Posts Tagged ‘trends’

What Countries Smoke The Most Cigarettes?

Friday, December 17th, 2010

Smoking has become the affliction of a large magnitude of people and others seem to be joining the smoke bandwagon at an alarming rate. Smoking has become a very common sight with one out of every fifth person being a smoker. The trend of smoking has become very common among teenagers also. The problems one gets due to smoking are many, but they do not seem to encourage people to stop smoking or deter people for starting to smoke. The hazardous effects of smoking are many, but people do not seem to be paying heed; the tobacco companies seem to be the only one is reaping the rewards out of smoking.

Since tobacco was born, it has been a few companies dominate the tobacco industry. These companies control most of the production and distribution around the world. They are quick to adapt to their policies and tactics to conform to the regulations set by the government and cater to the needs of the ever-increasing number of smokers around the world.

Tobacco companies of the world

A few companies hold the tobacco production and control of tobacco; the three largest companies sell close to two thirds of the entire supply. The stagnation in demand has prompted them to explore new markets.

The government is in a predicament since the tobacco industry accounts for a vast amount of jobs, but it also has to protect the health of its citizens. The government has tried to cut down on smokers by increasing the taxes imposed on them. By increasing the taxes on tobacco products and leveling higher duties on the companies, the companies are forced to raise the prices, which indirectly reduce use; since higher priced goods will be used less often. There is not much the government can do since tobacco is not a banned product.

The large companies also diversify their business to keep abreast in the market. They use various ways the companies diversify.

By market segments: Products are usually divided into categories, from high priced premium cigarettes to low and middle class of cigarettes. Companies with big brand names sell premium high priced cigarettes but also expand in to lower class sales to protect them from susceptibility. A decline in sales of premium cigarettes will be ploughed back by the sales in the lower or middle brands of cigarettes.

By target group: Every cigarette has its target group. By creating a new target group, the company can raise its overall market share. Thus the need to branch out into women cigarettes and target young people.

This targeting of women and youngsters has been seen in bad light. The tobacco industry has long targeted young people with its advertising and promotional campaigns. One of the most memorable, “Joe Camel” campaign initiated by the R.J. Reynolds Tobacco Company, helped generate public outrage against tobacco company efforts to reach young audiences and it is no longer used. The reason is obvious, most people start smoking at an early age. Getting a hold on a new segment will increase its share in the market.

Women are also a segment that the industries try to win over. Cigarettes for women are put forward as a symbol of liberation and some even shown in the light of slimming products. Manufacturers produce (long, slim) cigarettes especially for women. Perfumed or scented cigarettes with exotic flavors are targeted at women. Cigarettes usually have the word “slim” or “lights” to attract women consumers. Minorities are also a target for the tobacco industry.

Diversification by tobacco products: cigarettes companies also try to branch out into other tobacco products. For example, Imperial tobacco has decided to branch out into the roll your own segment; it dominates both the tobacco and the paper for this segment.

Diversification by non-tobacco products: food seems to be the favorite for companies seeking to diversify. R.J. Reynolds bought Nabisco (which, in turn, was later acquired by Kraft) owned by Philip Morris. Japan Tobacco derives a (small) part of its sales from food. Logistics and wholesaling are another favorite

Austria Tabak, wholesaling of tobacco and other products (and the operation of vending machines) makes up a large share of turnover. Over 20 per cent of Altadis’ earnings originate in its logistics division. Skandinavisk Tobakskompagni owns the largest wholesaler of consumer goods in Denmark. BAT tried financial services (but, since 1998, is a pure tobacco company).

Diversification into food and other activities makes the tobacco companies less dependent on (slow-growing) sales of tobacco products. However, the profit margins in these industry are usually well below those attained in tobacco processing. Producing and marketing cigarettes remain the more lucrative activity.

Incase of diversification by geographical market, OECD-based tobacco companies are keen to reduce their dependence on their stagnant home markets and establish a presence in markets where growth is above average. After having started business in many markets in Latin

America, Central and Eastern Europe, and the Central Asian republics in the 1990s, their center of attention is shifting to the Far East. All the major tobacco companies now have a presence in Poland, Russia and the Central Asian republics. Austria Tabak, which gained a presence in

Estonia when it acquired the cigarette activities of Swedish Match also has a 67 per cent market share in Guinea. The company was considering entering Asian markets when it was taken over by Gallaher in June 2001. Through this take-over and the acquisition in 2000 of Liggett-Ducat, the Moscow cigarette maker, Gallaher greatly reduced its dependence on the UK market. Similarly, Japan Tobacco became a world player when it acquired the international activities of R.J. Reynolds. Thanks to a relentless internationalization drive, Germany’s Reemtsma now sells less than one-third of its total in its home market (compared to over 60 per cent in 1991) (see also figure 6). It is now on the go in several Central and Eastern European countries and, in 1999, it acquired Cambodia’s Paradise Tobacco Company.

The government.

A predicament is generally faced by the Governments all across the world. On the one hand, tobacco-growing and processing can makes a large contribution to employment, tax revenue and foreign exchange receipts. In many developing and formerly centrally planned economies, the tobacco companies have made sizeable and most welcome investments when other investors were disinclined to do so. On the other hand, governments have the responsibility to protect the population’s health. Smoking is harmful to health and treating people for smoking-related illnesses is expensive. This can lead to heated debates within the same government as each sector defends the interests it believes it should represent.

The economic importance of tobacco growing and processing differs from country to country. At the national level, cigarette (sales and import) tax can be a main source of government revenue. In Russia, cigarette tax revenue contributes around 8 per cent to the financing of the state budget.

When the government owns the industry, it receives profits in addition to tax. That is why, in so many countries, State monopolies continue to control cigarette trade and production. In China, proceeds from state-owned CNTC amounted to the equivalent of US,000 million in 1999. CNTC has been the Chinese State’s top revenue generator for years. Japan Tobacco earned more than US0 million for the Japanese State in the fiscal year ending March 2000. The monopolies can also play a social function. In Italy, several of the state monopoly’s factories are to be found in areas of high unemployment.

Then there are balance of payments issues to mull over, many low-income countries rely on the export of cash crops such as tobacco to pay for the service of their foreign debt.

Tobacco exports made up close to 10 per cent of Cuba’s exports in 1997-98. In the case of

Tanzania it was 15 per cent, In Zimbabwe over 25 per cent and in Malawi tobacco exports made up two-thirds of commodity exports.

Citizens smoke. But, if they smoke domestically produced cigarettes, using homegrown tobacco or use imported cigarettes and tobaccos can make a large difference when foreign exchange is scarce. That explains why so many countries try to restrict the imports of cigarettes and encourage domestic producers to use local tobaccos, for example, by providing a favorable tax treatment to companies that use a minimum percentage of homegrown tobaccos. The cigarette companies have also been a key source of investment in the formerly centrally planned countries of Central and Eastern Europe, and Central Asia. When others were disinclined to invest, those companies saw the possibilities offered by a blend of pent-up consumer demand, outdated production facilities and the association with independence and “western style” living that so appealed to the people in these countries after many years of central planning and little consumer choice. After having lobbied successfully for the reduction of restrictions of Asian markets such as Japan and the Republic of Korea, the large tobacco companies are eagerly waiting for the opening up of the other economies (notably China) that continue to restrict imports from and/or investments by foreign tobacco companies.

Tobacco growing, processing and exports can thus make a significant involvement to national employment and national income. Yet, however important tobacco growing and processing may be at the national level, its full economic and social significance is best grasped at the micro or regional level. In some regions, tobacco is grown side by side with the crop, which is the main source of income; its contribution to overall income is modest. However, in many others, tobacco is a main source of income and employment.

Tobacco growing and tobacco processing may bring substantial economic and social benefits, but the treatment of smoking-related illness is costly. Cigarette smoking causes cancer. It is addictive. The WHO estimates that tobacco products cause around 3 million deaths per year. Cigarette smoking is the major cause of preventable mortality in developed countries. In the mid-1990s, about 25 per cent of all male deaths in developed countries were due to smoking. Among men aged 35-69 years, more than one-third of all deaths were caused by smoking. The costs of treating all these people are clearly enormous (WHO, 1997).

So far, smoking has not had the same impact on mortality among women and among people from developing countries. There is an approximate 30-40 year time lag between the onset of persistent smoking and deaths from smoking. The effects of the greater incidence of smoking between these two groups will thus be felt with a lag, but it seems reasonable to believe that its impact on them will not differ fundamentally from that on developed country males.

It may be argued that smokers willingly take a certain health risk when enjoying their smoke. They like the taste and all the other things that they associate with smoking. Nevertheless, this does not apply to environmental tobacco smoke (ETS) or “second-hand smoke”.

Smoke gets in your eyes your clothes. Moreover, it gets in your lungs. Non-smokers cannot escape from smoke in badly ventilated areas. To be exposed to other people’s tobacco smoke can be a nuisance in addition to being a health risk for non-smokers.

Governments and conflicting pressures: How do they get by?

In practice, governments have opted for several strategies (which are often followed simultaneously). A recent strategy consists of seeking compensation for the costs of treating smoking-related illnesses. It has been followed with success in the United States, as we saw in section 3.4. Governments also set rules regarding the maximum content of hazardous substances in cigarettes. Most of all, however, governments try to discourage demand for what is, as the industry does not tire of telling us, essentially a legal product.

This is done in a variety of ways, with some governments applying particular vigor and others taking a more relaxed approach. Overall, however, the trend is clear: governments’ rules on smoking are becoming ever more restrictive. The use of tobacco products is being discouraged in several ways.

Limitation of the space where smoking is allowed.

This is done above all to protect non-smokers from involuntary exposure to tobacco smoke. Smoking is being prohibited in public places (particularly health care and educational facilities) and in mass transport. Legislation requires restaurants to reserve space for non-smokers.

Limitation by age group

It is prohibited to sell tobacco products to people under a certain age.

Limitations on points of sale.

The use of vending machines is being restricted because these cannot discriminate against sales to young people.

Health warnings stating that tobacco is harmful to health have become obligatory.

The warnings must be placed on packets and in ads, with the authorities prescribing the text and the minimum space allotted to the warning in the ad or on the pack. Governments sponsor education and public information programs on smoking and health.

Advertising bans. Restrictions concern the location of ads, the media used (no billboards, no ads in the printed media or in cinemas), the images presented (no young people, no cigarette packets), and the time when broadcasting is allowed (not during hours when children watch television).

The manufacturers are unhappy with these restrictions, and in particular with the ban on advertising. In their view, it is not proved that such a ban discourages demand for cigarettes (as its proponents claim). They are concerned about its effect on the value of their prime asset, the brand name.

Worldwide, the tobacco-processing industry employs hundreds of thousands of people. However, due to a combination of slow demand growth, consolidation, and higher productivity, this number is unlikely to increase by much in the near future. Fewer people are needed per unit of production. The industry is becoming less intensive in the use of labor. Tobacco growing, in contrast, gives work to millions of people. It continues to be a highly labour-intensive activity. The scope for productivity increases in tobacco growing would appear to be more limited than those in tobacco processing.

Over a million people are employed in the world tobacco industry

However, of this number a high percentage is employed in just three countries: China, India and Indonesia. The large number employed in China comes as no surprise in view of the large number of cigarettes (one-third of the world total) produced there. Still, the productivity gap with the United States is striking. China produces roughly three times as many cigarettes as the US, but it needs over nine times as many people to produce them. In the other two countries, the scope for productivity improvements would appear to be even higher.

THE SCENARIO TODAY.

The situation concerning smoking are scary, if global trends continue as they are doing today by 2030 more than 8 million people will die each year from tobacco related causes-80% in the developing regions of the World. In India per example where 120 million smoke 1 in 5 men will die for smoking. Smoking is on the decline in developed nations but is on a large-scale rise in developing or underdeveloped nations. The statistics are frightening, every eight seconds someone dies from smoking; about 15 billion cigarettes are sold daily. There are 1.1 billion smokers in the world today, and if things continue as they have, that number is expected to increase to 1.6 billion by the year 2025.

Smoking and use of tobacco products is on a decline in most developed countries. However, it is on a rampant increase in other developing countries.

In the US, there has been a decrease in the number of smokers. This can be attributed to the growing awareness of the damage smoking causes to the health of the individual. There is however a sad side to the story, smoking has increased to a drastic level in other countries and the figures are staggering.

China is home to 300 million smokers who consume upwards of 1.7 trillion cigarettes a year, or 3 million cigarettes a minute. As many as 100 million Chinese men presently under the age of 30 will die from tobacco use. There are approximately 120 million smokers in India today, and it is estimated that in the year 2010 alone, there will be close to one million tobacco-related deaths among men and women age 30 to 69 in India. Worldwide, tobacco use will kill more than 175 million people between now and the year 2030. Current tobacco-related health care costs in the United States total US billion annually. Germany spends an average of US billion, and Australia, US billion each year on health care directly related to tobacco use. Health care costs associated with secondhand smoke total US billion a year in the U.S. It is estimated that as many as 500 million people alive today will be killed by tobacco use. The statistics are chilling.

One reason for the sudden spurt in the numbers in these countries may be due to the arrival of tobacco companies. The lax stand of the governments in these countries makes it a good bet to start business. The anti smoking lobbies in these countries have not been able to combat the increase. Increased awareness has made it hard for tobacco companies to work in many countries and so the tobacco companies have shifted their sights to greener pastures.

These countries have a very small anti smoking lobby and the government restrictions o them are not so tough and the government is dependent on the revenues it earns from them. Setting up business in these countries has resulted in increased used of tobacco products.

The anti smoking lobby has been very effective in curtailing the spread and increase of smoking around the world.

Advertising related to tobacco has is banned in most countries. Warnings of the harmful effects of the product have to be printed on the packet. This statutory warning is mandatory in most countries. The WHO in its Framework Convention on Tobacco Control, which came into effect on 27 February 2005 has specified that all 168 countries should ban advertisements unless their constitutions forbade them to do so.

Today, we are aware of the hazards of smoking. Even though the people are aware of the harmful effects of smoking they rarely seem to pay heed. Everyone knows that smoking causes cancer, heart diseases and can shorten the life span of an individual. It is a highly addictive habit and smokers are at a risk of losing ten years of their life.

With so many smokers around the world, tobacco companies are the only ones gaining form the increase.

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What Are The Different Vaccine Types

Friday, December 17th, 2010

“A vaccine is a biological preparation that establishes or improves immunity to a particular disease.”

Vaccines can be prophylactic (e.g. to prevent or ameliorate the effects of a future infection by any natural or “wild” pathogen) or therapeutic (e.g. vaccines against cancer are also being investigated). The term vaccine derives from Edward Jenner’s 1796 use of the term cow pox (Latin variolæ vaccinæ, adapted from the Latin vaccīn-us, from vacca cow), which, when administered to human, provided them protection against small pox.

History

The early vaccines were inspired by the concept of variolation originating in China, in which a person is deliberately infected with a weak form of smallpox as a form of inoculation. Jenner observed that milkmaid who had contact with cowpox did not get smallpox. He discovered that deliberate vaccination with cowpox (which has very mild effect in humans) would prevent smallpox (which is often fatal). Jenner’s work was continued by Louis Pasteur and others in the 19th century. The 19th and 20th centuries saw the introduction of several successful vaccines against a number of infectious diseases. These included bacterial and viral diseases, but not (to date) any parasitic diseases. Opposition to vaccination, from a wide array of vaccine critics, has existed since the earliest vaccination campaigns. Disputes have arisen over the morality, ethics, effectiveness, and safety of vaccination. The mainstream medical opinion is that the benefits of preventing suffering and death from serious infectious diseases greatly outweigh the risks of rare adverse effect following immunization. Some vaccination critics say that vaccines are ineffective against disease or that vaccine safety studies are inadequate. Some religious groups do not allow vaccination, and some political groups oppose mandatory vaccination on the grounds of individual liberty.

Types of Vaccines

There are four types of traditional vaccines:

Dead microorganisms containing vaccines-Vaccines containing killed microorganisms – these are previously virulent micro-organisms which have been killed with chemicals or heat. Examples are vaccines against flu, cholera, bubonic plague and hepatitis A.
Live-attenuated vaccines-Vaccines containing live-attenuated  microorganisms – these are live micro-organisms that have been cultivated under conditions that disable their virulent properties or which use closely-related but less dangerous organisms to produce a broad immune response. They typically provoke more durable immunological responses and are the preferred type for healthy adults. Examples include yellow fever, measles, rubella and mumps. The live tuberculosis vaccine is not the contagious strain, but a related strain called “BCG”; it is used in the United States very infrequently.
Toxoids  - these are inactivated toxic compounds in cases where these (rather than the micro-organism itself) cause illness. Examples of toxoid-based vaccines include tetanus and diptheria. Not all toxoids are for micro-organisms; for example, Crotalis atrox toxoid is used to vaccinate dogs against rattlesnake bites.
Protein subunit- rather than introducing an inactivated or attenuated micro-organism to an immune system (which would constitute a “whole-agent” vaccine), a fragment of it can create an immune response. Characteristic examples include the subunit vaccine against HBV that is composed of only the surface proteins of the virus (produced in yeast) and the virus like particle (VLP) vaccine against human papillomavirus (HPV) that is composed of the viral major capsid protein.

A number of innovative vaccines are also in development and in use:

Conjugate - certain bacteria have polysaccharide outer coats that are poorly immunogenic. By linking these outer coats to proteins (e.g. toxins), the immune system can be led to recognize the polysaccharide as if it were a protein antigen. This approach is used in the Haemophilus influenzae type B vaccine.
Recombinant Vector – by combining the physiology of one micro-organism and the DNA of the other, immunity can be created against diseases that have complex infection processes
DNA vaccination – in recent years a new type of vaccine, created from an infectious agent’s DNA called DNA vaccination, has been developed. It works by insertion (and expression, triggering immune system recognition) into human or animal cells, of viral or bacterial DNA. Some cells of the immune system that recognize the proteins expressed will mount an attack against these proteins and cells expressing them. Because these cells live for a very long time, if the pathogen that normally expresses these proteins is encountered at a later time, they will be attacked instantly by the immune system. One advantage of DNA vaccines is that they are very easy to produce and store. As of 2006, DNA vaccination is still experimental.

While most vaccines are created using inactivated or attenuated compounds from micro-organisms, synthetic vaccines are composed mainly or wholly of synthetic peptides, carbohydrates or antigens.

MONOVALENT AND MULTIVALENT VACCINES

Vaccines may be monovalent (also called univalent) or multivalent (also called polyvalent).

Monovalent Vaccine

A monovalent vaccine is designed to immunize against a single antigen or single microorganism.

Multivalent Vaccine

A multivalent or polyvalent vaccine is designed to immunize against two or more strains of the same microorganism, or against two or more microorganisms.

In certain cases a monovalent vaccine may be preferable for rapidly developing a strong immune response.

Injections are now marketed (e.g. Pneumococcal conjugate vaccine and MMRV vaccine), which provide protection against multiple diseases.

Methods of administration

A vaccine administration may be

Oral,
By injection (intramuscular, intradermal, subcutaneous),
By puncture,
Transdermal or
Intranasal.
Efficacy

Vaccines do not guarantee complete protection from a disease. Sometimes this is because the host’s immune system simply doesn’t respond adequately or at all. This may be due to a lowered immunity in general (diabetes, steroid use, HIV infection) or because the host’s immune system does not have a B cell capable of generating antibodies to that antigen.

Even if the host develops antibodies, the human immune system is not perfect and in any case the immune system might still not be able to defeat the infection.

 Adjuvants are typically used to boost immune response. Adjuvants are sometimes called the dirty little secret of vaccines in the scientific community, as not much is known about how adjuvants work. Most often aluminium adjuvants are used, but adjuvants like squalene are also used in some vaccines and more vaccines with squalene and phosphate adjuvants are being tested. The efficacy or performance of the vaccine is dependent on a number of factors:

the disease itself (for some diseases vaccination performs better than for other diseases)
the strain of vaccine (some vaccinations are for different strains of the disease)
whether one kept to the timetable for the vaccinations
some individuals are ‘non-responders’ to certain vaccines, meaning that they do not generate antibodies even after being vaccinated correctly
other factors such as ethnicity or genetic predisposition

When a vaccinated individual does develop the disease vaccinated against, the disease is likely to be milder than without vaccination.

The following are important considerations in the effectiveness of a vaccination program:

careful modeling to anticipate the impact that an immunization campaign will have on the epidemiology of the disease in the medium to long term
ongoing surveillance for the relevant disease following introduction of a new vaccine and
Maintaining high immunization rates, even when a disease has become rare.

In 1958 there were 763,094 cases of measles and 552 deaths in the United States. With the help of new vaccines, the number of cases dropped to fewer than 150 per year (median of 56).  In early 2008, there were 64 suspected cases of measles. 54 out of 64 infections were associated with importation from another country, although only 13% were actually acquired outside of the United States; 63 of these 64 individuals either had never been vaccinated against measles, or were uncertain whether they had been vaccinated.

Adjuvants and preservatives

Vaccines typically contain one or more adjuvants, used to boost the immune response. Tetanus toxoid, for instance, is usually adsorbed onto alum. This presents the antigen in such a way as to produce a greater action than the simple aqueous tetanus toxoid. People who get an excessive reaction to adsorbed tetanus toxoid may be given the simple vaccine when time for a booster occurs.

In the preparation for the 1990 Gulf campaign, Pertussis vaccine (not acellular) was used as an adjuvant for Anthrax vaccine. This produces a more rapid immune response than giving only the Anthrax, which is of some benefit if exposure might be imminent.

They may also contain preservatives, which are used to prevent contamination with bacteria or fungi. Until recent years, the preservative thiomersal was used in many vaccines that did not contain live virus. As of 2005,  the only childhood vaccine in the U. S. that contains thiomersal in greater than trace amounts is the influenza vaccine, which is currently recommended only for children with certain risk factors. The UK is considering Influenza immunisation in children perhaps as soon as in 2006-7. Single-dose Influenza vaccines supplied in the UK do not list Thiomersal (its UK name) in the ingredients. Preservatives may be used at various stages of production of vaccines, and the most sophisticated methods of measurement might detect traces of them in the finished product, as they may in the environment and population as a whole.

Combined vaccines

Combined vaccinations are now widely used around the world, a result of the rapid increase in the number of shots recommended in current vaccination schedules.

 Oral Vaccine

The latest developments in vaccine delivery technologies have resulted in oral vaccines. A polio vaccine was developed and tested by volunteer vaccinations with no formal training; the results were very positive in that the ease of the vaccines increased dramatically. With an oral vaccine, there is no risk of blood contamination. Oral vaccines are likely to be solid which have proven to be more stable and less likely to freeze; this stability eliminates the need for a “cold chain”: the resources required to keep vaccines within a restricted temperature range from the manufacturing stage to the point of administration, which, in turn, will decrease costs of vaccines. Finally, a microneedle approach, which is still in stages of development, seems to be the vaccine of the future, the microneedle, which is “pointed projections fabricated into arrays that can create vaccine delivery pathways through the skin”.

Use in nonhumans

Vaccinations of animals are used both to prevent their contracting diseases and to prevent transmission of disease to humans. Both animals kept as pets and animals raised as livestock are routinely vaccinated. In some instances, wild populations may be vaccinated. This is sometimes accomplished with vaccine-laced food spread in a disease-prone area and has been used to attempt to control rabies in raccoons.

Where rabies occurs, rabies vaccination of dogs may be required by law. Other canine vaccines include canine distemper, canine parvovirus, infectious canine hepatitis, adenovirus-2 etc. among others.

Trends

Vaccine development has several trends:

Until now, most vaccines have been aimed at infants and children, but adolescents and adults are increasingly being targeted.
Combinations of vaccines are becoming more common; vaccines containing five or more components are used in many parts of the world.
New methods of administering vaccines are being developed, such as skin patches, aerosols via inhalation devices, and eating genetically engineered plants.
Vaccines are being designed to stimulate innate immune responses, as well as adaptive.
Attempts are being made to develop vaccines to help cure chronic infections, as opposed to preventing disease.
Vaccines are being developed to defend against bioterrorist attacks such as anthrax, plague, and smallpox.

Principles that govern the immune response can now be used in tailor-made vaccines against many noninfectious human diseases, such as cancers and autoimmune disorders. For example, the experimental vaccine CYT006-AngQb has been investigated as a possible treatment for high blood pressure.

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