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Background and Aims Visit-to-visit systolic blood pressure variability (BPV) is an important predictor of cardiovascular (CV) outcomes. The long-term effect of a period of blood pressure (BP) control, but with differential BPV, is uncertain. Morbidity and mortality follow-up of UK participants in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure-Lowering Arm has been extended for up to 21 years to determine the CV impact of mean systolic blood pressure (SBP) control and BPV during the trial, and amongst those allocated to amlodipine- and atenolol-based treatment. Methods Eight thousand five hundred and eighty hypertensive participants (4305 assigned to amlodipine ± perindopril-based and 4275 to atenolol ± diuretic-based treatment during the in-trial period (median 5.5 years) were followed for up to 21 years (median 17.4 years), using linked hospital and mortality records. A subgroup of participants (n = 2156) was followed up 6 years after the trial closure with a self-administered questionnaire and a clinic visit. In-trial mean SBP and standard deviation of visit-to-visit SBP as a measure of BPV, were measured using >100 000 BP measurements. Cox proportional hazard models were used to estimate the risk [hazard ratios (HRs)], associated with (i) mean with SBP and BPV during the in-trial period, for the CV endpoints occurring after the end of the trial and (ii) randomly assigned treatment to events following randomization, for the first occurrence of pre-specified CV outcomes. Results Using BP data from the in-trial period, in the post-trial period, although mean SBP was a predictor of CV outcomes {HR per 10 mmHg, 1.14 [95% confidence interval (CI) 1.10–1.17], P <.001}, systolic BPV independent of mean SBP was a strong predictor of CV events [HR per 5 mmHg 1.22 (95% CI 1.18–1.26), P <.001] and predicted events even in participants with well-controlled BP. During 21-year follow-up, those on amlodipine-based compared with atenolol-based in-trial treatment had significantly reduced risk of stroke [HR 0.82 (95% CI 0.72–0.93), P =.003], total CV events [HR 0.93 (95% CI 0.88–0.98), P =.008], total coronary events [HR 0.92 (95% CI 0.86–0.99), P =.024], and atrial fibrillation [HR 0.91 (95% CI 0.83–0.99), P =.030], with weaker evidence of a difference in CV mortality [HR 0.91 (95% CI 0.82–1.01), P =.073]. There was no significant difference in the incidence of non-fatal myocardial infarction and fatal coronary heart disease, heart failure, and all-cause mortality. Conclusions Systolic BPV is a strong predictor of CV outcome, even in those with controlled SBP. The long-term benefits of amlodipine-based treatment compared with atenolol-based treatment in reducing CV events appear to be primarily mediated by an effect on systolic BPV during the trial period. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses recommendations regarding the implementation of Article 14 of the World Health Organization's (WHO's) Framework Convention on Tobacco Control which deals with evidence-based support for tobacco smoking cessation. The international public health aspects of tobacco cessation are examined, along with well-being, premature mortality prevention, and the United Nations' Sustainable Development Goals. Tobacco cessation costs and affordability are assessed.

Background: Tobacco control in China, the world's largest producer and consumer of tobacco, began in the 1980s with the first national prevalence survey and a conference on tobacco held in Tianjin. Since then, there have been dozens of research papers, partial restrictions on smoking and tobacco advertising, public education campaigns, and the ratification of the World Health Organization Framework Convention on Tobacco Control, but progress has been slow. The state-owned tobacco industry remains a major obstacle to tobacco control. Recent developments: In the last few years, tobacco control efforts have accelerated beyond expectations. The triggering event was the publication on tobacco by the Chinese Central Party School, the ideological think tank of the Communist Party, followed by a spate of activity: directives to government officials; regulations issued by the Ministry of Education, the People's Liberation Army and the Healthy City Standards; tobacco clauses in national advertising and philanthropy laws; the creation of a Smoke-free Beijing; an increase in tobacco taxation; and a national smoke-free law currently in draft. Areas timely for policy research and action: There is a crucial need for China to build upon these recent developments, in accepting the economic research evidence of the debit of tobacco to the economy; in implementing robust, comprehensive legislation; in increasing cigarette price through taxation and, most challenging of all, to tackle the power and influence of the state tobacco monopoly over tobacco control. [ABSTRACT FROM AUTHOR]

The article outlines why tobacco harm reduction policy is based on incorrect assumptions and claims. Topics discussed include need for policy to motivate and support tobacco users to quit and achieve long-term abstinence; little evidence on the health effects of heated tobacco devices; and planning of tobacco company to phase out manufacturing of cigarettes and move into smoke-free product.

Introduction or background Tobacco currently kills 6 million people each year, increasingly in the low- and middle-income countries, which will bear the economic brunt of this epidemic. Tobacco control takes health professionals to very new destinations, away from the traditional curative medical model to mastering the corridors of power, using the media, and political lobbying and advocacy. None of these skills is taught in medical schools. Areas of agreement The magnitude and future expansion of the tobacco epidemic is beyond controversy, as is the fact that the economic costs of tobacco outweigh any benefits. The tools needed to reduce the epidemic are also known and accepted, and these are virtually identical in all countries. It only requires political will to implement these. Growing points All countries should ratify and implement the WHO Framework Convention on Tobacco Control and commit adequate funding to counter this global pandemic. Areas timely for developing research Action must be based on the science of epidemiology, prevalence, health effects, economic burden, success of action taken and tracking the tobacco industry. [ABSTRACT FROM PUBLISHER]

Abstract: Smoking prevalence is lower among women than men in most countries, yet there are about 200 million women in the world who smoke, and in addition, there are millions more who chew tobacco. Approximately 22% of women in developed countries and 9% of women in developing countries smoke, but because most women live in developing countries, there are numerically more women smokers in developing countries. Unless effective, comprehensive and sustained initiatives are implemented to reduce smoking uptake among young women and increase cessation rates among women, the prevalence of female smoking in developed and developing countries is likely to rise to 20% by 2025. This would mean that by 2025 there could be 532 million women smokers. Even if prevalence levels do not rise, the number of women who smoke will increase because the population of women in the world is predicted to rise from the current 3.1 billion to 4.2 billion by 2025. Thus, while the epidemic of tobacco use among men is in slow decline, the epidemic among women will not reach its peak until well into the 21st century. This will have enormous consequences not only for women's health and economic wellbeing but also for that of their families. The health effects of smoking for women are more serious than for men. In addition to the general health problems common to both genders, women face additional hazards in pregnancy, female-specific cancers such as cancer of the cervix, and exposure to passive smoking. In Asia, although there are currently lower levels of tobacco use among women, smoking among girls is already on the rise in some areas. The spending power of girls and women is increasing so that cigarettes are becoming more affordable. The social and cultural constraints that previously prevented many women from smoking are weakening; and women-specific health education and quitting programmes are rare. Furthermore, evidence suggests that women find it harder to quit smoking. The tobacco companies are targeting women by marketing light, mild, and menthol cigarettes, and introducing advertising directed at women. The greatest challenge and opportunity in primary preventive health in Asia and in other developing areas is to avert the predicted rise in smoking among women. [ABSTRACT FROM AUTHOR]

Sex: this most universal experience comes complete with an array of international similarities and some surprising differences - from country to country; between different ages, genders and cultures; and from the intensely personal to the economic and political. This essentially private activity often raises public and legal issues, even invoking the death penalty. Researching sex on a worldwide, comparable basis is not easy. There is no central depository for global sex information (in contrast to the World Health Organisation's databank of health statistics); very few sexology institutes or specialists exist in most countries; and only a handful of countries have comprehensive statistics. Sex research, where it exists, is usually fertility-related, rather than sex-orientated. Even definitions vary, for example of 'sex counselling', 'obscenity', or 'normal sex'. This paper explores global sexual practices, key comparative indicators such as laws and attitudes towards sexual orientation; availability of sex education and counselling; marriage, divorce, and adultery; reproductive health, safe sex and cloning; sexually transmitted infections; pornography and degrees of state censorship; religious attitudes; prostitution and sex tourism; sex crimes such as rape, harassment and stalking; and speculates on the future of sex. [ABSTRACT FROM AUTHOR]

Provides information on predictions extracted from a keynote address given by the author, at the closing session of the 10th World Conference on Tobacco or Health, in Beijing, China during August 24-28, 1997. INSET: The conference response to the proposed U.S. tobacco settlement.

Information is presented on the United Nations High-level Meeting on Prevention and Control of Non-communicable Disease, which was held in New York on September 19-20, 2011. The meeting recognized global oral health as crucial for the first time. World governments committed to address the issues of increase in non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular diseases, with oral diseases as an important part.

The authors reflect on the achievements of the World Health Organization (WHO) and public health advocates worldwide regarding tobacco control. They note some of these attainments including strengthening of global non-governmental movement against tobacco, increasing worldwide conferences on smoking, and the establishment of the International Network of Women Against Tobacco. They also explore the challenges faced by the WHO in 2012.

Examines the effects of government legislation against tobacco in Hong Kong, China. Increase of taxation in tobacco products; Reduction on the number of cigarette smokers; Publication of articles on smoking.

The article focuses on a comprehensive analysis of global tobacco use and control launched by the World Health Organization (WHO). It states that the report, funded by the Bloomberg Philanthropies, states that the global tobacco epidemic is included in the greatest public health threats of modern times. It mentions that this epidemic is shifting to the developing world and that only 4% of populations are protected by complete bans on tobacco advertising.

Considers the international ramifications of United States legislation related to the tobacco industry. Reference to the February 1998 issue and article entitled `Reinventing American Tobacco Policy'; US lawsuit against the tobacco industry; The McCain bill; Suggested requirements that should be included in any US tobacco legislation to ensure that it does not harm outside the US; Other countries that are using the US example in claiming tobacco-attributable health care costs.

Editorial. Reports on the increasing number of people in China who smoke cigarettes. Details of the increased number and reasons; Possibility of China becoming the leading exporter of tobacco by 2025; Measures taken by the Chinese government to reduce the trend; Steps the country should take to achieve an even greater reduction by 2025.

Talks about the ban on smokeless tobacco before it becomes established on a market and causes an additional epidemic of tobacco-related disease. Adverse effect of smokeless tobacco; Views on the promotion of smokeless tobacco.

Focuses on the significance of Hong Kong to the tobacco industry with its crucial position as the crossroads of Asia and the gateway to the People's Republic of China, which is potentially the most lucrative tobacco market in the world. Amount spent annually by Hong Kong in advertising cigarettes; Average rate of increase in tobacco consumption in developing countries per annum.

The article presents the author's comments on global oral health with particular reference to the World Health Organization (WHO) and the United Nations' call for a High-level Summit on Chronic Diseases in September 2011. It is commented that the international health community has finally realised that the burden of chronic and oral diseases which are growing at alarming rates.

Presents an obituary for David D. Yen, a pioneer of tobacco control program in Asia, who died on September 6, 2002. Family background; Educational achievements; Commitment to tobacco control.

Urumqi, in the extreme north-west Xinjiang Province of China, could be regarded as one of the remotest cities on earth, yet at the same time- nestling between Mongolia, Russia, and northern Pakistan-the centre of Asia. Yet even here, the Marlboro cowboy, depicting cigarette brand Marlboro, already rides the range. China banned all electronic and print advertising in 1992, but the national law did not cover either sponsorship or other promotion, or outdoor advertising. The smoking rates in China have not decreased in the last 20 years and the population increases during this period means that there are now more smokers.

Offers the author's thoughts on sex education. Research conducted on the subject; How in some countries laws relating to sex may be disregarded, including, for example, parental decisions can override the legal minimal age of marriage; Thoughts on the age at which children should be taught about sex.

Reports that Hong Kong legislators has voted in favor of tough antismoking measures in a tobacco bill passed in the week before the handover to China on July 1, 1997. Ban of tobacco advertising in the electronic media; Coverage antismoking provisions of the bill; Response from the tobacco industry; Potential impact of the antismoking measures on Hong Kong's economy.

Reports the approval of tobacco law by the Standing Committee of the 7th National People's Congress, the highest legislative body in China. Rate of women and men smoked daily; Effects of smoking on the rural population; Actions of the government for tobacco control in the area; Regulation of national tobacco monopoly.