UK government considers raising smoking age limit

Last Updated: 2006-07-03 9:00:30 -0400 (Reuters Health)

LONDON - The Department of Health (DoH) announced on Monday it was considering whether to raise the age limit for buying cigarettes or tobacco from 16 in a bid to cut the level of smoking among teenagers.

A consultation exercise has been launched to look at whether the age limit should be increased to 17 or 18, which would bring it into line with the sale of alcohol.

The government is also looking at whether there should be tougher measures introduced at shops that sell cigarettes to under-age children.

"Smoking is dangerous at any age, but the younger people start, the more likely they are to become life-long smokers and to die early," Health Minister Caroline Flint said.

"Someone who starts smoking aged 15 is three times more likely to die of cancer due to smoking than someone who starts in their late twenties."

The government said about 9 percent of children aged between 11 and 15 smoke. Raising the age limit to the same required to buy alcohol would bring Britain into line with the likes of Canada, Australia and the United States.

It is also pondering new sanctions including banning shops that regularly sell cigarettes to children from being allowed to sell tobacco at all.

The DoH said there was evidence that nearly 70 percent of underage smokers bought cigarettes from small local shops and newsagents.

"Access to cigarettes by under-16s is not as difficult as it should be and this is partly due to retailers selling tobacco to those under the legal age," Flint said.

"If a particular shop is known locally as the place for children and teenagers to easily buy tobacco, we want to stop that shop selling it."

Anti-smoking campaign groups welcomed the proposals but warned they might not have much effect.

"I don't think it will affect the number of young smokers as children smoke because it is seen as an adult habit, so in a way you are giving children even more incentive to start," Ian Willmore, of Action on Smoking and Health (Ash) told the BBC.

The consultation comes after MPs voted in February to ban smoking in pubs, restaurants and work places from the middle of next year.

The ban has already been introduced in Scotland and Ireland.

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Third antidepressant seldom effective: study

Last Updated: 2006-07-03 9:30:11 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Two prior unsuccessful antidepressant trials usually spell treatment failure with a third, new research suggests. In this scenario, remission rates are less than 20 percent.

The findings of the study, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, "continue to be sobering," AJP editor-in-chief Dr. Robert Freedman said in a statement. "By the third wave of the study, the rate of remission continues to be quite low, which underscores the persistence of depression and its resistance to current treatments."

The focus of the current analysis was to determine which agent, Remeron (mirtazapine) or Pamelor (nortriptyline), was most effective after two consecutive failed medication treatments for depressed outpatients. The study involved 235 adults who had failed treatment with Celexa (citalopram) and then with other antidepressants.

The subjects were randomized to receive Remeron (up to 60 mg/day) or Pamelor (up to 200 mg/day) for 14 weeks, lead author Dr. Maurizio Fava, from Massachusetts General Hospital in Boston, and colleagues note.

Pamelor therapy was associated with a remission rate of roughly 20 percent -- higher but not significantly different from the 12 percent rate seen with Remeron. Testing with another self-report measure of depressive symptoms, confirmed that each agent provided similar remission and response rates.

No significant differences in side effects or tolerability were noted between mirtazapine and Pamelor.

"The study has confirmed much of what we suspected, based on industry and federally sponsored clinical trials, case reports, and expert opinion," Dr. Matthew Menza, from the University of Medicine and Dentistry of New Jersey in Piscataway, notes in a related editorial.

"STAR*D does not answer all of our questions, but progress in science is incremental, and STAR*D has added incrementally to the evidence base for the use of antidepressants."

SOURCE: American Journal of Psychiatry July 2003.

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