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• • mediately post mortem from cadaver kidney donors. We were unable to detect ICAs in any of the sera. Our failure to confirmthe findings of Helmkc et al, may be due to differences in techniques or reagents, or it may reflect differences in the populations of mumps patients. However, our findings suggest that there is no serological cross-reaction between the mumps virus antigen and the islet cell antigens against which ICAs are reactive. schoof ofPharmacyand Pharmacoloyy, UniversilyofBasq Ba1hBA2]AY E.R.RICHENS Dcpavmcnr of Parhology, Nevole HaR Hnspiul, Abenvenny W. G. JONES SMOKERS, NON-SMOKERS, AND LOW-TAR SMOKE SIR,-Cigarette advertising has lately been concentrating on low- tar cigarettes. Besides a growing crop of 8-3 mg tar brands, there is close competition for the title of lowest tar cigarette, with brands weighing in at 1, 0-1, and even 0-Ol mg tar. Before ioining in the celebration of these advances in tobacco technology, we should ask how these reduced vields are achieved. Cigarette smoke falls into two classes. Mainstream smoke issues from the smoker's end of the cigarette during pufTng; sidestream smoke is all of the remaining smoke and it causes most of the air pollution from cigarettes. Ultra-low-tar cigarettes (<6 mg) do not deliver uhra-low-tar tobacco smoke-they deliver less smoke and more air per pufFand use air-dilution filters and high porosity paper to reduce yields of mainstream smoke. A Glter manufacturer has reported on the properties of thirteen commercially available ventilated filters. Non-perforated Glters delivered smoke with about 14 mg tar. All cigarette smoke is diluted with air: the following figures refer only to the added dilution caused by the pcrforutions. 15% air dilution in the mainstream smoke was associated with yields of 11 .9 mg tar, I- 0 mg nicotine, and I 1 mg carbon monoxide (CO) and 70% air dilution with yields of 1-5, 0-2, and 1-8 Ing, respectively.' The results fitted the equation=air dilution (No)=-5-]5 (tar, in mg)+78-71 (r'=0.91, p<0,05); it can be estimated that a 0.01 mg tar cigarette might deliver mainstream smoke that is diluted 79%u with air. A cigarette is a°mrrow tube ofcut tobacco enclosed in paper and designed for smoking".2 Do these,ulua low-tar brands ehallengethe traditional definition of a cigarette? Would milk diluted 70`Y, with water be marketable as milk? Tar is not a discrete substance but the total particulate matter in smoke (i.e., all material greater than 0- 1 pm, less water and nicotine). No matter how it is done, extreme tar reductions cannot be accomplished without extreme reductions in the amount of "smoke" per puff. The quest For a Iess harmhrl cigarette by way of extreme reductions in tar yields (rather than bv reductions of specific carcinogens in tar) would seem to have inherent limitations. Non-smokers have reason to be cancerned about the physiological consequences of involuntary smoking.l Sidestream smoke from ventilated-Glter cigarettes is much like that from unvented cigarenes. Gram for gram of tobacco consumed sidestream tar, nicotine, and CO yields are essentially unreduced by air-dilution techniques.4 A smoker's ultra-low yield cigarette does not present ultra low-yield sidestrcam smoke, and if he compensates for reduced yields by smoking more' non-smokers may be more disadvantaged by this sidestream smoke than by that from higher-vield cigarettes. 1. ParkrrJM a'tonegomerr RT. Design crncria for vennlueed nhcrs. Hnn ]'etuklf•u:4 19J9;10:1-b. 2. tt'oolf HB, ed. N'ebsrcr's nesv collceiuw Jmlionary. SpringfdJ. 1hv.r Q 3 C. \Lrrriam, 1977. 3. \Chitv 1R, Fweb HE Smalbairxvysdvsfuncriun in nonsmakers rl,:onaally expase.f to toG~co smoke. A' b,gl7 M<J 1980; 302: 720-23. 4. Bmwnc CZ, Keith CH, 911m RE. The clrecr or 51ter veneilmion on rhe vkld and romposi[ion of mainslrpm and sitles[mam smokes. Bnn ]b'mk/uah 1980: 10: 91-90. >.Ko.lowskit.T.Behavioralreaenrchonlnu•yleld6sareues:Pdminesandrecommend. stions (noal reponof Wurking Group on Bchnvinml Rescamh Nads on Lmv Yicld Clgareute; sponsorrd by the L5 Surgcon-General). In: flcalth conscyucnas of smokfn5: US Surgcon-0eneral's reporr. Washingms C'S Public Healeh Servieepn pres). Incidentally, some smokers defeat the vented filters by blocking holes with fingers, lips or tape, and can turn a 4 mg tar cigarette into al3mgone.6 _ Clearly, these low-tar brands may be as disappointing to smokers who seek smoke as they are to non-smokers who wish to avoid it. Dupanmenr.ofPSychology, clinical Institute, Addinion Rcsarch Pounda,ian, Toronro,Onmrio,Gvvda.~liS?SI LYNNT.ItOZLOIXSKI , GOUTY PERICARDITIS StR,-Dr Paulley (Jan. 24, p. 218) reminds us of his suggestion' that pericarditis might be due to gout. Although he could find no previous reference in the medical literature, this possibility must have been well known to the layman a century ago. In Mrs Henry Wood's (1861) East Lynne, when William Earl of Mount Severn is in mortal agony, Mr Wainwright (the surgeon from West Lynne) suggests "that the gout had reached the stomach, and might be rushing on to the heart". London Nw8 J. H. BARON 6. Suxluwskl CL P-kcr RC, Shouw V, Pnpa 6L\. Thc misus. of"less huaardous" clgntt¢s and les Jetemon: Holcblocking nlYCmiluud tilarv. am 7 A,M1fie (lre/rh 1980;70:1101-04. l. Pautley JEW, Badn,v KE, Cuning PAJ, Stevens J. Acu[e gonry perinrLisiv. Cancer 1961; i: 21-?2. Commentary from Westminster More Minor Operations in the G.P.'s Surgery? A WIDER role for general practitioners, who would under- take more minor operations in their surgeries, is the substance of a paper being prepared by the General Medical Services Committee of the B1v1.A. The paper will form the basis of a meeting in about a month's time between the B.M.A., the Health Minister, Dr Gerard Vaughan, and the Royal College of General Practitioners. The parties have already agreed to the idea in principle. Dr Vaughan is keen on the plan, which has the dual advantage of relieving pressure on N.H.S_ beds and outpatient clinics and of making G.P.s' work more varied. Operations for which many G.P.s send pa- tients to hospital, though they could often be done in the surgery, include suturing of injuries, vasectomies, some operations on varicose veins, and the treatment of abscesses. The D.H.S.S. and the professions agree that much depends on whether a particular G.P_ feels happy about performing a particular operation in the surgery. Also under discussion is an expansion in the number ofhospital beds directly available to G.P.s. G.P.s would expect to be paid extra for such work, but that need not be a problem, in the view of Dr John Ball, chairman ofthe General Medical Services Committee. G.P.s, he believes, would be able to do the work in their surgeries at much less cost to the N.H.S., because their overheads are far lower than those of hospitals, so they would not be asking for huge payments. The much smaller administrative element in G.P. work is another advantage. The simplification of ad- ministration would be a tremendous advantage to the patient; and children could have the benefit of treatment in familiar circumstances. Dr Ball sees no drawbacks in relieving hospitals ofthe kind of work under discussion: "it is an abuse for hospitals to have to do the work which can be done at a dif- ferent point and less expensively. This is one of the reasons why the N.H.S. is so expensive." Origin: minor op the profc problems now it sec does not might fee the rangc the hospi relieving elsewherr With v likely to I to see the list is a CD across th, mendatio spite ofr\ sent finat ideas ver A The t Fund,hn Britain's week, D °Weknt reason v figures s Asian cc there we the Midi per 100C the Asia The r and has s Growing U rdu, B directed Children launche: speakss[ ffcer. H about th now pro why it w ferent w such as The plal set up l Asian ct tion wol Oversea materia' be a spr dentalc Thea problen cultural points c habits i There , suitable