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DEATHS / 100,000 DEATHS / 100,000 7 6 5 4 3 2 1 FEMALES, AGE 20–44 Smoking among children and youth DEATHS / 100,000 FEMALES, AGE 45–64 WITOLD ZATOŃSKI 245 0 1959 1964 1969 1974 1979 1984 1989 1994 1999 0 1959 1964 1969 1974 1979 1984 1989 1994 1999 YEAR YEAR 250 200 150 100 50 POLAND UK USA HUNGARY POLAND UK USA HUNGARY FEMALES, AGE 65 AND OVER 0 1959 1964 1969 1974 1979 YEAR 1984 1989 1994 1999 DEATHS / 100,000 In paternalistic and conservative societies of eastern Europe, cigarette smoking was strongly forbidden among children, particularly girls. Estimates based on the fragmentary data available indicate that in the early 1980s about 25% of 15-year-old boys and less than 10% of girls smoked cigarettes at least once a week, which was much less than in western Europe (Zatoński and Przewo´zniak 1992). However, there was also another social norm. Entering adulthood on the eighteenth birthday meant acquiring the right to smoke officially, also at school. Consequently, smoking rates rose abruptly among 18-year-olds and later. With every recruit given 70 60 50 40 30 20 10 30 25 20 15 10 5 FEMALES, ALL AGE GROUPS 0 1959 1964 1969 1974 1979 1984 1989 1994 1999 YEAR POLAND UK USA HUNGARY POLAND UK USA HUNGARY Fig.13.4 Mortality trends from lung cancer, selected countries 1959–1999.
246 TOBACCO SMOKING IN CENTRAL EUROPEAN COUNTRIES: POLAND cigarettes for free, army service was a good school in smoking. For this reason, smoking rates among young (20–29 years old) men were 70–80% (depending on the level of education) in the early 1980s. Smoking was also quite widespread among young women, of whom nearly a half were smokers (Fig. 13.2). The transformation of the late 1980s/early 1990s brought about changes in norms and behaviour. Access of children to cigarettes increased (Westernization?!). International studies of 13–15-year-old children carried out in the 1990s showed the rates of smokers (at least 1 cigarette a week) in boys at an unchanged level of 30% and a rapid rise in girls—from 16% (in 1990) to 28% in 1999 (Mazur et al. 2000). Still, these rates, especially among girls, are again lower than in western European countries (Mazur et al. 2000). At the same time, the steep rise in smoking rates in early adulthood has been stopped, at least in Poland (1999 data for 20–29-year-old men and women: 49% and 22% respectively) (Fig. 13.2). Smoking among women Historically, smoking was rare among women in eastern Europe. Women from rural areas did not smoke at all before World War II. The smoking habit was spreading among better educated women living in towns and cities. This is confirmed by epidemiological data on lung cancer (Zatoński et al. 1996). After World War II, the popularity of smoking among women rose rapidly, with 18% of adult women smoking in 1974, and 30% in 1982. The 1974 survey revealed considerable differences in successive birth cohorts (Fig. 13.2). The smoking habit begins to increase more rapidly among less well-educated women, but is still grossly limited to the urban female population. There are still much fewer smokers among women from rural areas, also at the end of the twentieth century (not only in Poland but in most EE countries). These observations are confirmed by data on the distribution of lung cancer, which is invariably rare among women from rural areas (Zatoński et al. 1996). Data from the 1980s and 1990s reveal a picture of a rapid diversification of smoking rates among Polish women by level of education. For example, in the early 1990s about 40% of pregnant women with elementary education and about 10% of those with university education smoked cigarettes (Szamotulska et al. 2000). A change in attitude towards smoking led to a rapid decline in smoking rates among the youngest women, especially those better educated (Fig. 13.2). Between 1980s and 1999, the rate of women smokers in the 20–29 age group fell nearly by half (from 36% to 22%). There is still a large population of never-smoking adult Polish women (66% in 1999) (Zatoński 2002b). Now, at the turn of the century, smoking is much more popular among less welleducated women, unlike the pattern that was prevalent as late as the mid-1970s. This is again well illustrated by epidemiological data on the incidence of lung cancer.
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Tobacco and Public Health: Science
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Tobacco and Public Health: Science
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Preface Tobacco: The public health
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PREFACE vii The cigarette companies
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dramatically. Once more, I am not s
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it impairs quality of life for year
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documents and through litigation by
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PREFACE xv it will not succeed. Now
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Stratton, K., Shetty, P., Wallace,
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Contents Preface v C. Everett Koop
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27 Tobacco and pancreas cancer 479
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Contributors Amanda Amos Reader in
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Stephen S. Hecht University of Minn
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Cecily S. Ray Project Assistant Epi
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Abbreviations AAA Abdominal aortic
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Introduction The publication of thi
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Part 1 Tobacco: History
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Introduction Chapter 1 Evolution of
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RICHARD DOLL 5 However, little atte
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RICHARD DOLL 7 lung’ (Doll and Hi
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Table 1.1 Principal diseases caused
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Table 1.4 Manufactured cigarette co
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in 1995 was approaching the maximum
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References Adler, I. (1912). Primar
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Introduction Chapter 2 The great st
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MICHAEL J. THUN AND JANE HENLEY 19
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it seems likely that some of this v
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steady increase in lung cancer occu
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cigarette smoking in deaths from co
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the effects of smoking and smoking
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Lung cancer death rate (per 100,000
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Lickint, F. (1929). Zeitschrift fur
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Chapter 3 Dealing with health fears
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LYNN T. KOZLOWSKI AND RICHARD J. O
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Table 3.3 Selected cigarette advert
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Part 2 Tobacco: Composition
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Introduction Chapter 4 The changing
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ILSE HOFFMANN AND DIETRICH HOFFMANN
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Table 4.4 (continued) Carcinogens i
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Table 4.5 Standard conditions for m
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Table 4.7 Comparison of experimenta
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the lung in rats treated with NNK (
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serve as the scientific basis in su
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Senkus, M. (ed.) (1976). Leaf compo
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Introduction Chapter 5 Tobacco smok
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STEPHEN S. HECHT 95 Established pul
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STEPHEN S. HECHT 97 magnitude lower
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STEPHEN S. HECHT 99 generally great
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Table 5.1 1-Hydroxypyrene in the ur
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Table 5.2 NNAL and its glucuronides
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STEPHEN S. HECHT 105 Table 5.2 (con
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Table 5.3 Representative DNA adduct
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G No (Wang et al. 2001a) N 2 CHCH 2
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STEPHEN S. HECHT 111 N-Nitrosopyrro
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(Kozack et al. 2000; Seo et al. 200
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the DNA adducts resulting from toba
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Culp, S. J., Gaylor, D. W., Sheldon
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STEPHEN S. HECHT 119 International
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STEPHEN S. HECHT 121 Melchior, W. B
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STEPHEN S. HECHT 123 Rivenso, A., H
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Wang, M., McIntee, E. J., Cheng, G.
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Part 3 Nicotine and addiction
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Chapter 6 Pharmacology of nicotine
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JACK E. HENNINGFIELD AND NEAL L. BE
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Pickworth et al. 1995; Shiffman et
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American Caucasians and Hispanics (
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(US DHHS 2001). At doses delivered
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References JACK E. HENNINGFIELD AND
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Introduction Chapter 7 Behavioral p
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BRIDGETTE E. GARRETT ET AL. 151 How
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(Fischman and Foltin 1991). Another
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following repeated, infrequent and
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BRIDGETTE E. GARRETT ET AL. 157 oth
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BRIDGETTE E. GARRETT ET AL. 159 cli
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to tobacco product ingredients and
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BRIDGETTE E. GARRETT ET AL. 163 Gom
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BRIDGETTE E. GARRETT ET AL. 165 Ris
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Introduction Chapter 8 Cigarette sc
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JEFF FOWLES AND DENNIS SHUSTERMAN 1
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◆ The pressure drop of the filter
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Nitrosamines Nitrosamines are biolo
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Physical design features of cigaret
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Introduction Chapter 9 Nicotine dos
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world tobacco burden (World Health
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Table 9.2 The ranges of nicotine, n
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MIRJANA V. DJORDJEVIC 187 turing a
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Poland 19 1.4 n.a. n.a. 68−347 36
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MIRJANA V. DJORDJEVIC 191 cigarette
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MIRJANA V. DJORDJEVIC 193 Table 9.5
Page 228 and 229: MIRJANA V. DJORDJEVIC 195 MS wherea
Page 230 and 231: MIRJANA V. DJORDJEVIC 197 In recent
Page 232 and 233: MIRJANA V. DJORDJEVIC 199 Table 9.8
Page 234 and 235: MIRJANA V. DJORDJEVIC 201 Burns, D.
Page 236 and 237: International Agency for Research o
Page 238 and 239: Part 4 Tobacco use: Prevalence, tre
Page 240 and 241: Chapter 10 Tobacco in Great Britain
Page 242 and 243: Adult smoking PATTI WHITE 209 Since
Page 244 and 245: oys who were regular smokers report
Page 246 and 247: PATTI WHITE 213 cancer, and bringin
Page 248 and 249: Introduction Chapter 11 The epidemi
Page 250 and 251: since the late 1980s. In 2001, Phil
Page 252 and 253: YANG HONGHUAN 219 ◆ Among males,
Page 254 and 255: Table 11.1 Smoking among adolescent
Page 256 and 257: (57%) was higher than in males (45%
Page 258 and 259: 20 cigarettes a day had double the
Page 260 and 261: Chapter 12 Patterns of smoking in R
Page 262 and 263: DAVID ZARIDZE 229 Ignatova et al. (
Page 264 and 265: DAVID ZARIDZE 231 Tyumen, respectiv
Page 266 and 267: References DAVID ZARIDZE 233 Alexee
Page 268 and 269: Chapter 13 Tobacco smoking in centr
Page 270 and 271: WITOLD ZATOŃSKI 237 The developmen
Page 272 and 273: especially post-Soviet countries, w
Page 274 and 275: No. of Cigarettes 3000 2500 2000 15
Page 276 and 277: WITOLD ZATOŃSKI 243 young men and
Page 280 and 281: WITOLD ZATOŃSKI 247 According to d
Page 282 and 283: Unfortunately, available data on th
Page 284 and 285: Kaczmarczyk-Chalas, K., Gdulewicz,
Page 286 and 287: Chapter 14 The epidemic in India Pr
Page 288 and 289: aniseed, and musk, also available a
Page 290 and 291: PRAKASH C. GUPTA AND CECILY S. RAY
Page 292 and 293: Prevalence among youth PRAKASH C. G
Page 294 and 295: treatment and premature death were
Page 296 and 297: Although tobacco control legislatio
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Page 300 and 301: Chapter 15 Tobacco in Africa: More
Page 302 and 303: In assessing tobacco use in Africa
Page 304 and 305: YUSSUF SALOOJEE 271 plug the gap th
Page 306 and 307: Table 15.2 Cigarette taxes as perce
Page 308 and 309: YUSSUF SALOOJEE 275 In recent years
Page 310 and 311: World Bank (2001). Economics of Tob
Page 312 and 313: Part 5 Tobacco and health. Global b
Page 314 and 315: Chapter 16 The future worldwide hea
Page 316 and 317: RICHARD PETO AND ALAN D LOPEZ 283 a
Page 318 and 319: UK male death rate at ages 35-69 ha
Page 320 and 321: Overview Chapter 17 Passive smoking
Page 322 and 323: evidence have proved to be effectiv
Page 324 and 325: JONATHAN M. SAMET 291 a thousand de
Page 326 and 327: Table 17.2 Occupational ETS exposur
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Table 17.3 Nicotine concentrations
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portable piezobalance to sample aer
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JONATHAN M. SAMET 299 Fetal effects
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JONATHAN M. SAMET 301 Investigation
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Table 17.4 Summary of pooled random
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JONATHAN M. SAMET 305 also reported
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and involuntary exposure to tobacco
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Glantz, S. A. and Parmley, W. W. (1
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JONATHAN M. SAMET 311 O’Connor, G
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JONATHAN M. SAMET 313 US Department
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Introduction Chapter 18 Adolescent
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JOHN P. PIERCE ET AL. 317 would be
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JOHN P. PIERCE ET AL. 319 Indeed, t
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JOHN P. PIERCE ET AL. 321 reached i
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subsequent consumption. Most studie
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Burns, D., Garfinkel, L., and Samet
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JOHN P. PIERCE ET AL. 327 US Depart
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The epidemic Chapter 19 Tobacco and
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AMANDA AMOS AND JUDITH MACKAY 331 w
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AMANDA AMOS AND JUDITH MACKAY 333 T
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AMANDA AMOS AND JUDITH MACKAY 335 w
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AMANDA AMOS AND JUDITH MACKAY 337 p
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AMANDA AMOS AND JUDITH MACKAY 339 T
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AMANDA AMOS AND JUDITH MACKAY 341 o
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AMANDA AMOS AND JUDITH MACKAY 343 M
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such as Jewel and Madonna, who woul
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AMANDA AMOS AND JUDITH MACKAY 347 t
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particularly in developing countrie
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AMANDA AMOS AND JUDITH MACKAY 351 L
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Part 6 Tobacco and cancer
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Chapter 20 Cancer of the prostate F
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Table 20.1 Summary of results of ca
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Andersson et al. 1996 Sweden 256 ca
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Table 20.2 Summary of results of co
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cancer in younger or elderly men, w
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FABIO LEVI AND CARLO LA VECCHIA 365
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Summary Chapter 21 Laryngeal cancer
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12-year follow-up of the American C
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Hedberg et al. USA, 235, 81% P, 547
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cigarettes as compared to blond-tob
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of 3.78 and 11.47. An interpretatio
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Effect on survival In two studies f
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Cattaruzza, M. S., Maisonneuve, P.,
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USDHEW (1964). Laryngeal cancer. In
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Chapter 22 Smoking and cancer of th
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Table 22.1 Results from selected ca
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Asia Gao et al. 1994— Population
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EVA NEGRI 389 Ille-et-Vilaine, Fran
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Odds Ratio 2.5 2 1.5 1 0.5 0 0.30 2
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Garidou et al. 1996— Hospital ≤
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De Stefani, E., Barrios, E., and Fi
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Wynder, E. L. and Bross, I. J. (196
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Introduction Chapter 23 Tobacco use
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Table 23.1 Tobacco use and risk of
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Franceschi et al. Oral cavity, Oral
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Muscat et al. Oral cavity OR = 2.1
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Population-based case-control studi
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Lewin et al. Oral cavity, RR = 6.5
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TONGZHANG ZHENG ET AL. 411 the cont
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TONGZHANG ZHENG ET AL. 413 For smok
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TONGZHANG ZHENG ET AL. 415 per day
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TONGZHANG ZHENG ET AL. 417 than tha
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TONGZHANG ZHENG ET AL. 419 For exam
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TONGZHANG ZHENG ET AL. 421 decline
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Studies in India: Oral cancer is th
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carcinoma compared with other combi
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studies have demonstrated a positiv
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TONGZHANG ZHENG ET AL. 429 Garrote,
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TONGZHANG ZHENG ET AL. 431 Notani,
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Chapter 24 Smoking and stomach canc
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DAVID ZARIDZE 435 such as sex, age,
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DAVID ZARIDZE 437 (Kato et al. 1990
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DAVID ZARIDZE 439 respectively. The
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Gajalakshmi, C. K. and Shanta, V. (
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Pisani, P., Parkin, D. M., Bray, F.
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Introduction Chapter 25 Cigarette s
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attenuated in every study after con
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EDWARD GIOVANNUCCI 449 with a gener
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(Baron et al. 1994) of 352 colon ca
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(U.S. Dept. of Health Education and
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References EDWARD GIOVANNUCCI 455 A
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EDWARD GIOVANNUCCI 457 Kono, S., Ik
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Chapter 26 Smoking and cervical neo
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Tokuhata 1967* Williams 1977* Wigle
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Clarke 1985* Hellberg 1986* La Vecc
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ANNE SZAREWSKI AND JACK CUZICK 465
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case-control study nested in a scre
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five-fold risk of cervical cancer f
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(typically around two-fold), but be
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Introduction Chapter 27 Tobacco and
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Cigar, pipe, and chewing tobacco Wh
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Conclusion Overall, tobacco smoking
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Summary Chapter 28 Smoking and lung
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GRAHAM G. GILES AND PETER BOYLE 487
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quit for 20 years or more (Rogot an
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cancer and others where there is st
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Peto, R. (1986) Influence of dose a
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Chapter 29 Tobacco smoking and canc
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He further noted that case-control
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coefficients from the data in Table
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DIMITRIOS TRICHOPOULOS AND ARETI LA
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Epidemiology Chapter 30 Smoking and
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CRYSTAL N. HOLICK AND HARVEY A. RIS
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and at least the enteric variety of
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Chapter 31 Endometrial cancer Paul
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Table 31.1 Epidemiological studies
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studies (Terry et al. 1999, 2002a),
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Newcomer Population 740/2372 40-79
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PAUL D. TERRY ET AL. 531 levels, an
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Relative body weight Obesity is an
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Key et al. 1991 147 pre- and postme
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lood levels among current smokers,
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Table 31.7 Studies of cigarette smo
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of the association between cigarett
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Jensen, J., Christiansen, C., and R
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PAUL D. TERRY ET AL. 545 Weiderpass
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Part 7 Tobacco and heart disease
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citations of some of the best-known
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KONRAD JAMROZIK 553 because the dat
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KONRAD JAMROZIK 555 Fig. 32.2 Trend
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Table 32.3 Case-control studies of
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Table 32.5 Cohort studies of active
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Table 32.6 Effect of exclusion of p
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eadily addressed by cohort studies
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Specificity The entries in Table 32
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Table 32.8 Application of Bradford
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KONRAD JAMROZIK 569 arterial CVD re
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elationship goes beyond statistical
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Garland, C., Barrett-Connor, E., Su
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National Health and Medical Researc
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Part 8 Tobacco and respiratory dise
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Introduction Chapter 33 Chronic obs
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Many of the constituents in both th
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DAVID M. BURNS rate of growth in lu
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Death rates from COPD in smokers an
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Fraction of Excess Risk 1.20 1.00 0
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DAVID M. BURNS Higgins, M. W., Enri
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Part 9 Tobacco and other diseases
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Introduction Chapter 34 Smoking and
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ALLAN HACKSHAW 595 several mechanis
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Table 34.4 Studies that reported re
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Table 34.5 Cohort studies that repo
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than non-smokers; they have about h
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Table 34.8 Cohort studies that repo
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esults from cohort studies. There i
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ALLAN HACKSHAW 607 (DiFranza and Le
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Table 34.12 Cohort studies that rep
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Caries and tooth loss Because perio
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Table 34.16 Summary of disorders in
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References ALLAN HACKSHAW 615 Allar
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Johnsen, R., Forde, O. H., Straume,
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Seddon, J. M., Willett, W. C., Spei
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Part 10 Genetics, nicotine addictio
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Chapter 35 Genes, nicotine addictio
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Cotinine (ng/ml) 750 500 250 OXCHEC
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MICHAEL MURPHY ET AL. 627 of those
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MICHAEL MURPHY ET AL. risk associat
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Table 35.2 (continued) Gene map Chr
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MICHAEL MURPHY ET AL. pre-clinical
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Steps to carcinogenesis Exposure to
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DNA repair As previously alluded to
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MICHAEL MURPHY ET AL. Lichtenstein,
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Part 11 Tobacco and alcohol
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Table 36.1 Comparison of alcohol an
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Although gene therapy has rarely be
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20+ TABAC 5.1 10-19 0-9 3.4 12.3 0-
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Heavy drinking is known to cause ga
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Treatment issues and co-dependence
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ALBERT B. LOWENFELS AND PATRICK MAI
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Part 12 Tobacco control: Successes
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Introduction Chapter 37 Global toba
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NIGEL GRAY (sometimes at state leve
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NIGEL GRAY The first attempt to red
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per litre of smoke. Reduction of th
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Borland, R., Cappiello, M. and Owen
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Chapter 38 Lessons in tobacco contr
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entangling relationships with negot
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successful country advocates deeply
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Thus, when the opportunity arose, t
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Chapter 39 A brief history of legis
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Committee, mentioned above, little
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4. Tobacco and its related processi
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RUTH ROEMER 683 advertising and adv
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or shows, and distribution of free
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RUTH ROEMER 687 threat to the peopl
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RUTH ROEMER 689 The case was settle
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Another study by Harvard researcher
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At the end of 2003, 83 countries ha
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Chapter 40 Roles of tobacco litigat
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NGOs obtained sanctions against tob
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RICHARD A. DAYNARD 699 In a 1980s c
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RICHARD A. DAYNARD 701 Fourth, the
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even impossible. Such a statute pre
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RICHARD A. DAYNARD 705 Daynard, R.
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Introduction Chapter 41 Impact of s
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in this chapter, is evidence that s
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RON BORLAND AND CLAIRE DAVEY 711 Wh
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RON BORLAND AND CLAIRE DAVEY 713 On
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RON BORLAND AND CLAIRE DAVEY 715 ro
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you are subject, but this does not
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RON BORLAND AND CLAIRE DAVEY 719 to
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RON BORLAND AND CLAIRE DAVEY 721 fo
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RON BORLAND AND CLAIRE DAVEY 723 (E
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RON BORLAND AND CLAIRE DAVEY 725 th
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advanced. Although in countries lik
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RON BORLAND AND CLAIRE DAVEY 729 Da
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RON BORLAND AND CLAIRE DAVEY 731 Pr
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Introduction Chapter 42 Effective i
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PRABHAT JHA ET AL. 735 India (Gupta
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Average price or tax per pack (US$)
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PRABHAT JHA ET AL. 739 Bans on adve
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PRABHAT JHA ET AL. 741 Table 42.2 T
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PRABHAT JHA ET AL. 743 antismugglin
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Farrelly, M. C., Pechacek, T. F., a
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PRABHAT JHA ET AL. 747 Raw, M., Mc
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Part 13 Treatment of dependence
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Introduction Chapter 43 Treatment o
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Nocturnal sleep-disturbing nicotine
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MICHAEL KUNZE AND E. GROMAN 755 tob
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Fifteen different products were ide
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In summary, tobacco dependence amon
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medications for OTC sale in 1996, t
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MICHAEL KUNZE AND E. GROMAN 763 US
Page 798 and 799:
Chapter 44 Regulation of the cigare
Page 800 and 801:
as these correlate quite well with
Page 802 and 803:
NIGEL GRAY 769 within three major g
Page 804 and 805:
of carcinogens and toxins in its wa
Page 806 and 807:
Index abdominal aortic aneurysm see
Page 808 and 809:
aromatic amines 58, 60, 98 DNA addu
Page 810 and 811:
central and eastern Europe (CEE) (C
Page 812 and 813:
coronary thrombosis 5 see also myoc
Page 814 and 815:
epinephrine 169 epoxide hydrolase g
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health professionals advice on smok
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laryngeal cancer (Continued) animal
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Morris, Philip 207 see also Philip
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nursing home residents 718 nutritio
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Polish Central Statistical Office (
Page 826 and 827:
smoke, tobacco (including cigarette
Page 828 and 829:
Sweden female smoking rates 330-1 l
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United Nations agencies 680-1 Unite
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Tobacco and Public Health - TCSC Indonesia

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