Concerning: Prevalence and awareness of risk factors and behaviours of coronary heart disease in an urban population of Karachi.

educational messages that accompanied the introduction of legislation may also have had an effect – national radio and television advertising not only publicized the new legislation but also explained the dangers of using a mobile phone whilst driving. Any trend in decreasing compliance could, therefore, be due to two reasons. First, following a period of compliance, some drivers may judge that the risk of being caught using their phone (and the penalty if caught) is small enough to warrant continued usage. And secondly, drivers may forget or downplay the dangers of using their mobile phone whilst driving, as a result of decreased publicity and education around the issue. This calls for a policy response that addresses both enforcement and education. Indeed, the UK Road Safety Bill, currently before Parliament, seeks to increase the penalty for using a mobile phone while driving from £30 to £60 plus three penalty points.4 If introduced, these tougher measures should be combined with high-profile enforcement by police forces and regular education campaigns. This concurs with the conclusions of the New York study, which recommends vigorous enforcement campaigns accompanied by publicity in order to achieve long-term compliance.2 The Government should continue to monitor trends in usage of mobile phones whilst driving and alter policy accordingly. Depending on the impact of any changes made by the Road Safety Bill, the Government may have to consider even stronger deterrents to ensure that drivers respect this law aiming at protecting the public’s health.