France has seen a sharp fall in the number of people smoking daily, with one million fewer lighting up from 2016-2017, a survey suggests. Such a drop has not been seen in a decade, according to Public Health France, which carried out the study. There has also been a decline in smoking among teenagers and those on low incomes. The study pointed to the slew of anti-smoking measures introduced to France as a likely reason for the decline. Recent years have seen neutral packaging, reimbursements for people using tobacco substitutes, higher cigarette pricing and campaigns like the national tobacco-free month. According the survey, in 2017 26.9% of 18- to 75-year-olds smoked every day, compared with 29.4% a year earlier. This amounts to a drop from 13.2 million smokers to 12.2 million over the period. France’s Health Minister Agnès Buzyn in particular welcomed the decline in smoking among those on low incomes, saying that “tobacco is a trajectory of inequality, it weighs particularly on the most disadvantaged and it gets worse”.A study last year found that despite decades of tobacco control policies, population growth had meant there was an increased number of smokers. Worldwide, smoking causes one in 10 deaths, half of them in just four countries – China, India, the US and Russia, according to the Lancet. A country-by-country analysis warns that “the smoking epidemic is being exported from the rich world to low-income and middle-income countries”.
9. Cultural Practices Affect Fistula Epidemic Says Health Workers
Vesico-vaginal fistula, VVF is a medical condition whereby a hole is between the birth canal and the bladder leaving the women in a state of not being able to control their urine. Women with a hole between the birth canal and the rectum, recto-vaginal fistula (RVF) experience uncontrollable leakage of stool. Some women have both VVF and RVF. Some women are born with fistula, which is rare. Other causes include injuries sustained during pelvic surgery and hysterectomies, inflammation and infections in the genital area, and sexual violence. But the leading cause of fistula is prolonged and obstructed labor.  In Nigeria, between 400,000 and 800,000 women is currently living with fistula. The World Health Organization describes fistula as “the single most dramatic aftermath of prolonged or neglected childbirth,” and estimates more than two million women live with fistula worldwide. Nigeria has the world’s highest occurrence of obstetric fistula and the Nigerian government says early marriage is largely to blame. Often, the bodies of young wives are not physically prepared for childbirth. But health workers say other cultural factors contributing to the high occurrence of fistula need to be addressed and focusing on early marriage oversimplifies the problem.

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