Tobacco and Public Health - TCSC Indonesia

Unfortunately, available data on the development of tobacco smoking in CE countries
apart from Poland are fragmentary and not based on representative population
studies using the same standardized research techniques over a number of years
(WHO report 2002). Thus it is not possible to reliably compare these countries and
Poland with respect to long time trend in tobacco smoking. Still, for instance, studies
carried out under the MONICA program in the Czech Republic involve representative
samples of the Czech population and always use the same research procedures. These
studies likewise show a decrease in smoking frequency among 25–64-year-old men
(49% in 1985, 27% in 1998) and stabilization in women (27% in 1988, 25% in 1998)
(Bruthans 2000). Similarly, trends regarding lung cancer mortality seem to further
confirm this parallel development in central European countries mentioned above
(Zatoński and Jha 2000; WHO report 2002).
Epilogue: Democracy is healthier
In the 1990s, sales figures for cigarettes in Poland decreased for the first time since
World War II. Tobacco industry data show that cigarette consumption fell by 10%
between 1990 and 1998 (Michaels 1999). This reduction was achieved when the
market was functioning normally and despite the enormously aggressive advertising
policies of the tobacco companies. (In the late 1990s, the tobacco industry was spending
$100 million annually on advertising) (Krajowe NTIA 1998.)
Smoking in Poland peaked at the end of the 1970s with approximately 14 million
smokers (62% of adult men and 30% of adult women). It remained at this level in the
1980s, and decreased substantially in the 1990s. At present, slightly fewer than 10 million
Poles smoke—about 40% of adult Polish men and a little more than 20% of adult
Polish women (Zatoński 2002a).
Decreasing exposure of the Polish population to tobacco smoke has been accompanied
by dramatic health improvements. In the period 1991–2001, life expectancy rose
rapidly (after a 30-year period of no change) by about 4 years in men and 3 years in
women (GUS [Central Statistical Office] 2002). Our epidemiological estimates indicate
that an approximately third of this trend is due to reduced incidence of smoking
(Zatoński et al. 1998). For the first time after the World War II morbidity in men due to
lung cancer, a form of cancer affecting almost exclusively smokers, do not increase.
Moreover, between 1991 and 1999 in men before the age of 65 lung cancer morbidity
decreased by 20% (Fig. 13.3) (Zatoński 2002a).
References
WITOLD ZATOŃSKI 249
Adriaanse, H. and Van Reek, J. (1989). Physicians’ smoking and its exemplary effect. Scand J Prim
Health Care, 7,193–6.
Akcja Rzuc · palenie razem z nami. (1999). ‘99 [Let’s stop smoking together, The Great Polish Smokeout
1999] Centrum Onkologii—Instytut im. Marii Sklodowskiej-Curie, Warszawa [in Polish].
Becher, H., Zatoński, W., and Jockel, K. H. (1992). Passive smoking in Germany and Poland:
comparison of exposure levels, sources of exposure, validity and perception. Epidemiology, 3, 509–14.