precises sur ce sujet avant la fin de 1991. Dans leur article Goldman et ses collegues affirment que certains medecins peuvent pratiquer un taux eeve de cesariennes a cause d'une clientele plus a risque. Une etude de la Corporation en 1987 et en 1989 sur des gestes obstetricaux, dont la cesarienne, n'a pas permis de tirer cette conclusion. ' Enfin, ltude de Goldman et de ses collegues a permis de situer le groupe d'age des femmes qui ont un AVAC. La majorite sont des femmes de plus de 30 ans. Les auteurs deplorent ne pas connaitre le niveau de scolarite de celles-ci. Nous sommes d'accord avec eux, car a notre avis le mouvement de 1'AVAC est venu d'une clientele feminine scolarisee. Gilles Bernier, MD, FRCSC Service d'inspection professionnelle Corporation professionnelle des medecins du Quebec Montreal (Que.)

Reference 1. Profil de l'utilisation des interventions obstetricales au Quebec. Bull Corp Prof Med Que 1990; 30 (4): 9-13

Looming manpower shortage has Canada's obstetricians worried his article (Can Med Assoc J 1991; 144: 478-479, 482), by Lynne Cohen, briefly addresses reasons for this development but focuses largely on the reasons family physicians are opting out of intrapartum care.

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they might encounter, as newly qualified specialists, to share a portion of the abortion workload. Forgoing a career in obstetrics would be an understandable response to this dilemma. It would be most unfortunate if this reasoning played a muted role in the recruitment shortage. Perhaps this possibility should be researched.

John Biehn, MD, CCFP St. Joseph's Family Medical Centre 346 Platt's Lane London, Ont.

Preventing smoking among young people I t is surprising that US cigarette companies are spending $9 million daily in tobacco advertising, as noted in Patrick Sullivan's article "Tobacco companies have sights on teens, US activist warns Nova Scotia MDs" (Can Med Assoc J 1990; 143: SMOKING thru Sthe ceONE 19th

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CAN MED ASSOC J 1991; 144 (9)

Hiroshi Kawane, MD, DMS Department of Medicine Kawasaki Medical School Kurashiki City, Okayama, Japan

References

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Gii,If I

I have wondered what role abortion may play in the obstet- ("pctre ofth flotin world"),; a rician-gynecologist recruitment shortage. For a variety of reasons increasing numbers of obstet- style of painting and wood-block prints rician-gynecologists are opting developed in Japan from the 17th out of performing therapeutic through the 19th centuries. The subabortions. Potential recruits could jects depict the world of pleasure plus not be oblivious to the pressure landscape. 1108

1351-1352). They are also advertising cigarettes aggressively in Japan, promoting them on television every night as a glamorous product. ' Another problem in Japan is the sale of tobacco through vending machines. It is estimated that there are 500 000 tobacco vending machines throughout the country.2 Children can get cigarettes as easily as they buy soft drinks. According to calculations by the Japan Tobacco Problem Information Center, underaged smokers smoked approximately 60 billion cigarettes last year, nearly twice as many as 6 years ago. Youngsters, especially teenage girls, tend to think that smoking is glamorous and fashionable. I have launched an antismoking campaign with the theme "Smoking is old-fashioned" (Fig. 1). The theme for last year's World No-Tobacco Day was "Growing up without tobacco." I hope that the government will take immediate action to prohibit tobacco advertising on television and restrict sales of cigarettes in vending machines.

1. Kawane H: Tobacco advertising in

Japan [C]. Can Med Assoc J 1988: 1 39: 193-194 2. Idem: A smoke-free hospital [C]. A4rcli InternAMed 1990: 150: 1350

Informed consent to HIV antibody testing I n response to the letter from Dr. D.P. Hill (Can Med Assoc J 1991; 144: 403) about the legal status of informed consent to HIV antibody testing, Dr. EikeHenner W. Kluge (ibid: 403-404) states that testing in the absence of consent should "Xbe approached LE I e

MAI 1991