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

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

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

'I don't think anybody explained to me how it works': qualitative study exploring vaccination and primary health service access and uptake amongst Polish and Romanian communities in England.

OBJECTIVES: This study explored vaccination attitudes and behaviours among Polish and Romanian communities, and related access to primary healthcare services. DESIGN: A qualitative study using in-depth semistructured interviews with Polish and Romanian community members (CMs) and healthcare workers (HCWs) involved in vaccination in areas with large Polish and Romanian communities. CMs discussed their vaccination attitudes and their experiences of accessing vaccinations in England. HCWs shared their experiences in vaccinating Polish and Romanian communities. SETTING: Recruitment focused on three geographical areas in England with large Polish and Romanian populations (in London, Lincolnshire and Berkshire). PARTICIPANTS: 20 Polish and 10 Romanian CMs, and 20 HCWs. Most CMs were mothers or pregnant women and were recruited from London or Lincolnshire. HCWs included practice nurses, health visitors and school nurses recruited from the targeted geographical areas. RESULTS: Although most CMs reported vaccinating according to the UK schedule, obstacles to vaccination were highlighted. CMs experienced difficulties navigating and trusting the English primary healthcare system, and challenges in accessing credible vaccination information in Polish and Romanian. CM vaccination expectations, largely built on knowledge and experiences from Poland and Romania, were often unmet. This was driven by differences in vaccination scheduling and service provision in England, such as nurses delivering vaccines instead of doctors. CMs reported lower acceptance of the influenza vaccine, largely due to perceptions around the importance and efficacy of this vaccine. HCWs reported challenges translating and understanding vaccination histories, overcoming verbal communication barriers and ensuring vaccination schedule completeness among families travelling between England and Poland or Romania. CONCLUSIONS: This study identified vaccination uptake and delivery issues and recommendations for improvement. HCWs should discuss health service expectations, highlight differences in vaccination scheduling and delivery between countries, and promote greater understanding of the English primary healthcare system in order to encourage vaccination in these communities

Characteristics and correlates of electronic cigarette product attributes and undesirable events during e-cigarette use in six countries of the EUREST-PLUS ITC Europe Surveys

Introduction: This study assessed characteristics and correlates associated with e-cigarette product attributes and identified correlates of experiencing undesirable events during e-cigarette use among adult smokers across six European Union (EU) Members States (MS) prior to the implementation of the Tobacco Products Directive (TPD) in 2016. Methods: We conducted a cross-sectional survey with a nationally representative sample of adult cigarette smokers from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) reporting e-cigarette use; randomly selected through a multistage cluster sampling design from June to September 2016. Stepwise logistic regressions were used to identify factors associated with use of flavors, noticing health warnings, mixing e-liquids, experiencing 'dry puff', e-liquid leaking during use and e-liquid spilling during refill. Results: Current daily or weekly prevalence of e-cigarette use among this sample of adult smokers was 7.5%. The most common attributes of e-cigarettes used included those that are flavored, contain nicotine, and are of tank style. Noticing health warnings on e-cigarette packaging and leaflets, respectively, was low (10.2% and 28%, respectively). Use of e-liquid refill nozzle caps, described as easy for a child to open, was associated with spilling during refill (OR=6.73; 95% CI: 2.02-22.37). Participants who adjusted occasionally or regularly the power (voltage) or temperature of their e-cigarette had greater odds of ever experiencing a 'dry puff' (OR=6.01; 95% CI: 2.68-13.46). Mixing different e-liquids was associated with leaking during use (OR=7.78; 95% CI: 2.45-24.73) and spilling during refill (OR=8.54; 95% CI: 2.29-31.88). Conclusions: Ongoing evaluation of factors associated with e-cigarette attributes and of the correlates of experiencing e-cigarette undesirable events during use, related to product design, is crucial to monitoring the impact of the implementing Acts of the EU TPD

Impact of the WHO “best buys” for alcohol policy on consumption and health in the Baltic countries and Poland 2000–2020

Funding Information: Funding: Research reported in this publication was in part supported by the (U.S.) National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH), grant number 1R01AA028224 . This research was conducted as part of the project ‘Evaluation of the impact of alcohol control policies on morbidity and mortality in Lithuania and other Baltic states’ and we would like to thank the whole team for their input to wider discussions in generating the research reported in this paper. Content is the responsibility of the authors and does not reflect official positions of the NIAAA or the NIH. Publisher Copyright: © 2023Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.Peer reviewe