Projections of future population trends that do not explicitly include education in their analysis may be flawed

ScienceDaily (July 28, 2011) — Future trends in global population growth could be significantly affected by improvements in both the quality and quantity of education, particularly female education. Projections of future population trends that do not explicitly include education in their analysis may be flawed, according to research published in the journal Science.

The study uses a novel "multi-state" population modeling approach to incorporate education attainment level, along with age and sex. The integration of education in the analyses adds a "human quality" dimension to projections of fertility, mortality and migration. As education also affects health, economic growth, and democracy, these projections provide a more comprehensive picture of where, how, and under what conditions human well-being is increasing.

The research reinforces earlier findings that the level of formal education achieved by women is, in most cases, the single most important determinant of population growth. More educated women generally have fewer children, better general health, and higher infant survival rates. Education also appears to be a more important determinant of child survival than household income and wealth. The study also found that if concerted efforts were made to fast track education, the global population could remain below 9 billion by 2050. Thus the global population outlook depends greatly on further progress in education.

Researchers Wolfgang Lutz and Samir K.C. from the International Institute for Applied Systems Analysis (IIASA), the Vienna Institute of Demography (VID) of the Austrian Academy of Sciences (ÖAW) and the Vienna University of Economics and Business (WU), evaluated the effect of education on population growth to 2050 using four alternative education scenarios. The scenarios are based on identical sets of education-specific fertility, mortality, and migration rates. They differ only in terms of their assumptions about future school enrolment rates.

"The most ambitious, or 'fast track' (FT) scenario we apply assumes all countries expand their school system at the fastest possible rate -- this is comparable with past, best performing countries, Singapore and South Korea, says co-author Samir K.C.."The most pessimistic scenario of 'constant enrollment numbers' (CEN), assumes no new schools are built and the number of people attending schools remains constant, which, under conditions of population growth, means declining enrolment rates."

"Under these two extreme scenarios, population size in 2050 could vary by as much as 1 billion-with 8.8 billion people expected under the fast track scenario and as many as 9.9 billion under the constant enrolment numbers scenario .... The effect is greatest in countries with current high fertility rates and high education differentials," he stated.

Kenya's population, as an example, would increase from 31 million in 2000, to 85 million in 2050, under the optimistic FT scenario. Under the pessimistic CEN scenario with no new schools, Kenya's population could increase to 114 million. The difference of 30 million between these extremes is equivalent to the size of Kenya's population in 2000. As the scenarios only consider the individual-level effects, not the broader community-level impacts that education can have such as better availability of reproductive health services, the results are likely to be an underestimate of potential population change.

The authors emphasize that the effect of better education on population growth may not be obvious for some time. This is because the effect on fertility of girls entering school now may not be evident for about 15 years, when they enter their prime child bearing years.

The study supports earlier findings by IIASA and the VID regarding the level of educational attainment needed to bring about changes in fertility, with secondary education bringing greater reductions in fertility than primary education alone.

The research highlights the strong link between economic growth and 'human capital' -- the combination of health status and the education levels achieved by adults. Better education affects many aspects of human development, including health, economic growth, and democracy.

The study by Wolfgang Lutz and Samir K. C., from the International Institute for Applied Systems Analysis, the Vienna Institute of Demography of the Austrian Academy of Science, and the Vienna University of Economics and Business (all three institutions have merged their scientific strengths and collaborate in the Wittgenstein Centre for Demography and Global Human Capital) is published in the latest issue of Science. Reference: Global Human Capital: Integrating Education and Population. Science July 29 2011. Lutz W. and Samir K. C.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by International Institute for Applied Systems Analysis, via EurekAlert!, a service of AAAS.

Journal Reference:

W. Lutz, S. KC. Global Human Capital: Integrating Education and Population. Science, 2011; 333 (6042): 587 DOI: 10.1126/science.1206964

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

E-cigarette or drug delivery device? Questions about safety, usage and future implications of new nicotine delivery products

ScienceDaily (July 21, 2011) — Devices marketed as "electronic cigarettes" are in reality crude drug delivery systems for refined nicotine, posing unknown risks with little new benefits to smokers, according to tobacco control experts.

In a "Perspective" published in the New England Journal of Medicine, researchers from the Legacy's Steven A. Schroeder National Institute for Tobacco Research and Policy Studies explore the current regulatory climate around electronic cigarettes ("e-cigarettes") and their safety. The authors, Nathan K. Cobb, MD, a pulmonologist and assistant professor at Georgetown University Medical Center, and David B. Abrams, PhD, executive director of the Schroeder Institute, also question future implications for physicians, policy makers and e-cigarette users.

E-cigarettes are constructed to mimic real cigarettes in size and appearance, but contain no tobacco and are not cigarettes at all. In reality they are delivery devices for refined nicotine, having more in common with inhalers used to treat asthma or other delivery devices for both approved and illicit drugs. Though individual brands vary in construction, the products generally produce a propylene glycol mist containing nicotine along with flavorings and other chemicals.

Currently, three interrelated products are being sold: the delivery device itself; cartridges that can contain up to 20 mg of nicotine; and refill kits that allow consumers to fill used cartridges with replacement nicotine solution. Some refill bottles, easily obtained over the Internet, contain enough nicotine to kill an adult if accidentally ingested.

The U.S. Food and Drug Administration (FDA) announced April 25, 2011, that it would regulate e-cigarettes as "tobacco products" and not as "drug-delivery devices." That action came after federal courts blocked the agency from regulating the products as drug-delivery devices. The courts maintained that, under the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA), the FDA must regulate as tobacco products any product that contains nicotine from tobacco and that makes no claims to be therapeutic. These decisions together, the authors note, "upend[ed] the status quo" by having the effect of allowing the sale of unregulated refined nicotine directly to consumers, unless and until the FDA takes further action.

"The court's decision that e-cigarettes should be regulated as tobacco products and not as drug-delivery devices has substantially delayed the FDA regulatory process that normally protects the public health. It has the practical effect of allowing manufacturers to sell potentially dangerous refined nicotine products directly to consumers," said Cobb. "It is entirely possible that future modifications to the products will improve the efficiency of nicotine delivery and could dramatically increase the risks of addiction, abuse and serious overdose."

While most devices and nicotine fluids are produced by small manufacturers, Cobb and Abrams note that the fact that leading cigarette manufacturers Philip Morris International and British American Tobacco recently purchased sophisticated nicotine inhaler technologies may be an indication that both companies are developing next generation nicotine delivery devices of their own.

Abrams, a professor at Johns Hopkins Bloomberg School of Public Health added "Any refined nicotine product, whether used for smoking cessation and tested and approved by the FDA (like the Nicotrol inhaler) or a new product designed for 'reduced or modified' risk, can and must be tested and strictly regulated before being introduced to the market."

The authors argue that a comprehensive approach to regulating products containing refined nicotine is needed to protect the public's health and should involve Congress, the courts and the FDA.

In this piece, Cobb and Abrams discuss several safety concerns:

Testing of cartridges reveals poor quality control, variability in nicotine content among brands, and deviations between label claims and cartridge content.The devices do not reliably deliver nicotine, and have not been sufficiently evaluated in scientific studies the way the FDA requires of other drugs and devices used for smoking cessation. Smokers attempting to use e-cigarettes as quitting aids will most likely find them ineffective due to the fluctuating nicotine content and unpredictable delivery.Manufacturers sell cartridges with a range of up to 20 milligrams of nicotine. However, refill kits allow consumers to fill used cartridges with replacement solutions at much higher doses. In fact, the devices are not limited to delivering nicotine. The paper notes that instructions for filling cartridges with marijuana hash oil can be easily accessed on the Internet.The safety of inhaling propylene glycol over an extended period of time has not been studied in humans.E-cigarettes may serve as a "bridge product" that smokers use in places where traditional tobacco smoking is prohibited, thus perpetuating their addiction and use of real cigarettes. Additionally, they may be used as a 'starter' product for young people considering smoking, especially since the cartridges can be purchased over the Internet with tempting flavoring like grape and chocolate.

In their conclusion, Cobb and Abrams counter the argument made by e-cigarette advocates that taking the devices off the market could mean current users would be forced to return to traditional tobacco products. Instead, the two researchers point to the multiple pharmaceutical-grade nicotine products on the market that have been regulated, approved and deemed safe and effective by the FDA, including patches, gums, lozenges, nasal sprays and even an FDA-approved inhaler. The two researchers also state that current users should pursue research-proven effective cessation tools, such as nicotine replacement products, telephone quit lines, and Web-based cessation services, as well as non-nicotine pharmacotherapies like bupropion and varenicline.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Georgetown University Medical Center, via EurekAlert!, a service of AAAS.

Journal Reference:

Nathan K. Cobb, David B. Abrams. E-Cigarette or Drug-Delivery Device? Regulating Novel Nicotine Products. New England Journal of Medicine, 2011; 365 (3): 193 DOI: 10.1056/NEJMp1105249

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here