10 It is a well-established principle that in cases such as this, personal and general deterrence are major sentencing considerations and that personal circumstances are of less impact. However, the latter are not irrelevant. At 35 years of age the appellant cannot claim youth as a mitigating factor. But he has suffered significant medical disabilities since birth. They include chronic asthma (necessitating the administration of oral and intravenous steroids to prevent attacks becoming life threatening), severe lower back pain following a spinal fusion at 18 years of age, eczema, and obesity. A psychiatrist noted that the appellant suffered from low self esteem and depression. The psychiatrist opined that the depression aggravated the constant back pain, causing the appellant to feel demoralised and hopeless about his future. It should be noted that these physical and mental issues are long standing and there is no suggestion that they were caused or contributed to by substance abuse.