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

Zawartość substancji smolistych w papierosach sprzedawanych w Polsce w latach 1983–2000

The content of tar in cigarettes sold in Poland in the years 1983–2000Cigarette smoke contains over forty carcinogenic compounds, including tar that is evaluated as carcinogen A for human beings. The World Health Organization recommends reduction of carcinogenic and toxic substances in cigarettes as one of the elements in cancer control programs and tobacco control policies. In the beginning of 1990s, the Polish norm for tar, nicotine and carbon monoxide was first time enforced in Poland. This paper makes an attempt to collect available data on the content of tar in cigarettes sold in Polish market between 1983 and 2000, analyze time trends for average tar content in these cigarettes, compare Polish data with study results from Unites States, Finland and other Central and Eastern European countries, and evaluate whether tobacco product control measures that have been enforced at that time contributed to reduction of tar in cigarettes sold in Poland and what was its potential impact on time trends in lung cancer mortality in the last decades

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

Cancer epidemiology in Poland

W pracy przedstawiono obraz epidemiologiczny nowotworów złośliwych w Polsce, jego zmiany w czasie oraz porównanie z krajami Unii Europejskiej. Przebieg trendów czasowych umieralności w głównych lokalizacjach nowotworów złośliwych w Polsce jest podobny do obrazu nowotworowego krajów UE. Transformacja epidemiologiczna umieralności z powodu nowotworów w Polsce odbywa się w stosunku do krajów Europy Zachodniej z pewnym opóźnieniem czasowym.  Ogółem trendy epidemiologiczne wszystkich lokalizacji nowotworowych są uśrednieniem rozbieżnych trendów w zachorowaniach na poszczególne nowotwory, często zdominowanym przez zmiany trendów największych lokalizacji nowotworowych. Tak dzieje się np. u mężczyzn w Polsce w przypadku umieralności na nowotwory złośliwe płuca. W drugiej części pracy poddano analizie zjawisko zachorowalności, które także wskazuje na wyraźne zróżnicowanie trendów czasowych poszczególnych lokalizacji. Trendy częstości zachorowań mierzone bezwzględną liczbą nowo diagnozowanych chorób zależą od wielu czynników — środowiskowych czynników ryzyka (np. częstości palenia), które są modyfikowalne, ale także kluczowe znaczenie mają zmiany struktury wieku populacji. Krzywa zachorowań rośnie wykładniczo wraz ze wzrostem długości życia (czynnik niemodyfikowalny). Znaczna większość (60%) zachorowań na nowotwory złośliwe jest diagnozowana wśród osób po 65 r.ż., a w Polsce obserwuje się stały przyrost ludności w tym wieku. Trzy zjawiska są najbardziej charakterystyczne dla obrazu trendów czasowych zachorowalności z powodu nowotworów złośliwych w Polsce: 1) gwałtowny spadek zachorowań z powodu nowotworów złośliwych płuca u mężczyzn (po okresie trwającego kilka dekad wzrostu zachorowań); 2) bardzo szybki wzrost zachorowań z powodu nowotworów złośliwych prostaty, szczególnie po 1990 roku; 3) dramatyczny wzrost nowo diagnozowanych nowotworów złośliwych piersi u kobiet, który zdominował zachorowalność na nowotwory złośliwe w Polsce u kobiet (obecnie co czwarty nowo diagnozowany nowotwór u kobiet to nowotwór złośliwy piersi). Dodatkowo szczegółowej analizie epidemiologicznej poddano kilka głównych lokalizacji nowotworów złośliwych (nowotwory płuca, piersi, gruczołu krokowego, jelita grubego, szyjki macicy i żołądka) oraz przedstawiono ich po­równanie z innymi krajami.  Największy sukces w kontrolowaniu nowotworów złośliwych osiągnięto w tych schorzeniach, w których możliwa jest prewencja (przede wszystkim nowotwory złośliwe płuca u mężczyzn), ale także w tych nowotworach, gdzie możliwy jest skuteczny populacyjny skrining (nowotwory złośliwe szyjki macicy, nowotwory złośliwe piersi).This paper presents the epidemiological picture of cancer in Poland, its changes over time and a comparison with other countries of the European Union (EU). The mortality time trends for the main cancer sites in Poland are similar to those observed in other EU countries. However, the epidemiological transformation in cancer mortality in Poland is delayed with respect to countries of Western Europe. The overall epidemiological trends are an average of the individual trends for different cancers, often dominated by changes in trends for the major cancer sites. This is observed, for example, in the case of male lung cancer mortality in Poland. In the second part of the study we analysed cancer morbidity, which also demonstrated clear differences in time trends in each site. Incidence trends measured by the absolute number of newly diagnosed diseases depend on many factors. The most important factor is the modifiable environmental risk factors (e.g. smoking prevalence), as well as the changes in the age structure the population. The incidence curve grows exponentially with the increase of lifespan (a non-modifiable factor). The vast majority (60%) of cancer cases are diagnosed among people over 65 years, and in Poland a steady increase of population in this age group is observed. Three phenomena emerge as the most characteristic of the time trends of cancer morbidity in Poland. (1) A sharp decline in incidence of lung cancer in men (after a period of rising incidence that lasted for decades). (2) Rapid growth in incidence of prostate cancer, especially after 1990. (3) A dramatic increase in newly diagnosed breast cancer cases in women, which dominated the incidence of cancer in women in Poland (currently one in four of newly diagnosed cancers among women is breast cancer).In addition, a detailed epidemiological analysis was conducted for several major cancer sites (lung, breast, prostate, colorectal, cervix and stomach) and its results were compared with trends observed in other countries. The biggest success in cancer control was achieved in those cancer locations, for which prevention is possible (especially lung cancer in men), and also in those cancers, where it is possible to effectively screen a population (cervical cancer, breast cancer).

Stosunek Polaków do wprowadzenia całkowitego zakazu palenia we wszystkich miejscach publicznych

Attitude of Poles toward enforcement of complete smoking ban in all public placesWHO Framework Convention on Tobacco Control recommends enforcement of strong smoke-free policy in public places and worksites. Many countries of European Union, cities and states of the Unites States of America, Canadian provinces and other countries worldwide have been effectively enforced comprehensive ban of smoking in public places and worksites. Follow up studies show health and social benefits of the smoke-free policy. However, its effective enforcement requires public support. This paper analyzes results of the 2006 nation-wide randomized survey on attitudes toward complete ban of smoking in public places and worksites in Poland. In Poland, public support for the enforcement of smoke-free legislation (76%), even very restrictive, belongs to the highest in European Union countries. Its effective enforcement is crucial for improvement of public health in Poland since over 8,700 deaths (including almost 2,000 deaths among non-smokers) in Poland are caused by passive exposure to tobacco smok

Lung cancer, the leading cause of cancer deaths among women in Europe

Wstęp. Artykuł ten ma celu przedstawienie obrazu umieralności wśród kobiet w krajach Unii Europejskiej z powodu nowotworów złośliwych płuca na tle umieralności z powodu raka piersi. Badanie ma także na celu zwrócenie uwagi na czynnik ryzyka nowotworów płuca, jakim jest palenie tytoniu — wciąż rozwijający się problem zdrowia publicznego. Materiał i metody. Materiał będący podstawą tego opracowania stanowią dane o zgonach z powodu nowotworów złośliwych płuca i piersi u kobiet w Polsce i w innych krajach Unii Europejskiej za wszystkie dostępne lata w okresie 1960–2010. Analizę trendów czasowych umieralności z powodu nowotworów złośliwych płuca i piersi przeprowadzono przy użyciu programu Joinpoint Regression Program. Analizą objęto kobiety w wieku 45–74 lat. Wyniki. Umieralność z powodu raka płuca wśród kobiet rośnie od wielu lat i w większości krajów ta przyczyna zgonów już jest lub w najbliższej dekadzie będzie najczęstszą przyczyną zgonów nowotworowych Europejek. Podsumowanie. Nowotwory złośliwe płuca stają się pierwszą przyczyną zgonów nowotworowych wśród kobiet w Europie. W większości krajów trendy czasowe umieralności wykazują tendencję wzrostową. Głównym tego powodem jest rozwój epidemii palenia tytoniu wśród kobiet. Leczenie zespołu uzależnienia od tytoniu wydaje się być najskuteczniejszym sposobem na zmianę tych niekorzystnych tendencji. Edukowanie kobiet i wskazywanie efektywnych sposobów zerwania z paleniem papierosów powinno pozostawać priorytetem w zakresie działań prewencji pierwotnej nowotworów i promocji zdrowia.Introduction. This article presents the picture of mortality from lung cancer among women in the European Union in relation to breast cancer mortality. It also draws attention to tobacco smoking as a main cause of lung cancer and still a significant public health problem. Material and methods. Data on mortality due to lung cancer and breast cancer among women in Poland and other European Union countries were derived from the WHO mortality statistics for the period 1960–2010. The analysis of time trends in mortality from lung cancer and breast cancer were performed using Joinpoint Regression Program for women aged 45–74 years. Results. Lung cancer mortality among women has been increasing for many years, and in most countries this is already or will be in the next decade, the leading cause of cancer deaths European women. Conclusions. Lung cancer is the leading cause of cancer deaths among women in Europe. In majority of countries the mortality time trends are increasing and the main reason for this is a persistent epidemic of tobacco smoking in women. Treatment of tobacco dependence seems to be the most effective way to change these negative trends. Educating women and indicating them to effective ways of smoking cessation should remain a priority of cancer primary prevention and health promotion activities

Palenie tytoniu a umieralność na choroby odtytoniowe w Europie Środkowo-Wschodniej

Tobacco smoking and smoking-attributable mortality in Central and Eastern EuropeTobacco is the major determinant of the health gap between the east (EU10) and the west part (EU15) of European Union. Over half of the excess mortality among middle-aged men in the EU10 countries might have been avoided if the tobacco consumption of these men had been the same as that of equivalent men in the EU15. The role of tobacco in shaping mortality differences between the EU10 and EU15 countries in women is less prominent than in men. Nevertheless, about one fourth of the excess mortality among middle-aged women in EU10 countries can be attributed to their higher tobacco consumption. 41% of male deaths between 35 and 64 years were attributable to tobacco smoking in the EU10 countries compared with 33% in the EU15 countries. The figures for women were 17% in the EU10 and 14% in the EU15 countries. It is worth emphasizing that, in some EU10 countries, the tobacco control policies and programmes have already produced notable results on tobacco- attributable mortality, in particular among men