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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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Women Hit Especially Hard In Congo’s Worst Ebola Outbreak

For the afflicted, the road to recovery is long and lonely.

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Ebola, WHO, UNICEF, congo, Uganda, women
Congolese health workers register people and take their temperatures before they are vaccinated against Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo. VOA

The Democratic Republic of Congo is in the throes of its worst-ever Ebola outbreak, with more than 420 cases in the country’s volatile east, and a mortality rate of just under 60 percent. But this outbreak — the nation’s tenth known Ebola epidemic — is unusual because more than 60 percent of patients are women.

Among them is Baby Benedicte. Her short life has already been unimaginably difficult.

At one month old, she is underweight, at 2.9 kilograms. And she is alone. Her mother had Ebola, and died giving birth to her. She’s spent the last three weeks of her life in a plastic isolation cube, cut off from most human contact. She developed a fever at eight days old and was transferred to this hospital in Beni, a town of some half-million people in the east of the Democratic Republic of Congo.

More than 400 people have been diagnosed with Ebola here since the beginning of August, and more than half of them have died in a nation the size of Western Europe that struggles with insecurity and a lack of the most basic infrastructure and services. That makes this the second-worst Ebola outbreak in history, after the hemorrhagic fever killed more than 11,000 people in West Africa between 2013 and 2016.

This is 10th outbreak to strike the vast country since 1976, when Ebola was first identified in Congo. And this particular outbreak is further complicated by a simmering civil conflict that has plagued this region for more than two decades.

Guido Cornale, UNICEF’s coordinator in the region, says the scope of this outbreak is clear.

“It has become the worst outbreak in Congo, this is not a mystery,” he said.

What is mysterious, however, is the demographics of this outbreak. This time, more than 60 percent of cases are women, says the government’s regional health coordinator, Ndjoloko Tambwe Bathe.

“All the analyses show that this epidemic is feminized. Figures like this are alarming. It’s true that the female cases are more numerous than the male cases,” he said.

Congo, Uganda, ebola, Women
Health workers walk with a boy suspected of having been infected with the Ebola virus, at an Ebola treatment center in Beni, near Congo’s border with Uganda. VOA

Bathe declined to predict when the outbreak might end, though international officials have said it may last another six months. Epidemiologists are still studying why this epidemic is so skewed toward women and children, Cornale said.

“So now we can only guess. And one of the guesses is that woman are the caretakers of sick people at home. So if a family member got sick, who is taking care of him or her? Normally, a woman,” he said.

Or a nurse. Many of those affected are health workers, who are on the front line of battling this epidemic. Nurse Guilaine Mulindwa Masika, spent 16 days in care after a patient transmitted the virus to her. She says it was the fight of her life.

“The pain was enormous, the pain was constant,” she said. “The headache, the diarrhea, the vomiting, and the weakness — it was very, very bad.”

Congo, Ebola, Women
Marie-Roseline Darnycka Belizaire, World Health Organization (WHO) Epidemiology Team Lead, talks to women as part of Ebola contact tracing, in Mangina, Democratic Republic of Congo. VOA

For the afflicted, the road to recovery is long and lonely. Masika and her cured colleagues face weeks of leave from work to ensure the risk of infection is gone. In the main hospital in the city of Beni, families who have recovered live together in a large white tent, kept four meters from human contact by a bright orange plastic cordon. They yell hello at their caretakers, who must don protective gear if they want to get any closer.

And for Baby Benedicte, who is tended to constantly by a nurse covered head to toe in protective gear, the future is uncertain. Medical workers aren’t entirely sure where her father is, or if he is going to come for her.

Also Read: Congo Start Trials For Drugs Against Ebola

She sleeps most of the day, the nurse says, untroubled by the goings-on around her. Meanwhile, the death toll rises. (VOA)