Health improvement in Poland is contingent on continued extensive tobacco control measures

Tobacco smoking is a major avoidable single cause of premature mortality in Poland. Almost one in three Polish males do not live to 65 years of age, and almost half of this premature mortality can be traced back to the much higher smoking prevalence in Poland than in Western Europe – every third Polish male and every fourth Polish female smokes daily. However, the current health situation in Poland is much better than two decades ago when the country entered a period of political and economic upheaval. In the early 1990s, the state of health of the Polish population was catastrophic and its tobacco consumption levels the highest in the world. In the early 1990s, the probability of a 15-year-old Polish boy living to the age of 60 was not just twice lower than in Western Europe, but also lower than in China or India. The health policy of limiting the health consequences of smoking conducted by the European Union and, in the last two decades, by the Polish parliament and government, helped to stop this health catastrophe. In Poland, cigarette consumption has decreased by 30% since 1990, as did lung cancer mortality among males. Despite this progress, tobacco smoking remains the most serious health problem in Poland. Therefore, comprehensive tobacco control policy should not only be continued, but expanded and accelerated. The EU Tobacco Products Directive proposes a package of actions for reducing tobacco-related health harm in Europe. The Directive proposal is rational, science-and-evidence based, and grounded on the best practice examples from other countries. Both the Polish tobacco control law and the WHO Framework Convention on Tobacco Control (FCTC), ratified by Poland in 2006, oblige our country to support tobacco control, including all the initiatives taken by the European Union

On ageing, economization of health, and media ethics: how much is a month of life worth?

In recent years, scholars and public health officials have increasingly perceived tobacco as a threat to sustainable development. This article explores how stronger tobacco control efforts can contribute to the achievement of the Sustainable Development Goals (SDGs) set by the United Nations General Assembly in 2015. Most obviously, given that tobacco use and exposure account for over 7.2 million deaths annually, tobacco control is a fundamental prerequisite for achieving SDG 3: Good Health and Well- Being. However, the article also shows how tobacco is, among others, a driver of poverty and inequalities, a threat to sustainable economic growth, a challenge to the environment, and an obstacle to good governance. In effect, tobacco hinders progress on a host of other SDGs. Particular emphasis is placed on SDG 17: Partnership for the goals. While tobacco control partnerships for the past decades have helped attain public health progress globally, there is a risk of this SDG being hijacked by the tobacco industry and other corporate actors, who use it as a tool to justify the proliferation of public-private partnerships. Finally, the article calls for greater cross-disciplinary thinking and closer collaboration between tobacco control and development scholars, which could be crucial in designing successful tobacco control interventions in low- and middle-income countries, and could help achieve the Sustainable Development Agenda

Tobacco control and sustainable development: shared challenges and future opportunities

INTRODUCTION – TOBACCO CONTROL AS A DEVELOPMENT PRIORITY In May 2017, just months before the end of her second term as Director-General of the World Health Organization (WHO), Margaret Chan spoke about championing the WHO’s mission to fight tobacco use as one of her proudest achievements in office. What was surprising was the justification that followed. Dr. Chan did not focus on the usual costs associated with smoking – the millions of premature deaths globally, the US$ 1.4 trillion wasted annually in healthcare expenditure and lost productivity, or the human suffering brought by the host of cancers, heart diseases, and respiratory diseases caused by tobacco use. Instead, she declared that ‘tobacco is a deadly threat to global development’, affecting ‘every country on every level and across many sectors – economic growth, health, education, poverty, and the environment’ [1]. The slogan ‘Tobacco – a threat to development’ became the theme of the 2017 World No Tobacco Day. This was not the first time that tobacco has been recognised by the public health community as posing a threat ‘to the cause of social and environmental justice’, rather than just being a matter of individual health [2]. In 2015, the magnitude of the tobacco epidemic was acknowledged in the 2030 Agenda for Sustainable Development [3]. The agenda, which encompasses 17 Sustainable Development Goals (SDGs), directly addresses the importance of tobacco control in SDG Target 3.a, calling for the strengthening of ‘the implementation of the World Health Organization Framework Convention on Tobacco Control [WHO FCTC] in all countries’. The FCTC, adopted in 2003, was the first legally binding multilateral international public health treaty. It covers the production, sale, distribution, advertisement, and taxation of tobacco, setting an evidence-based framework of minimum requirements for the signatory states in controlling tobacco products [4]. The FCTC – as of May 2019 – was legally binding in 181 ratifying countries. While in most high-income countries (HICs) the implementation of the FCTC has advanced markedly, in some low- and middle-income countries (LMICs) the progress has been much slower [5, 6]. This is particularly alarming given that in 2018 four out of five smokers (or 880 million out of 1.1 billion smokers) lived in LMICs [7]. Drawing on evidence and examples from LMICs, in this article we explore key synergies between the SDGs and tobacco control. We demonstrate that strengthening tobacco control is not only relevant for achieving SDG 3 (Good Health and Well-Being), but also for broader social, economic, and environmental dimensions of sustainable development encompassed in several other SDGs [8]. We also point to the agenda of the transnational tobacco companies (TTCs) as a fundamental obstacle to achieving the SDGs and, more widely, to continued public health progress. To conclude, we argue that in order to drive progress in sustainable development, especially given the interference of TTCs, international tobacco control networks need to be further strengthened in LMICs. These processes need to be accompanied by greater cross-disciplinary collaboration, especially between the fields of tobacco control and development studies

Primary Hodgkin lymphoma of the nasopharynx: Case report

Primary extranodal location of Hodgkin lymphoma is uncommon. We present a case of a 43-year old man with isolated Hodgkin disease localized in the nasopharynx who presented with a complaint of bilateral nasal congestion. Primary location of Hodgkin lymphoma (HL) in the non-lymphoid tissue is very uncommon and the primary isolated involvement of the nasopharynx has been described in 35 cases in the worldwide literature

Cigarette smoking in Poland in 2019: the continuing decline in smoking prevalence

The aim of the study: To present comprehensive national estimates of prevalence of cigarette smoking by sociodemographic characteristics in Poland in 2019 and to analyse the changes in smoking prevalence in the Polish population after 2014. Material and methods: A cross-sectional survey on a representative sample of adult Polish population was conducted on 4-11 July 2019 by the Public Opinion Research Center (Centrum Badania Opinii Społecznej). A total of 1016 adults (42.4% men and 57.6% women) aged 20 years and older were included in the analysis. Data for smoking prevalence were analysed according to gender, age groups, birth cohorts, place of residence and education. Statistical analysis was done using Statistica 13.1 and assumed a significance level of p < 0.05. Results: Of the total sample population, 21.8% of Polish adults declared they are daily smokers (in the general population this would translate to 6.8 million Poles, including 3.9 million men and 2.9 million women), 27.8% that they are ex-smokers and 50.4% that they never smoked tobacco. More men than women declared they are daily smokers (26.9% vs 18.1%) and ex-smokers (36.2% vs 21.5%), and women were more likely to declare they are never smokers than men (60.3% vs 36.9%). Conclusions: Poland has experienced a decrease in smoking prevalence since 1976 in men and since 1982 in women. In 2019 the most important factor shaping smoking prevalence in Poland was education. Sex differences in smoking rates have been converging since late 1970s. Those with lower levels of education, as well as middle-aged men and women (45-64 years old) were found to have the highest levels of daily smoking and should be offered targeted support promoting smoking cessation. There is an urgent need to bring back and strengthen a national tobacco control strategy in Poland. This should include systematic annual surveys of smoking behaviours on a representative sample of Polish population using a standardised methodolog

Vaccination uptake and health service access amongst Polish and Romanian communities in England: a qualitative interview study – research summary

At the London School of Hygiene and Tropical Medicine, we are conducting a study to explore vaccination uptake and health service access amongst Polish and Romanian communities in England. In this summary, we provide the rationale for conducting this research and an overview of the study design

Jewish Politics in the New Poland: The 1922 Elections, a Case Study

The three million-strong Jewish community constituted almost ten per cent of the population of the Polish state that emerged from the Great War in 1918. In the turbulent years of Poland’s reformation many of them suffered from anti-Semitic excesses and a number of pogroms. However, the threat of violence and an electoral system biased in favour of big parties proved insufficient in uniting the fragmented Jewish political organisations. The run-up to the first nationwide elections in 1922 saw the formation of six different Jewish parties and a myriad of local political organisations, rather than a broad electoral bloc. This paper analyses the three explanations for this Jewish disunity that have been dominant in historiography: ideological conflicts, the different political realities Jews experienced in the Russian and Austrian partitions, and pragmatic considerations. The interaction between these motivations is investigated by focusing on parties representing the most powerful Jewish political movements in the post-war era: Zionism, Orthodoxy, and Socialism

Building health literacy in a Polish region: protocol for the POWER project in Lower Silesia

There is a high prevalence of premature mortality and unhealthy lifestyle behaviours in Lower Silesia in Poland (regional capital is the city of Wroclaw). One plausible reason is low health literacy among this population. Health literacy is one of the most important elements of public health and health promotion endeavours. It can be conceptualised as abroad range of cognitive and social skills as well as knowledge needed by an individual to maintain good health, prevent or manage diseases, and effectively engage with healthcare professionals and resources. The Health Promotion Foundation (HPF), in collaboration with regional institutions and organisations, initiated in 2017 a broad initiative to improve health in this region. The overarching aim of the wider programme is to improve the quality of care among primary care patients. The project stream led by HPF aims to improve knowledge and health-related competences in the population of primary care patients in Lower Silesia. It involves (1) needs assessment based on the analysis of data on health status and neds from 50 participating primary care clinics, followed by (2) development of tailored face-to-face workshops that will be delivered by trained public health students, (3) who will be mentored using train-the-trainer approach. It is anticipated that the project will impact on three main areas in the long term. First, it will lead to creation of a package of workshops that could be delivered to other primary care patients. Second, it will create opportunities for students majoring in public health in the region to become directly involved in activities focused on health education and promotion. Three, it is anticipated that the project will lead to improvements in health and wellbeing among the participating patient groups. The present report describes the scope and method of the project