The Empirical Analysis of Cigarette Tax Avoidance and Illicit Trade in Vietnam, 1998-2010

Illicit trade carries the potential to magnify existing tobacco-related health care costs through increased availability of untaxed and inexpensive cigarettes. What is known with respect to the magnitude of illicit trade for Vietnam is produced primarily by the industry, and methodologies are typically opaque. Independent assessment of the illicit cigarette trade in Vietnam is vital to tobacco control policy. This paper measures the magnitude of illicit cigarette trade for Vietnam between 1998 and 2010 using two methods, discrepancies between legitimate domestic cigarette sales and domestic tobacco consumption estimated from surveys, and trade discrepancies as recorded by Vietnam and trade partners. The results indicate that Vietnam likely experienced net smuggling in during the period studied. With the inclusion of adjustments for survey respondent under-reporting, inward illicit trade likely occurred in three of the four years for which surveys were available. Discrepancies in trade records indicate that the value of smuggled cigarettes into Vietnam ranges from $100 million to $300 million between 2000 and 2010 and that these cigarettes primarily originate in Singapore, Hong Kong, Macao, Malaysia, and Australia. Notable differences in trends over time exist between the two methods, but by comparison, the industry estimates consistently place the magnitude of illicit trade at the upper bounds of what this study shows. The unavailability of annual, survey-based estimates of consumption may obscure the true, annual trend over time. Second, as surveys changed over time, estimates relying on them may be inconsistent with one another. Finally, these two methods measure different components of illicit trade, specifically consumption of illicit cigarettes regardless of origin and smuggling of cigarettes into a particular market. However, absent a gold standard, comparisons of different approaches to illicit trade measurement serve efforts to refine and improve measurement approaches and estimates.     

Aplasia cutis congenita.

A newborn child was noted to have an ulcerated lesion on the vertex of her scalp, which was diagnosed as aplasia cutis congenita. As this disorder is relatively rare and frequently misdiagnosed, this case is reported and the relevant literature reviewed.     

Diazepam tolerance: effect of age,regular sedation,and alcohol.

The dose of intravenous diazepam required for sedation was estimated in a series of 78 patients aged 17-85 years given the drug for dental and endoscopic procedures. Multiple regression analysis showed a significant correlation (r = 0.71; p less than 0.001) between dose and age, body weight, the taking of regular sedation, and the taking of more than 40 g alcohol daily, but there were no differences in the doses required between men and women, smokers and non-smokers, inpatients and outpatients, or dental and endoscopy patients. Patients aged 80 required an average dose of 10 mg and patients aged 20 an average dose of 30 mg, and the dose required was much higher in those receiving regular sedation or having a high alcohol intake. Plasma total and free diazepam concentrations were measured in the second half of the series of patients (n = 37). Plasma concentrations required for sedation fell twofold to threefold between the ages of 20 and 80 and were significantly higher in those taking regular sedation or alcohol. Differences in the acute response to diazepam appeared to be due to differences in the sensitivity of the central nervous system (pharmacodynamic tolerance) rather than to differences in pharmacokinetic factors.     

3. Control of sex expression in conifers

Despite considerable progress in recent years in the promotion of flowering in conifers, relatively little is known about the endogenous control of sex expression or its practical manipulation to aid pollen and crop management in seed orchards. Well defined patterns of sexual zonation exist within the tree crown and shoot, and these appear to be associated with hormonal and possibly nutritional gradients. No firm conclusions, however, are possible regarding the specific role(s) of different PGRs in sex expression, this being as much as a problem of lack of critical study as the complexity of the process itself. Whether a PGR such as gibberellins or auxins, or a cultural treatment that itself may influence endogenous hormone levels, primarily promotes female or male flowering often depends on the position within the crown of the shoot being treated, and its timing in relation to stage of primordia development. Photoperiod also may be involved- short days favoring females and long days males, at least in some species- although its role in controlling sex expression is by no means clear. Practical manipulation of sex expression may be possible through selective crown pruning, different PGR combinations, treatment timing and/or photoperiod control, but the development of such techniques for operational use will require a better basic understanding of the endogenous regulatory mechanisms involved.