Class difference in disease and survival

Men and women living in the poorest areas of England not only die younger than those living in more affluent districts, they also spend twice as many years in poor health, says a report in Health Statistics Quarterly. Conclusions are based on 1994-1999 data from the annual health survey for England, which each year asks about 20,000 people to rate their health on a five point scale from ‘very good’ to ‘very bad’. On average, men in England spend 59.1 years in good health and 15.9 years in poor health, while women spend 61.4 years in good health and 18.6 years in poor health. It is in the poorest areas that long years of ill health are most common. Men’s healthy life expectancy was 66.2 years in the richest tenth but only 49.4 years in the poorest tenth. Health Statistics Quarterly (2005;No 25:19-27) is available online at www.statistics.gov.uk/downloads/theme_health/HSQ25.pdf (BMJ 2005;330:498)

WHO tobacco control treaty

The World Health Organisation’s tobacco control treaty came into force on 27 February. 57 countries, including the UK, have ratified the treaty, which aims to reduce the number of smokers worldwide. Under the treaty, governments must:

• ban tobacco advertising, sponsorship and promotion, where constitutions allow, within five years
• include health warnings on tobacco packets that cover at least 30% of the packaging, within three years
• introduce measures to protect people from second-hand tobacco smoke in public places
• draw up strategies to combat smuggling
• adopt tax policies which discourage smoking

Some of the world’s largest tobacco growers - India, Japan, Pakistan, Thailand and Turkey – have ratified the treaty. However, more than two thirds of WHO countries have not agreed to be bound by its restrictions. (bbc.co.uk 2005; 27 February)

Kenyan boys castrated for AIDS potion

Late last year two teenage boys from the remote northern region of Bungoma, had all or part of their genitals cut off to be sold for the making of an HIV/AIDS potion. A six-year-old was also attacked in a similar way. Both older boys were taken to Bungoma hospital, where they came to the attention of Spanish doctor Pedro Cavadas, who was on a surgical trip in Kenya. The older boys have since been taken to Spain and had reconstructive treatment at the Levante Rehabilitation Centre in Valencia; the six year old is expected there later this year. The boys are expected to make a full recovery. (bbc.co.uk 2005; 3 February)

Deaths from assisted suicide

40 people from the UK have ended their lives at the Swiss assisted suicide clinic run by Dignitas. Michael Irwin of Friends at the End (FATE), a Scottish group that openly assists people in going to Switzerland, said that nine out of ten Britons he has helped to join Dignitas have committed suicide. Dignitas is thought to have some 800 British members. (Sunday Times 2005; 13 March) 37 people from Oregon also died via physician-assisted suicides last year according to official reports. Psychiatric evaluation was performed in only five per cent of cases. (CWNews 2005; 14 March)

NZ study links cannabis to psychosis

Researchers from Christchurch School of Medicine, New Zealand, have found that smoking cannabis nearly doubles the risk of developing mental illness. Over 1,000 young adults were interviewed. The study took into account factors such as family history, mental illness and other substance abuse, and whether illness encouraged more cannabis use. Nevertheless there was an increase in rates of psychotic symptoms with regular cannabis use. They note the findings add to the growing body of evidence which suggest heavy cannabis use may lead to increased risk of psychotic symptoms and disease in susceptible individuals. (Addiction 2005;100;3:354. Reported in Doctor 2005; 8 March 2005)

NICE withdraws Alzheimer’s drugs from NHS

New NICE guidance advise that certain Alzheimer’s drugs should no longer be prescribed on the NHS, having reviewed the latest evidence on efficacy and cost effectiveness. Comments on the proposals were taken until 21 March, and final guidance is expected in July. The NICE assessment group says that although the anticholinesterase inhibitors donepezil, rivastigmine and galantamine have proved gains in cognitive and global scales compared with placebo in people with mild to moderate Alzheimer’s disease, there is ‘limited and largely inconclusive’ evidence on outcomes that are important to patients and carers, such as quality of life and time to admission to a nursing home. (BMJ 2005;330:495)

New pre-eclampsia clue

A research team at Imperial College, London has found higher levels of antibodies to Chlamydia pneumoniae in women with pre-eclampsia. Their report in the British Journal of Obstetrics and Gynaecology says the infection could be a factor contributing to the development of preeclampsia in a small number of women predisposed to it. 91 pregnant women were included in the study. If further studies support these findings it may be advisable to screen women in early pregnancy and treat them if indicated. The research is seen as a promising development in the prevention and management of pre-eclampsia. C. pneumoniae, a cause of atypical pneumonia, is a different type of chlamydia to that which is sexually transmitted. (bbc.co.uk 2005; 28 February)

UN adopts human cloning ban

The UN General Assembly has voted to accept a declaration supporting a total ban on all forms of human cloning. The declaration urges member states to outlaw all cloning practices ‘as they are incompatible with human dignity and the protection of human life’. The General Assembly voted 84-34 with 37 abstentions to accept an earlier report against cloning. The non-binding declaration was put to the vote after the UN had failed to reach agreement on a binding ban. (bbc.co.uk 2005; 5 March) Richard Gardner, chairman of the working group on stem cell research and cloning at the Royal Society, said that the declaration would have no effect on ‘promising’ research into therapeutic cloning in the United Kingdom. He commented, ‘The voting shows a divided UN and fails to send out a clear message to maverick scientists that reproductive cloning is unacceptable’. (BMJ 2005;330:496) The UK government voted against the proposal. Health Secretary John Reid said the UK stem cell research industry remained ‘open for business’.