In the smoking room at the Kathmandu airport, there were no matches or lighters to be found. People stood around lighting up from other cigarettes, passing the torch, as it were, and keeping the flame alight. It reminded me of a story in Jonathan Safran Foer’s Everything is Illuminated where a group of smokers, the Wisps of Ardisht, are exiled to the rooftops. Under attack during the World War, the smokers turn hysterical as their matches run out, until a child realises that one cigarette can be used to light another and they get a schedule in place. Perhaps this is too sentimental an analogy for the situation in Nepal, but it aptly comes with an “injurious to health” warning.

Ever since New Delhi imposed an informal economic blockade on Nepal in September to coerce the country into making concessions in the new constitution for the Madhesis who live in the Terai region bordering India, the Himalayan country has found rough-hewn ways to function.

A black market has emerged to supply fuel and cooking gas to those who can afford the steeper prices. Hospitals have reportedly cut down on surgeries due to a medicine shortage. And as winter sets in and daily power outages last up to 18 hours even in Kathmandu, the main source of hot water, besides the weather-dependent solar geysers, are LPG cylinders.

The cold is looming like a dark cloud over the economically underdeveloped country that is yet to find its footing after the deadly earthquake in April. Outside of Kathmandu, many people are still living in relief camps and medicines are still running scarce.

Injurious to Health

                                                 A  cigarette between your index and middle finger is a sight we find everywhere we look. Be it peer pressure or depression, it is very common to see youngsters involve into a habit like this. On the basis of current smoking patterns, a global average of about 50 per cent of young men and 10 per cent of young women become smokers and relatively few stop. In 2010, there were 5 million tobacco-attributable deaths. This increase is due partly to population growth and partly to the fact that, in some large populations, generations in which few people smoked substantial numbers of cigarettes throughout adult life are being succeeded by generations in which many people did so. In the age group of 30 and above, nearly 29 per cent smoke daily.

Among women, only 2.5 per cent smoke.        

In September 2012, the health ministry set up a committee to recommend amendments to the Tobacco Regulation Act which may suggest raising minimum age for smoking from 18 years to 25, and also raising fines for tobacco related offenses, including smoking in public. Though the government has amended schemes, it is observed that it has hardly made a difference.

Hundreds of children still work in beedi factories and youngsters are prone to such habits especially because of peer pressure. Despite knowing the fact that smoking kills, a large number of people are still driven towards this slow poison. Do you think the government needs to ban smoking in the country?

In a high-five to citizen health, the Raghubar Das government has banned the sale of loose cigarettes and bidis across Jharkhand, toeing other states like Uttar Pradesh and Maharashtra, where clampdown on the cancer stick made headlines in the recent past.

The prohibition will come into immediate effect, with the issue of a notification under Section 7 of the Cigarettes and Other Tobacco Products Act (COTPA), 2003, by the third week of this month. Violations shall invite punishments ranging from cash fine to prison term (see box) under Section 20 of COTPA.

Dr Lalit Ranjan Pathak, nodal officer of the state's non-communicable disease cell, said the ban decision was taken on December 1. "The information and public relations department will issue a public notice within the next 10 days. Thereafter, we shall crack down on shops/outlets selling loose cigarettes."

To implement the ban, a state-level flying squad is being constituted under Dr Pathak. "There will be district and block-level flying squads too, which will be guided by respective deputy commissioners. So far, Dhanbad, Bokaro and Simdega have formed their squads," the nodal officer said.

Ranchi deputy commissioner Manoj Kumar said their squad was closer to orientation and would be notified soon.

Each flying squad, Pathak said, must have at least three members including one police sub-inspector or an officer of higher rank. The maximum number of members can be 10. Since district leprosy officers are also in charge of the programme under which tobacco control is done, the squads will work in tandem with them.

On their objective behind the ban, the nodal officer said, "The ultimate goal is to demoralise sale and purchase of cigarettes, prevent people from smoking and prevent diseases caused by tobacco use. There will definitely be an impact of the order towards these goals."

Why just loose cigarettes are being banned then? "Cigarettes cannot be sold without the statutory warning that they are injurious to health. When one cigarette is sold instead of a packet, the mandatory warning is not communicated," Dr Pathak contended.

Smokers are divided.

Debanjan Kumar, a 38-year-old software engineer who wants to kick the habit, welcomed the decision. "A standard brand of cigarette costs around Rs 80 to Rs 100 for a packet of 10. Since I wish to quit, I don't buy more than four loose cigarettes, which are cheaper too. The ban will encourage me to stop smoking," he said.

But, banker Kushal Kumar, who smokes at least two packets a day, feels otherwise. "Such bans are baseless. People like us who cannot give up smoking will find ways to buy their fag, loose or in packs," the 45-year-old said.

Dr Pathak, who was himself a chain smoker in the Nineties, claimed kicking the habit was not impossible. "I was a smoker for 15 years. All it requires to quit is determination and a little push. Our flying squads will give that push," he summed up.

The side-effects of PCC’s smoking ban

The side-effects of PCC’s smoking banPasadena City College’s campus has been smoke-free for almost two years, yet the smoking areas have shifted to the sidewalks and entrances that border that campus. Although the school is not responsible for these areas, the city does not provide a receptacle for cigarette butts and the smoking groups have created a new obstacle for students and locals.

In 2013, a campus-wide survey including students and faculty showed 61 percent in favor of a smoke-free campus.

“PCC is one of 1,620 college campuses that qualify as 100% smoke-free as of October 2, 2015,” said Liz Williams of Americans for Nonsmokers Rights (ANR).

Throughout the day, smokers congregate near the students’ parking lot on Hill Avenue and the student drop-off zone where hundreds of cigarette butts litter the ground and smokers impede passers-by until they finish.

The smokers feel that the school should provide a bin for their cigarette butts since they have no designated places to smoke on campus or nearby between classes.

“Obviously people are throwing their butts everywhere,” said Kevin Kim, automotive technician student. “I usually throw mine away in the trash can. A bin might help.”

Kim, who stopped smoking once for two years is also aware of PCC’s program to help with smoking cessation but hasn’t chosen to give it another try or utilize the school’s program.

It seems simple to place a bin on the sidewalk for smokers, so why hasn’t it been done?

According to PCC Police Sgt. Bill Abernathie, the sidewalks outside the college are the city’s property.

“Somebody would have to make an issue with the city,” said Abernathie. “Once they’re [smokers] off campus premises, we don’t have any jurisdiction. The sidewalks are actually considered the city.”

For the first month after the smoking ban, which includes electronic cigarettes, campus police only issued warnings to violators. Since the program was implemented, they have issued about 180 citations, according to Abernathie. Students, employees, and visitors who violate the policy will be cited using a tiered fine. The first is $25, second is $50, and third is $75, according to the school’s website.

Statice Wilmore of the Pasadena Public Health Department explained that the city’s policy is that smokers must obey the 20-foot rule. As for a bin on Hill Avenue, Wilmore said she’d have to check with the environmental health division.

“We’ve had one or two complaints [of smokers] as a result of PCC’s policy,” she said.

PCC isn’t alone in dealing with the side effects of a smoke-free policy. Portland Community College experienced the same issues when they also went to a smoke-free campus. To subdue complaints from nearby homeowners, they implemented a “good neighbor zone.”

“Good neighbor zones were formed from the smoking ban. People would go off campus and bother neighbors,” said Doug Schaefer of Portland Community College’s Campus Safety office. “The zones are out of way of foot traffic, each campus has about two to three. We’ve had about two years now and it’s working well, they have ‘butt cans.’”

Williams said that it’s important that colleges work with the city council and health department to discuss potential challenges that negatively impact public areas.

“We encourage schools to have conversations because of the unintended consequences we do encounter from time to time because it’s not thought out from the concept,” said Williams. “We provide language for campuses and guidance to identify the hot spots and transfer the problems.”

ACT has lowest smoking rates in Australia but the nation is still fat and unfit

People in the ACT are smoking and drinking less than they used to, but are among the most overweight in the country and still eat terribly and don't exercise quite enough.

Those are among the findings of the Bureau of Statistics' national health survey, a triennial report that takes the pulse of the nation based on a sample of 20,000 people.

It shows that almost two-thirds of the Australian adult population can be classed as overweight or obese, a figure that isn't improving over time.

The ACT has the highest proportion of people who can be classed as overweight at 39.1 per cent, while NSW has the lowest proportion, with 35.2 per cent.

Children are getting heavier too and a higher proportion of kids are struggling with their weight than they were three years ago – 27.4 per cent were obese or overweight last year compared with just over a quarter in 2011.

And as we get older and heavier we are also getting sicker, with the data showing a rise in some chronic health conditions.

Obesity Policy Coalition executive manager Jane Martin said the results showed people needed to be better educated on healthy food choices.

"There's still a lot more work that needs to be done promoting the dietary guidelines," she said.

Effective policies in reducing harm from smoking or excessive drinking – such as raising prices and curtailing advertising of alcohol and tobacco – had not been applied to unhealthy food in a meaningful way, she said.

Healthy eating campaigns also had more trouble reaching disadvantaged people, who did not have the means or the time to eat well and avoid the pull of unhealthy food options, Ms Martin said

The data shows that only one out of 20 Australians eats enough fruit or vegetables, while one in three Australians get enough exercise, both matching the numbers in the capital.

In the ACT, 96.1 per cent of people were not meeting the fruit and vegetable target. and 59.2 weren't exercising enough.

That means that most people are not meeting the government's health guidelines of eating 375 grams of vegetables and 300 grams of fruit a day, or doing 2½ hours of exercise each week.

Over the past seven years the figures on obesity, exercise and diet have remained fairly static.

But smoking and risky drinking rates are dropping – 14.5 per cent of adults were daily smokers in 2014, down from 16 per cent in 2011.

The ACT had the lowest rates of smoking, at 12.4 per cent of adults, while the highest rates were in the Northern Territory, at 20.9 per cent.

Consuming more than the recommended limit of two standard drinks each day has also dropped over the past three years, falling from 19 per cent of adults to 17 per cent.

Cassandra Szoeke, director of the Healthy Ageing Project at the University of Melbourne, said the health messages around alcohol ("don't drink too much") and smoking ("don't smoke") were easier for people to understand than healthy eating or exercise advice, which often differs depending on the person.

"Poor diet, low physical activity, smoking, excess alcohol, excess weight and high blood pressure all contribute to heart disease, depression, diabetes and even arthritis," Associate Professor Szoeke said.

"The top three causes of death in Australia are heart disease, conditions that affect circulation and dementia, and a lot of research has shown that you can halve the rates of these diseases by addressing these risk factors."

Acting health minster Andrew Barr said the ACT's low smoking rates showed the government's policies were working, but added: "We can always do more, and remain committed to further reducing these rates".

The government was "not shying away" from the ACT's obesity problem, but was addressing the dramatic increase over the last 20 years with initiatives including the $3.7 million Healthy Weight Initiative.

The most recent survey was also the first to include a dedicated module on mental health, giving the issue more prominence.

It shows the spectre of mental health problems such as anxiety or depression afflicted more than one in six Australians, with women reporting significantly higher levels of psychological distress.

Women aged 15-24 had the highest incidence of anxiety at 18.9 per cent, while 15 per cent of women aged 45-54 had been confronted with depression.

Pride of Plymouth 2015: Carer of the Year finalists

Pride of Plymouth 2015: Carer of the Year finalists

Foster parents Chris Gaydon and Anita May have had three foster children full-time in the last five years.

They also provide a temporary foster home for other children whose full-time foster carers have gone on holiday, as well as taking care of their own daughter, Trinity.

Chris said: "My partner, Anita, has prior experiences with children in care and wanted to give back. It seemed like a natural thing to do.

"We approached Action for Children and they came out to assess our suitability – they checked the safety of the home and we had to have an interview about our personal life in which we were asked if we smoked, drank alcohol and what our own upbringings were like."

Chris recently retired from the military after 25 years' service.

He worked as part of the 29 Commando Regiment at Royal Citadel.

After leaving the service, he volunteered for a local authority representing children if they had been arrested and required an adult to accompany them during police interviews.

"My foster children come from different backgrounds. The children that come into foster care have often offended, others have become involved in drugs and others have been neglected – some are all three."

Chris also praised the influence his foster children have had on his biological daughter and the effect she has had on them.

"A lot of these children enhance Trinity's life; it's therapeutic both ways because they are respectful of her and she is a calming influence on them."

One of Chris and Anita's foster children will start university in September with the future goal of becoming a teacher.

Chris and Anita are looking into the prospect of becoming legal guardians for their foster children so that they will always have some responsibility over their lives.

Phyllida Brown, of Action for Children Fostering South West Peninsula, has worked with Chris and Anita for many years. She said: "Chris and Anita are a warm, active and nurturing couple who offer young people the opportunity to be successful and work very hard to develop their skills as foster parents."

"Anita and I are so proud to be nominated for the Pride of Plymouth award - it is such an amazing honour," Chris said.

"Being nominated for something we love and feel privileged to be a part of is rewarding to say the least.

"We would like to give special thanks to Action for Children and Plymouth City Council Social services for their tireless and constant support to help these young people achieve great things in their life.

"We feel blessed that these young people share our lives and our home and trust us to support them through to the next chapter of there lives."

Make Your Life Smoke-Free

Don't let the festive season push you back into smoking

There are plenty in this country town who have health issues from doing so. I hasten to add that there but for the grace of God go I. For while I'm an ex-smoker, I agree with Mark Twain when he said: "Giving up smoking is easy... I've done it thousands of times."

I fit the theory that smokers may have an oral fixation, since I was an avid thumb sucker as a toddler. To deter me, my parents applied Colman's Mustard to that delectable digit. However, this was like putting ketchup on chips, because it just made my thumb even tastier.

I tried all the methods to stop. I even got hypnotised by a retired Irish doctor who operated on soldiers during World War 2 without anaesthetic. I stayed smoke-free for a week - but mainly out of respect for that impressive gentleman.

Tibetan Buddhists believe cigarettes are evil. Certainly, smoking is scary; not just for your body - but also your mind. Smokers can be unnervingly nonchalant about risks, sprouting sentiments about how we all have to go some way. Such detachment soon disappears if they are unlucky enough to be diagnosed with a disease. For smokers are unlikely to experience a sudden death. More probable - and painful - is a drawn-out deterioration in quality of life.

But penalising smokers by imposing outrageous taxes on cigarettes is both hypocritical and cynical, given smoking is now recognised as an addiction and not a take it or leave it habit. A profitable industry has grown around nicotine replacement therapy (NRT) and e-cigarettes. Yet statistics suggest that NRT has a poor success rate.

No method is foolproof. But speaking from my sadly vast experience, the Allen Carr clinics are among the best. It helps that they are run by former smokers who can thus empathise with those stuck in the trap.

"Smokers smoke because they believe it does something for them. But it's a total con job," says Brenda Sweeney, manager of the Carr clinics in Ireland. "No matter what happens, the solution to any problem or situation is not in 4,000 chemicals going through your body."

She believes "smoking is still a huge issue. The problem is that it is old news. A lot of people think that just because it is prohibited inside, it has gone away. But all that has happened is the problem has moved outside."

So why wait for next month's rigmarole of resolutions to save your life? There is no time like the present - make stopping smoking your Christmas one to yourself.