Higher cigarette taxes may improve childhood survival

TOBACCO SHOULD BE BANNED AS  A PESTICIDE

Karolinska Institutet

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Márta Radó

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Credit: Photo: Gunilla Sonnebring

A higher tax on cigarettes in low and middle-income countries can help to reduce child mortality, especially amongst the poorest children, a new study led by researchers at Karolinska Institutet and published in The Lancet Public Health suggests.

The World Health Organisation (WHO) recommends a tax of at least 75 percent on the retail price of cigarettes, but most countries impose a much lower tax than that.

“If all 94 countries included in the study had raised their cigarette tax to the level recommended by the WHO, the lives of over 280,000 children could potentially have been saved in a single year,” says Márta Radó, principal investigator at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Sweden. “Not only that, it would narrow the socioeconomic gap in child mortality rates in line with the UN’s sustainable development goals.”

The study examined the link between cigarette taxes and under-five mortality among different income groups in 94 low and middle-income countries.

Socioeconomic differences

The study is based on publicly accessible data from the WHO, the World Bank and the UN Inter-agency Group for Child Mortality Estimation (UN IGME) covering the years between 2008 and 2020. The researchers analysed the links between child mortality and different types of cigarette tax, such as specific excise duty (a fixed tax per packet regardless of sale price), ad valorem duty (a percentage of the product’s value), import duties and VAT.

Their calculations suggest that higher cigarette taxes can improve childhood survival among all socioeconomic groups, while reducing differences in survival between the richest and poorest groups. Excise duties had the most salient effect.

“Smoking related morbidity and mortality among children is disproportionately high in low and middle-income counties,” says lead author Olivia Bannon, researcher at Karolinska Institutet and Linköping University in Sweden. “An increase in cigarette tax is a vital policy measure that can improve the health of children worldwide, especially in the most vulnerable groups.”

Overcoming the obstacles

 “We know that the tobacco industry has a number of well-established tactics to undermine, disrupt and delay the implementation of effective tobacco control measures globally, including increasing taxation. Our study provides compelling evidence for governments to overcome tobacco industry interference and  other obstacles to implement higher taxes on tobacco in LMICs.” Says Dr Rado.

The study was conducted in close collaboration with Jasper Been, paediatrician and researcher at Erasmus MC (the Netherlands) and researchers at McGill University (Canada) and Imperial College London (the UK). It was financed by Forte (the Swedish Research Council for Health, Working Life and Welfare), Riksbankens Jubileumsfond and the EU Horizon 2020 Programme. There are no reported conflicts of interest.

Publication: “Cigarette taxation and socioeconomic inequalities in under-five mortality across 94 low- and middle-income countries”, Olivia S. Bannon, Jasper V. Been, Sam Harper, Anthony A. Laverty, Christopher Millett, Frank J. van Lenthe, Filippos T. Filippidis, Márta K. Radó, The Lancet Public Health, online 29 April 2025. 

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Journal

The Lancet Public Health

DOI

10.1016/S2468-2667(25)00065-9 

Subject of Research

People

Article Title

Cigarette taxation and socioeconomic inequales in under-five mortality across 94 low- and middle-income countries

Article Publication Date

29-Apr-2025

 

New study shows how ‘marine revolution’ shaped ocean life

University of Texas at Austin

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A scanning electron micrograph of Globorotalia tumida, a calcareous planktic foraminifera. This specimen was collected from IODP Site U1559 in the South Atlantic Ocean

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Credit: Chris Lowery/ The University of Texas at Austin Jackson School of Geosciences.

Between 252 and 66 million years ago, the ocean underwent a revolution.

That’s when plankton with calcium carbonate skeletons colonized the open ocean. When they died, their remains fell like snow over large parts of the seafloor. The abundance of their skeletons over time changed the marine landscape, leading to unique rock formations and vast deposits of carbonate rock.

This buildup of carbonate minerals was an important part of the Mesozoic Marine Revolution, or MMR — a period of transformation in Earth’s oceans that helped set the stage for today’s modern marine ecosystem.

According to a new study led by researchers at The University of Texas at Austin and published in the Proceedings of the Royal Society B: Biological Sciences, the change in calcium carbonate dynamics in the ocean appears to have influenced the evolutionary trajectory of tiny but mighty sea creatures: foraminifera.

Foraminifera — or forams for short — have called Earth’s oceans home for hundreds of millions of years and are an important part of the food chain, making up 50% of biomass in deep sea ecosystems. But on the individual level, forams are very small. Each one is just a single cell surrounded by a shell-like skeleton.

Forams can make their skeletons out of different materials, including sediments and organic matter. The researchers found that after the MMR, calcareous forams — which build their shells by secreting calcium carbonate — flourished, going on to become the dominant type of foram living today.

The study’s lead author Katherine Faulkner, who conducted the research when she was an undergraduate student at UT, said that in addition to shedding light on foram diversity through time, the findings could help researchers learn about how other forms of marine life responded to swings in ocean chemistry over geologic time.

“Foraminifera are these very abundant organisms and they can actually tell us a little more about what other organisms that also have calcium carbonate structures might have been doing during this time interval,” Faulkner said.

Faulkner is now a graduate student at the University of Oxford.

In their study, Faulkner and her collaborators tracked the diversity of forams over the past 541 million years — a period known as the Phanerozoic — analyzing how different types of forams fared during big changes in Earth’s environment. This included multiple bouts of ocean acidification and five mass extinctions. The data on foram diversity came from a previously compiled index. The researchers compared this data against changes in ocean chemistry over time.

Before the MMR, calcareous foram diversity was particularly sensitive to environmental changes, with these forams having extinction and origination rates on an order of magnitude higher than other forams. These changing rates reflected big contemporaneous changes in ocean chemistry, rather than longer term trends.

After the onset of the MMR, however, calcareous foram diversity steadily increased while their extinction rates declined. What’s more, even when short-term changes in ocean chemistry during the Cenozoic Era led to extinctions, the diversity of calcareous forams rapidly recovered once conditions improved. The researchers attribute the rebound to the buffering effect of the increased amounts of calcium carbonate on the ocean floor.

“Foram diversity stabilizes more than I expected it would, especially with all the huge Cenozoic climate changes,” said co-author Rowan Martindale, an associate professor at the UT Jackson School of Geosciences’ Department of Earth and Planetary Sciences. “It’s impressive to me how that switch in the Mesozoic really transforms how forams react to changes in the ocean.”

The research highlights the variable ways forams have responded to changes in ocean chemistry over time and how the influx of calcium carbonate during the MMR helped calcareous forams weather environmental swings, said co-author Chris Lowery, a Research Assistant Professor at the Jackson School’s Institute for Geophysics.

“You’ve got big changes in pH at the K/Pg boundary and the Paleocene Eocene Thermal Maximum, but there’s no real extinction [in forams] that we can observe in the latter record and certainly no big changes in [shell]-type through time,” he said. “It seems like forams on this scale are resistant to changes in ocean chemistry.”

A light microscope image of a Pleistocene assemblage of calcareous foraminifera from from IODP Site U1559 in the South Atlantic Ocean.

Credit

Chris Lowery/ The University of Texas at Austin Jackson School of Geosciences.

A light microscope image of two Ammobaculites, an agglutinated genus of foraminifera, from just about the Cretaceous/Paleogene Boundary at Trim Cane Creek in Starkville, MS.

Credit

Chris Lowery/ The University of Texas at Austin Jackson School of Geosciences.

Journal

Proceedings of the Royal Society B Biological Sciences

DOI

10.1098/rspb.2025.0221 

Article Title

Record of Foraminifera test composition throughout the Phanerozoic

Article Publication Date

29-Apr-2025

 

How ‘magic mushrooms’ could help Parkinson’s disease patients

University of California - San Francisco

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A UCSF pilot study finds psilocybin therapy surprises, showing meaningful improvements in mood, cognition, and motor symptoms.  

Psilocybin, a natural compound found in certain mushrooms, has shown promise in treating depression and anxiety. 

UC San Francisco researchers wanted to know if it could be used to help Parkinson's patients who often experience debilitating mood dysfunction in addition to their motor symptoms and don’t respond well to antidepressants or other medications. 

The results were surprising. 

Not only did participants tolerate the drug without serious side effects or worsening symptoms, which is what the pilot study was designed to test, they also experienced clinically significant improvements in mood, cognition, and motor function that lasted for weeks after the drug was out of their systems. 

It is the first time a psychedelic has been tested on patients with any neurodegenerative disease.

“We are still in very early stages of this work, but this first study went well beyond what we expected,” said the paper’s first author, Ellen Bradley, MD, assistant professor and associate director of UCSF’s Translational Psychedelic Research Program (TrPR). 

“Many people don’t realize this, but mood symptoms in Parkinson’s are linked to a faster physical decline,” she said. “And they are actually a stronger predictor of patients’ quality of life with Parkinson's than their motor symptoms.” 

Researchers in the TrPR Program, within UCSF’s Department of Psychiatry and Behavioral Sciences and the Department of Neurology, teamed up to lead this project, which was funded by an anonymous donor. The findings appeared online earlier this month in Neuropsychopharmacology, a Nature publication.

Psilocybin’s lasting mood and motor effects  
 
Parkinson’s disease, a progressive neurodegenerative disorder characterized by uncontrolled movements due to abnormal brain activity, affects about 1 million Americans. While medications like levodopa can relieve symptoms, there are no approved therapies to slow the progression or reverse the disease itself.  

Common early physical symptoms include tremors and foot dragging, but Bradley said anxiety and depression in patients with no history of psychiatric problems often precede the onset of motor symptoms by several years. It’s unclear why standard medications often don’t work well for these patients, but mood changes could be part of the neurodegenerative disease process.  

To test the safety of psilocybin for these patients, the researchers gave seven men and five women with mild to moderate Parkinson’s disease a 10 mg dose, followed two weeks later by a higher dose of 25 mg. The patients completed psychotherapy sessions before and after the psilocybin — eight sessions in total — and were evaluated for changes in mood, cognition, and motor functions. 

While nearly all participants experienced some adverse events while on the psilocybin, such as anxiety, nausea, and elevated blood pressure, these were not serious enough to require medical intervention.

The participants had meaningful improvements in their mood, cognition, and motor symptoms at both their one-week and one-month follow-up appointments. The team evaluated the participants’ mood again three months after their psilocybin sessions and found it was still significantly improved.

The researchers suggested a variety of explanations for the improvements. The beneficial impact of psilocybin on the patients’ mood could have led to better cognitive and motor functions. For example, people feel better, and that, in turn, helps them socialize and become more active – both key elements of Parkinson’s treatment. 

Another theory is that psilocybin could provide relief from multiple symptoms of the disease by reducing inflammation and promoting neuroplasticity — the growth and reconnection of brain cells involved in mood, cognition, and movement regulation. 

An expansion into unchartered territory 

The results of this pilot study were promising enough that the researchers are conducting a larger randomized controlled trial at UCSF, enrolling a larger and more diverse group of patients. The second study incorporates noninvasive brain stimulation, neuroimaging and other tools to understand how psilocybin impacts inflammation and neuroplasticity.  

It will include a second site at Yale University, with the aim of enrolling 100 participants. This work will be funded by the same anonymous donor that paid for the safety pilot as well as by the Michael J. Fox Foundation for Parkinson’s Research.

“The vast majority of brain diseases still lack interventions that change the course of illness,” said the study’s senior author, Joshua Woolley, MD, PhD, associate professor at UCSF and director of the TrPR Program. “We can often treat the symptoms, but we don’t alter the trajectory or prevent decline. Now, that’s beginning to change. These results raise the exciting possibility that psilocybin may help the brain repair itself.” 

Authors: Additional co-authors include Kimberly Sakai, BA, Gisele Fernandes-Osterhold, MFT, Balázs Szigeti, PhD, Connie Ludwig, PhD, Jill L. Ostrem, MD, Caroline M. Tanner, MD, PhD, Meredith A. Block, MD, Katia Llerena, PhD, Patrick R. Finley, PharmD, Aoife O’Donovan, PhD, Jose Rafael P. Zuzuarregui, MD, Amber McKernan, BA, Andrew D. Penn, NP, Aliss C.C. Wang, MFT, and Raymond C. Rosen, PhD. 
 
Funding: The trial was funded by an anonymous donor.   

 

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu, or see our Fact Sheet.

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Journal

Neuropsychopharmacology

 

Too few ward nurses linked to longer hospital stay, readmission, and risk of death

Redressing balance saves around £5000 for each year of healthy life gained But not if temporary agency staff are used

BMJ Group

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Employing too few permanent nurses on hospital wards is linked to longer inpatient stays, readmissions, patient deaths, and ultimately costs more in lives and money, finds a long term study published online in the journal BMJ Quality & Safety.

Redressing the balance is cost-effective, saving an estimated £4728 for each year of healthy life gained per patient, but not if  temporary agency staff are used to plug the gaps, the findings indicate. 

Inadvertent understaffing–through unfilled vacancies–or deliberate–through cost cutting measures–of ward nurses risks harming hospital patients, and is a key contributor to nursing recruitment and retention issues, say the researchers.

Much of the existing research on the impact of the nursing staff:patient ratio is cross- sectional and so of limited use in determining causal factors, they add.

To find out if investing in higher nurse staffing levels to offset understaffing would be cost-effective, they set out to estimate the associations between registered nurse and healthcare assistant staffing levels and risk of patient deaths, readmissions, and length of stay in acute adult inpatient wards.

They drew on data provided by four NHS hospital trusts with diverse nurse staffing levels, sizes, teaching status, serving diverse local populations in England. Three of the trusts provided acute inpatient services predominantly from single hospital sites, and the fourth provided inpatient services across four sites within one city.

The data were derived from electronic healthcare records and staffing rosters and spanned the period April 2015 to March 2020 for a total of 626,313 patients in 185 different acute care wards.

Two main nursing team roles were included in the study: registered nurses (RNs) who have completed university degree level training and are registered with the profession’s regulator; and nursing support staff (such as healthcare assistants) who don’t have this level of training and who are largely unregulated.

The incremental cost effectiveness of eliminating the understaffing of these two roles was estimated from the costs and consequences of moving from the observed staffing shortfall averaged over the study period to the planned staffing level. 

Patients spent an average of 8 days on the ward. Over the first 5 days of their inpatient stay, patients were provided with a daily average of just over 5 hours of care from RNs and just under 3 hours of care from nursing support staff.

The calculations showed that patients on wards understaffed by RNs were more likely to die (5% vs 4% for those with adequate RN staffing levels), to be readmitted (15% vs 14%), and to stay in hospital longer (8 days vs 5 days), with similar figures for inadequate numbers of nursing support staff. 

Patients who experienced understaffing received an average care shortfall of 1 hour 9 minutes/day in the first 5 days, while those who didn’t experience understaffing, received an average of 3 hours 22 minutes of care above the ward average. 

During the study period, 31,885 patients died. Each day a patient experienced RN understaffing (staffing below the ward average) during the first 5 days of their stay, the risks of death and readmission within 30 days increased by 8% and 1%, respectively. When all 5 days after admission were understaffed, length of stay increased by 69%. 

Days of nursing support understaffing were also associated with similar increases in the risks of death and length of stay within 30 days: 7% and 61%, respectively. But the risk of readmission within 30 days fell by 0.6%.

The estimated total cost of providing care for the 626,313 adults included in the study amounted to  £2,613,385,125, or £4173 per admission.

The researchers calculated that eliminating understaffing of both nursing roles would cost an additional £197 per patient admission, avoiding 6527 of the 31,885 deaths during the study period and gaining 44,483 years of life in good health. 

This equates to an additional staff cost of £2778 per healthy year of life, and £2685 if reduced sick leave and averted readmissions are taken into account. But accounting for reduced length of stay amounts to savings of £4728 per additional year of healthy life gained—an overall cost saving from increasing staffing levels.

If agency staff are used to eliminate understaffing instead, staff costs for each additional healthy year of life gained were higher, ranging from £7320 to £14,639.

“The findings give no indication that it makes rational economic sense to target efforts to rectify low staffing only on the most acute patients. Not only is this logistically difficult for patients whose acuity is emergent (occurring while on a general ward), it also gives much less benefit at a considerably higher cost per unit improvement in outcome,” explain the researchers. 

“Steps to address low staffing for the general (lower acuity) population are likely to benefit high-acuity patients as well, in so far as they are in the same units, whereas the opposite is unlikely to occur if interventions are targeted on high-acuity patients in high-acuity units,” they add.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge that the data came exclusively from hospitals in the English NHS, so may not be more widely applicable. Understaffing was also judged relative to ward norms rather than a validated assessment of staffing need.

But the researchers conclude: “When considering alternative policy strategies, this study indicates the importance of prioritising investment in RNs employed on wards over support staff, as well as showing there are no shortcuts to employing enough RNs, as using temporary staff is more costly and less effective.”

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Journal

BMJ Quality & Safety

DOI

10.1136//bmjqs-2024-018138 

Method of Research

Observational study

Article Title

Cost-effectiveness of eliminating hospital understaffing by nursing staff: a retrospective longitudinal study and economic evaluation

Article Publication Date

29-Apr-2025

DRUIDIC SCIENCE

Forest in sync: Spruce trees communicate during a solar eclipse

A ground breaking international study has revealed spruce trees not only respond to a solar eclipse but actively anticipate it by synchronising their bioelectrical signals hours in advance into a cohesive, forest-wide phenomenon.

Southern Cross University

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Study location in the Dolomite mountains in Italy

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Credit: Monica Gagliano/Southern Cross University

A ground breaking international study has revealed spruce trees not only respond to a solar eclipse but actively anticipate it by synchronising their bioelectrical signals hours in advance into a cohesive, forest-wide phenomenon.

The discovery, published in the journal Royal Society Open Science, shows older trees exhibit a more pronounced early response, suggesting these ancient sentinels retain decades of environmental memory and may use it to inform younger trees of impending events.

This study adds to the emerging evidence that plants are active, communicative participants in their ecosystems, capable of complex, coordinated behaviours akin to those seen in animal groups.

The lead authors are Professor Alessandro Chiolerio of the Italian Institute of Technology and University of the West of England, and Professor Monica Gagliano from Southern Cross University, Australia.

“This study illustrates the anticipatory and synchronized responses we observed are key to understanding how forests communicate and adapt, revealing a new layer of complexity in plant behaviour,” said Professor Gagliano.

“Basically, we are watching the famous ‘wood wide web’ in action!”

Using custom-built, ruggedised low-power sensors deployed across a forest in the Dolomites (Italy), the interdisciplinary team—comprising experts from Italy, the United Kingdom, Spain, and Australia—recorded simultaneous bioelectrical responses from multiple trees.

Their analysis demonstrates that individual trees’ electrical activity became significantly more synchronised before and during the eclipse, indicating that trees function as a unified living system that coordinates its response to external events.

“By applying advanced analytical methods—including complexity measures and quantum field theory—we have uncovered a deeper, previously unrecognised dynamic synchronisation not based on matter exchanges among trees,” said Professor Chiolerio.

“We now see the forest not as a mere collection of individuals, but as an orchestra of phase correlated plants.”

Professor Gagliano said the findings support calls for the preservation of wise old trees.

“The fact that older trees respond first — potentially guiding the collective response of the forest — speaks volumes about their role as memory banks of past environmental events.

“This discovery underscores the critical importance of protecting older forests, which serve as pillars of ecosystem resilience by preserving and transmitting invaluable ecological knowledge,” said Professor Gagliano.

Adding to its global impact, this pioneering research is set to be featured in an upcoming feature-length documentary, Il Codice del Bosco (The Forest Code), set to release in May 2025 in Italy. For a glimpse into this fascinating study, watch the official trailer:  https://vimeo.com/1065299976  

A spruce tree with recording unit attached. In the Dolomite mountains in Italy.

A spruce tree with wires attached. In the Dolomite mountains in Italy.

Credit

Monica Gagliano/Southern Cross University

Journal

Royal Society Open Science

DOI

10.1098/rsos.241786 

Method of Research

Observational study

Subject of Research

Not applicable

Article Title

Bioelectrical synchronisation of Picea abies trees during a Solar Eclipse

Article Publication Date

30-Apr-2025