Tobacco and Public Health - TCSC Indonesia

236
TOBACCO SMOKING IN CENTRAL EUROPEAN COUNTRIES: POLAND
After World War II the manufacturing of tobacco products was standardized across
the entire Soviet bloc. National tobacco monopolies were ruled and the tobacco market
consisted nearly exclusively of factory-made cigarettes. The state promoted cigarettes as
important basic goods, representing equality and socialist welfare and democratization.
But good quality information about frequency of smoking in EE countries is fragmentary,
with data on sales (consumption of tobacco/cigarettes) being the only source
(Forey et al. 2002). However, trends in smoking seem to be similar throughout the
region. The political and economic homogeny of all Soviet bloc countries also
embraced the smoking of cigarettes.
In the militarized societies of EE countries, cigarette production became a state
priority. In the army, everyone, including non-smokers, received a quota of cigarettes,
and non-smoking soldiers were looked at suspiciously and harassed. The prices of cigarettes
were low, and the product itself was widely available. Smoking was allowed
everywhere and at any time, except where it interfered with occupational safety (fire
hazard). This situation practically did not change until the end of the 1980s.
The closed societies of the Soviet empire were deprived of information on the harmful
effects of smoking. Reports from scientific studies of the relation of smoking to
cancer and other diseases, undertaken since the 1950s chiefly in the UK and the USA
(Doll, in this book), did not reach EE countries or, perhaps, were censored. Awareness
of the harm to health due to smoking was very low until the 1980s (Zatoński and
Przewo´zniak 1992). There were more smokers among better educated and better-off
people, especially among women (this observation is corroborated, among others, by
data about the incidence of lung cancer in the over-65 age group, which is higher
among women with university education than among those who only attended
elementary school) (Zatoński and Przewo´zniak 1992).
This attitude towards tobacco, which could be observed in EE countries almost until
the end of the 1980s, put these countries on top of the list of world tobacco consumption
from the early 1960s until the end of the twentieth century (WHO 1996).
A rapid rise in tobacco consumption in eastern Europe after WWII naturally resulted
in a similarly fast increase in the incidence of diseases caused by the inhalation of
tobacco smoke (Peto et al. 1994).
From the early 1980s onward, the incidence of lung cancer (almost exclusively
afflicting smokers) in men (especially in Poland, Hungary, former Czechoslovakia,
or some areas in Russia) remained at the highest level ever recorded in the world
(particularly in young and middle-aged adults) (Zatoński 1995; Zatoński et al. 1996).
Lung cancer rates in EE women also well reflect the rise in exposure: the incidence of
lung cancer in Hungarian under-65 women at the end of the twentieth century was
higher than the corresponding rates in men under 65 years old from most western
European countries (Fig. 13.3 and 13.4) (Zatoński et al. 1996).
Naturally, tobacco consumption is determined not only by public attitude to this
product but also by the market situation (the availability of cigarettes and their prices).