Butt lengths differ by area deprivation level: a field study to explore intensive smoking.

We collected cigarette butts in a range of residential areas, to assess differences in the length of unburnt tobacco in the butts, and in proportions of roll-your-own (RYO) cigarettes. Two high, two medium, and two low deprivation areas, as classified by deciles of the New Zealand Deprivation Index, were selected for the Wellington region. Collected butts were systematically classified and measured. A mixed model of analysis, treating location clusters nested within deprivation level areas as a random effect, was used to assess differences in mean length of unburnt tobacco in the butts. A total of 6,262 cigarette butts and separate filters were collected, of which 3,509 (56.0%) were measurable manufactured cigarette butts, 1,069 were unmeasurable manufactured butts, 1,450 were RYO butts, and 236 were RYO filters. The RYO butts were not measured because of the extent of their degradation. The unburnt tobacco lengths in manufactured cigarette butts were significantly shorter in the most deprived areas, relative to the least deprived areas (p = .035). Deformed manufactured cigarette butts (i.e., that potentially were stubbed out) showed the same pattern (p = .011 between the most and least deprived areas). We found no significant difference between deprivation areas in the proportion of RYO material found. The shorter mean unburnt tobacco length in the most deprived areas is consistent with more intensive smoking among smokers in those areas. This finding is consistent with other evidence of increased price sensitivity among poorer smokers, and with basic economic theory. Further evidence on observed smoking behavior in the field is necessary to better interpret these preliminary findings.

Hybrid total hip replacement: outcome after a mean follow up of 10 years.

BACKGROUND: Total hip replacement is one of the most successful surgical procedures of the modern surgical era. The method of fixation of implants continues to evolve, and as cemented acetabular fixation appears to be less durable than anticipated, the use of a cemented stem and an uncemented acetabulum - a so-called 'hybrid hip'- has become more popular. This paper reports the results of hybrid total hip replacement at an average of 10 years postoperatively. METHODS: Primary hybrid total hip replacements carried out by a single surgeon in 1994 and 1995 were identified; patients were sent Oxford Hip Score and EuroQuol-5 Dimension quality-of-life questionnaires and, where necessary, a radiograph appointment. Questions about diabetes, cigarette smoking and hip dislocation were included. First postoperative and final radiographs were compared for stem subsidence, cup migration, stem position, osteolysis of the femur and pelvis, and evidence of loosening of both components. RESULTS: At 10-year follow up the revision rate for femoral component loosening was 2.9%. Fifteen per cent showed some abnormality at the femoral interface, not related to stem size and more common in titanium stems. Average hip score was 20.9, and quality-of-life measures indicated a high level of satisfaction. CONCLUSIONS: Hybrid total hip replacement gives excellent clinical outcomes with low revision rates for both components. The one-piece uncemented cup offers important advantages over modular devices, the use of which should be re-evaluated.