Tobacco and Public Health - TCSC Indonesia

especially post-Soviet countries, where the 1990s were a period of stagnation (no significant
changes) in tobacco consumption (WHO report 2002).
History of tobacco exposure in central Europe:
The case of Poland
WITOLD ZATOŃSKI 239
Material and methods
My analysis of the development of exposure to tobacco smoke in eastern European
countries will be based on data regarding Poland, the country I know best and one
where the relevant data are of quite good quality (Zatoński and Przewo´zniak 1992, 1996).
Analysis of the developments in epidemiology of exposure to tobacco smoke in
Poland will be based on four sources of information:
1. Country’s sale statistics. Data on the sales of cigarettes in Poland in 1923–1999
were derived from state statistical sources (yearbooks of the Central Statistical
Office). These were quite accurate in the postwar period until 1989 owing to centralized
trade (including import) of cigarettes and reliable information on the
sales. Since 1990 the data have been much less credible, being disclosed rather
reluctantly by privatized tobacco companies for taxation-related reasons.
2. Surveys. Surveys regarding smoking were initiated in 1974 and since 1980
they have been carried out annually (sometimes twice a year). The studies are
invariably based on a representative sample of the adult Polish population (16 and
more years old). The three-degree, proportionally stratified, randomized sampling
design has not changed since the first study. In 1974–1991 sample size was 1000
individuals. Since 1991 this number has been 1500. The response rate has always
been higher than 70% (80–90% on average). The questionnaire has almost
not changed, either. Smoking categories are defined according to WHO recommendations
(Lewith 1983). Every year the study has been prepared and conducted
by the same research team from the Department of Cancer Epidemiology and
Prevention at the Center of Oncology in Warsaw (Zatoński and Przewo´zniak 1992,
1996) and carried out by the same public opinion research center (OBOP) almost
every year.
3. The Household Survey from 1996. In April 1996, the Polish Central Statistical
Office (GUS) together with its Dutch counterpart carried out a household survey
regarding health of Polish population. One of the questions was concerned with
smoking (it followed the standards used in the annual smoking surveys in Poland).
The study was based on a randomized and representative sample of households in
Poland. The sample comprised 19 203 households, with a total of 47 924 occupants.
The response rate was 88% (GUS [Central Statistical Office] 1997).
4. Lung cancer mortality data from 1963 onward from Central Statistical Office
(Statistical Yearbooks of Poland; Zatoński and Becker 1988; Zatoński et al. 1996).