Tobacco and Public Health - TCSC Indonesia

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TOBACCO SMOKING IN CENTRAL EUROPEAN COUNTRIES: POLAND
when assessed in 1994 (Fagerström et al. 1996). Among Polish ex-smokers, merely 2%
had been aided in their efforts by health professionals. Tobacco control campaigns
continuing over a number of years result in the accumulation of heavily dependent
smokers, who stand little chance of quitting solely ‘on strong will’.
Smoking among medical doctors
At the end of the 1990s, smoking rates among medical doctors in certain countries of
south-eastern Europe and ex-Soviet countries were higher than in the general population.
In Poland, the earliest study from 1983 found that 45% of male physicians and 36% of
female physicians were smokers (compared to 62% of men and 30% of women in the
general population in 1982) (Kaczmarczyk-Chaltas et al. 1984). In the last 20 years,
smoking rates have fallen to about 30% among male physicians and 11% among
female physicians (Przewo´zniak and Zatoński 2000). The decline has been particularly
marked among women and in younger medical doctors. It should be mentioned that
in such countries as the USA or Finland, the proportion of smokers in the medical
profession is very low, 2–5% (Adriaanse and Van Reek 1989).
Exposure to enforced passive smoking
In eastern Europe, just like in many western European countries, smoking in the presence
of non-smokers (including little children) is still an accepted social norm. A 1986
study found cotinine in urine in 92% of a sample of non-smoking Polish women.
Cotinine is a metabolite of nicotine and a marker of exposure to tobacco smoke
(through enforced smoking) (Becher et al. 1992). The proportion of smokers among
pregnant women was about 30% in the early 1990s (Szamotulska et al. 2000). More than
a half of all smokers admit that they smoke in the presence of children and 25% will
sometimes smoke in the presence of a pregnant woman (Zatoński 2002b). Sixty-five per
cent of children aged 13–15 are exposed to enforced passive smoking (Mazur et al. 2000).
Over the last decade, following the introduction of tobacco control legislation, exposure
to tobacco smoke in the workplace and in public places has been greatly reduced. In the
early 1990s, 84% of non-smoking women and 86% of non-smoking men stated that
they were passive smokers; the respective percentages for 2001 were 49% and 59%
(Zatoński and Przewo´zniak 1996). The frequency of smoking among pregnant women
fell from 30% to 20% in the period 1990–1999 (Brzeziński et al. 1998; Zatoński 2002b).
Summary
The development of the tobacco smoking situation in Poland, presented in the last part
of this paper, seems to parallel that in some CE countries (Slovenia, the Czech
Republic, Slovakia, and recently Hungary and the Baltic countries as well). In other
countries (Bulgaria, Romania, former Yugoslavia countries) the situation does not
appear to be changing (the levels of tobacco consumption remain high and steady)
(WHO report 2002).