warnings and effective taxation, making tobacco more accessible and affordable to minors.

This is the first study to have estimated the size of the country’s single stick market.The survey was conducted in February 2014 by 10 authors to estimate the sale of cigarettes in packs and sticks, by brands and price over a full business day. Smoking of cigarettes, bidis and other smoked forms of tobacco are the single largest cause of preventable death among adults in India with more than 1.2 million dying annually.

The study says singles are preferred by smokers as it helps to conceal their habit since it is largely unacceptable publicly in India.The singles also give vendors a perverse incentive to extract extra margins. For cigarette companies, singles make it easier to promote new brands and conduct market research on customers at the point of sale.

Vendor interviews reveal that the high volumes of singles sale in the premium segment is experimentation of new and existing users, who aspire to become regular smokers of these cigarettes, which are currently smoked occasionally by them, says the study. Goa among all jurisdictions has the lowest proportion of single cigarette sales and higher pack sales.

It finds that in effect a single cigarette market neutralises four important tobacco control strategies – protecting minors, pictorial warnings, support quitting and effective taxation. According to it, students are vulnerable to an early initiation of tobacco use. An easy affordability of loose cigarettes is an enabling factor for the students and minors. The study establishes that taxes can be raised from 15 percent to 32 percent (depending upon the segment) till such time as single stick price and pack price variance is zero or diminished.

(IANS)

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A New Virus Typhus Rises In Los Angeles

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases.

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Retired coal miner James Marcum, who has black lung disease, takes a pulmonary function test at the Stone Mountain Health Center in St. Charles, Virginia, U.S., May 18, 2018. (VOA)

Typhus, a bacterial infection that is sometimes life threatening, is on the rise in Los Angeles and several other U.S. cities. Public health officials say homelessness is making the problem worse and that the disease, which is associated with poverty and poor sanitation, is making a comeback in the United States.

Los Angeles County has seen 64 cases of typhus this year, compared with 53 at the same point last year and double the typical number, with a six-case cluster among the homeless in L.A. this year. Two cities in the county that have separate counts are also seeing higher numbers: Long Beach with 13 cases, up from five last year, and Pasadena with 20, a more than three-fold increase from 2017.

At a clinic in the L.A. neighborhood called Skid Row, Dr. Lisa Abdishoo of Los Angeles Christian Health Centers is on the lookout for symptoms.

“It’s a nonspecific fever,” she said, “body aches, sometimes a headache, sometimes a rash.”

This kind of typhus is spread by fleas on rats, opossums, or even pets and is known as murine typhus, from the Latin word for “mouse.”

The risk is higher when people live on the streets in proximity to garbage, but the disease seems to be spreading through the Southern United States.

Not the typhus of WWI

“It’s never been considered a very common disease,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, “but we seem to see it more frequently. And it seems to be extending across from Southern California all along the Mexican border into southeastern Texas and then into the Gulf Coast in Florida.”

 

Typhus
A homeless man sits at his street-side tent along Interstate 110 along downtown Los Angeles’ skyline, May 10, 2018. Thousands of homeless people sleep on the streets of Los Angeles County.. VOA

 

Texas had 519 cases last year, said spokeswoman Lara Anton of the Texas Department of State Health Services. That’s more than three times the number in 2010, with clusters in Houston and Galveston. No figures for this year have been released.

This is a separate disease from typhoid fever and is not the epidemic form of typhus that caused hundreds of thousands of deaths in war time. That type, called epidemic typhus, is carried by body lice and often spreads in conflict zones. It led to millions of deaths in World War I alone.

Flea-borne typhus, the kind seen in California and Texas, is serious but often clears up on its own and responds to an antibiotic, Abdishoo said.

Typhus
Dr. Peter Hotez, dean of the Baylor College of Tropical Medicine, shows Associated Press journalists areas of Houston’s 5th Ward that may be at high risk for mosquitoes capable of transmitting the Zika virus in Houston.. VOA

“It seems to get better a little faster if you have the treatment,” she said. “But there are cases where people have had more severe complications — it’s rare, but getting meningitis, and even death,” she cautioned.

Migration, urbanization, climate change

The reason for increased typhus numbers is uncertain, but it may be linked to migration, urbanization and climate change, said Hotez, the disease specialist. In some parts of the world, typhus is still linked to war and instability, “in the conflict zones in the Middle East, in North Africa, Central Asia, East Africa, Venezuela, for instance with the political instability there,” he said.

Murine typhus is one of several diseases on the rise in the southern United States, Hotez said.

Typhus
People line up on Skid Row in Los Angeles to receive food, water, clothing and other basic necessities from Humanitarian Day Muslim volunteers.. VOA

“Others include dengue, now emerging in southern Texas and Florida, the Zika virus infection, Chikungunya. We have a huge problem with West Nile virus,” he added, and Chagas disease, a condition usually seen in Latin America.

A report in May from the U.S. Centers for Disease Control and Prevention found that such “vector-borne” diseases, transmitted by ticks, fleas or mosquitoes, more than doubled in the United States between 2004 and 2016.

Hotez says they are on the rise in many industrial nations with crowded cities and pockets of poverty.

Also Read: A Full Guide To Public Health Disease Hepatitis

Skid Row physician Abdishoo says flea-borne typhus is still uncommon on the streets of Los Angeles, but “it has us all on high alert for this illness that we don’t necessarily think too much about. We want to be vigilant,” she added, “when you see a communicable disease on the rise.”

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases. Voters approved funding in 2016 and 2017 to finance the efforts. (VOA)