The Pharmaceutical Journal
Vol 275 No 7374 p586
5 November 2005

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Why a word in your ear can be dangerous more
Rising tides are an underrated threat to coastal communities more
Cutting young people's access to alcohol, tobacco and other drugs more

Why a word in your ear can be dangerous

There have been conflicting opinions over the desirability or otherwise of the use of mobile phones by drivers of motor vehicles. It seems a commonsense belief that any extraneous activity tending to distract a driver’s attention from the task in hand must, logically, be hazardous to some degree. On the busy roads of today, decisions affecting other road users need to be made in split seconds, not deliberated upon.

Some observers even believe that listening to a tape recording during a journey may prove tricky, the degree of risk bearing some relation to the nature of the music or speech of the programme to which a driver is listening. Background conversation with a passenger, too, must surely be subject to criticism.

The advent of the mobile phone, enabling aural communication during some other activity, has raised this issue of safety. In the BMJ for 27 August a group of researchers from Australia and the US has investigated the role of mobile phones in motor vehicle crashes which resulted in attendance at a hospital. It is accepted that phone use affects reaction time, variability of position in traffic lanes and speed. Both hands-free and hand-held phones involve distraction of attention. It has been estimated that the risk of driving while using a phone is four times higher than driving without one, and hands-free instruments appear to offer no advantage. Sex and age group make no difference.

A survey of 456 drivers aged 17 or older who had been involved in road crashes necessitating hospital attendance showed that using a phone up to 10 minutes before the crash increased risk fourfold. The risk was similar for men and women and drivers older or younger than 30 years. However, it is agreed that laws limiting phone use entirely during driving would be difficult to enforce. Technology using voice-activated devices is available, but if it results in wider use of phones during driving it might lead to even more crashes than at present.

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Rising tides are an underrated threat to coastal communities

Since the end of August we have heard increasingly worrisome accounts of what has happened in the wake of Hurricane Katrina's assault on New Orleans and its vicinity. Scientists had warned that such an event might occur, but no outstanding precautions had been observed to minimise the impact. It seems likely that parallel disasters are to be foreseen in the future, there and elsewhere.

Our own British coastal areas are known to be at some risk, and dwellings at or below present sea level are threatened. Now and then a violent rainstorm adds its quota to the shadow thrown by Mother Nature on the precarious achievements of the human race. Yet still we tend to dismiss future problems as not urgent. We still take an ambivalent view of the cumulative effects of global warming, and many politicians dismiss the idea as irrelevant to our future.

I notice from a review in the 15 August issue of Science that a book has now been published on the subject of the role of science in saving Venice. For centuries the Jewel of the Adriatic has been vulnerable to the onslaught of the sea. Indeed, the prosperity of Venice from the fifth century depended largely upon its location within a lagoon from which its fleets of commercial vessels could set sail with ease upon profitable enterprises, while protecting the city from invaders.

In November 1966, a great ocean surge raised the local water level by 2m, flooding more than 90 per cent of the city and prompting vigorous investigation and debate. The frequency of high water incursions in Venice increased dramatically over the past century. The flooding of St Mark’s Square occurred fewer than 10 times a year in the early years but more than 60 times in recent years. Land subsidence has added to the phenomenon by deepening the lagoon.

To save the city from destruction, three mobile flood barriers that can be raised when a storm surge is expected are being constructed. Yet there is more than an engineering problem to address. Water exchange between the lagoon and the Adriatic will involve ecological considerations that will have an impact on the future shape of storm surges. In Venice, as elsewhere in the world, preventing floods requires a vast amount of research and planning.

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Cutting young people's access to alcohol, tobacco and other drugs

In the BMJ for 13 August a group of public health doctors from Scotland summarise the situation regarding access to tobacco, alcohol and other drugs by youths in the UK. They point out that one potential approach to reducing the abuse of psychoactive substances is to control their availability, but that different substances have been considered in isolation and therefore in some confusion.

Tobacco, they state, is widely and legally available to persons from the age of 16. Cigarette prices may be high but cheaper tobacco can be imported for personal use, and underage smokers can acquire cigarettes easily from shops, relatives and schoolmates. Youngsters are sensitive to price, but often overcome this disadvantage.

Alcohol is also widely and legally available for sale. Young people often begin drinking it at home with their parents. Later they drink with friends or at parties and, at 14 or 15, start a round of clubs and public houses. Although those younger than 18 may not legally purchase alcohol, if aged between 12 and 15 they often manage to use friends or relatives and, thereafter, use off-licences or shops. Price plays some role in their purchase of alcohol, but changes in licensing hours have limited impact. Raising the minimum purchasing age reduces consumption and the traffic accidents associated with it.

About a third of 13-year-olds and two thirds of 15-year-olds find illicit drugs, particularly cannabis, “very easy” or “fairly easy” to acquire. By the age of 15 at least some 10 per cent claim to have been offered diamorphine or cocaine. Initially, friends or relatives supply them for experiment, and later they can be purchased at school.

Control through legislation is limited and younger children obtain most of their supplies from social rather than commercial sources.

There is little evidence that voluntary agreements with legitimate retailers or intervening in illicit distribution systems has any marked effect upon the pattern of abuse of tobacco, alcohol or any other drug by young people. Overall, there seems to be a sad failure to cope with the problem it raises for society at large.

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