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ObjectivesThe objective is to (a) refine and use methods to measure the point prevalence of smoking and of secondhand smoke exposure in moving vehicles and (b) compare these prevalences (1) between two areas of contrasting socioeconomic status and (2) over time.MethodsThe authors developed and tested a single-observer method and observed the point prevalence of smoking in vehicles in Wellington, New Zealand. The two observation sites represented high and low areas of socioeconomic deprivation (based on a small area deprivation index).ResultsA total of 149 886 vehicles were observed. The mean point prevalence of smoking in vehicles at both sites combined was 3.2% (95% CI 3.1% to 3.3%). Of those vehicles with smoking, 4.1% had children present. Smoking point prevalence in vehicles was 3.9 times higher in the area of high deprivation than in the area of low deprivation (95% CI 3.6 to 4.2). The same pattern was seen for vehicles with only the driver at 3.6 times (95% CI 3.4 to 4.0), in vehicles with other adults at 4.0 times (95% CI 3.4 to 4.7) and in vehicles with children at 10.9 times (95% CI 6.8 to 21.3), with all results adjusted for vehicle occupancy.ConclusionsObserving smoking in vehicles using a single-observer method provides a feasible and objective indicator of the different smoking behaviours, especially around children, within an area. This study further supports the evidence from this country and internationally that adults and children from high-deprivation areas are much more likely to be exposed to secondhand smoke. [ABSTRACT FROM AUTHOR]

Background The strength of the smoking–mortality association may vary over time and by ethnic group.Methods Cohort studies of 1.6 million (1981–84) and 1.9 million (1996–99) New Zealanders aged 25–74 years were formed by the linkage of census and mortality data. Comparing current smokers with never smokers, standardized rate ratios (RRs) and rate differences (RDs) were calculated for all-cause and ischaemic heart disease (IHD) mortality.Results Between 1981–84 and 1996–99 the all-cause mortality RR increased from 1.59 (95% CI 1.53–1.66) to 2.05 (1.97–2.14) for men and from 1.49 (1.42–1.56) to 2.01 (1.91–2.12) for women. All-cause RRs were significantly greater among non-Ma–ori non-Pacific than Ma–ori: 2.22 (2.12–2.33) compared with 1.51 (1.35–1.69) in men and 2.20 (2.09–2.33) compared with 1.45 in women (1.27–1.66), respectively, in 1996–99. This RR heterogeneity remained after adjusting for socio-economic factors and was similar for IHD. The RDs demonstrated less heterogeneity. For example, in 1996–99 the RDs were 627 per 100 000 (452–802) for Ma–ori compared with 464 (427–502) for non-Ma–ori non-Pacific among men, and 368 (228–509) compared with 340 (311–370) among women.Conclusions In New Zealand the relative effect of smoking on mortality differs over time and by ethnicity. We expect that such heterogeneity exists in other countries where the background mortality rates vary over time or between social groups. Information on this heterogeneity, including ethnicity-specific data, is needed to accurately determine the mortality burden owing to tobacco. The size of the RR estimates should be interpreted in the context of absolute mortality and effect measures. [ABSTRACT FROM AUTHOR]

Abstract We aimed to describe the public health burden and epidemiology of international terrorism (i.e. involving foreign nationals) with fatal outcomes in developed countries. Data was abstracted from a United States Department of State database for 21 ‘established market economy’ countries and 18 ‘former socialist economies of Europe’ for 1994–2003. To put the findings in a wider context, comparisons were made with WHO data on all homicides for each country. A total of 32 international terrorist attacks causing fatalities were identified over the 10-year period. These resulted in 3299 deaths, giving a crude annual mortality rate of 0.3 per million population. The mortality burden attributable to international terrorism in these countries was 208 times less than that attributable to other homicide. Even for the country with the highest mortality burden from international terrorism (the United States), this ratio was 60. There was no statistically significant trend in the number of attacks over time, but the attack severity (in terms of deaths per attack) was higher in the latter part of the 10-year period. A number of limitations with this data set were identified. If a more rigorous definition of ‘international terrorism’ was used, then this would substantially reduce the total number of such attacks defined in this way. In conclusion, there is a need for better quality data and improved classification systems for describing international terrorism. Nevertheless, the available data indicates that the mortality burden from international terrorism in developed countries is small compared to that from other homicide. [ABSTRACT FROM AUTHOR]