Tobacco and Public Health - TCSC Indonesia

or shows, and distribution of free samples. Most importantly, the legislation prohibits
advertising and sponsorship and sale of tobacco products without required labels and
health warnings. It requires one of ten warnings with white background and black letters.
The Nonsmokers’ Health Protection Act (the demand side law) bans smoking in a
wide range of public places designated by the Minister of Public Health. Strict enforcement
has followed enactment of the laws.
The tobacco-control program of Thailand has resulted in a decline in smoking prevalence
for men from 63.2% of the population in 1981 to 42.2% in 1999; for women from
5.4% in 1981 to 2.6% in 1999, and for both sexes from 35.2% in 1981 to 22.4% of the
population in 1999.
The experience of Poland 4
RUTH ROEMER 685
In response to the frighteningly increasing morbidity and mortality from tobacco-related
diseases, Polish tobacco control advocates, encouraged by international contacts with the
International Union against Cancer (UICC) and WHO and with help from Finnish and
UK health experts, undertook systematic studies of the tobacco and cancer epidemics in
the Polish population. These studies estimated that 58% of all malignant tumors in middle-aged
men were due to cigarette smoking, and 42% of cardiovascular deaths and 71%
of respiratory deaths among middle-aged men were due to smoking (Peto et al. 1994).
Once the legislation was drafted, a conference entitled ‘A Tobacco-Free Europe,’ was
held at Kazimierz, Poland in 1990. There a framework for cooperation on tobacco control
between central and eastern Europe was developed, and education and training for
public health workers on tobacco control was planned for the region.
The legislation was introduced in the upper chamber of the Parliament, the Senate, to
which a considerable number of physicians had been elected. Supporters of the bill
emphasized the health arguments and stressed the catastrophic state of adult health in
Poland. Despite strong opposition from the tobacco industry and delays in action caused
by the industry’s contention that ‘a parliamentary act, which is, after all, a piece of paper’
cannot improve the health of the nation, the legislation passed by an overwhelming
majority in November 1995.
After the law was passed, investigations were undertaken of the effect of tobacco
price policies on prevalence of smoking. As a result, in 1999 and 2000, the tobacco tax
was increased by 30% and again in 2001 by 20%. Not until 1999 did tobacco control
activities succeed in convincing Parliament to amend the law to provide for a total ban
on tobacco advertising and to allocate 5% of tobacco excise taxes to the national
tobacco program.
4 Based on ‘Case Study of Poland’s Experience in Tobacco Control’ by Professor Witold Zatonski, MD,
ScD, Director, Department of Cancer Epidemiology and Prevention, the Maria Sklodowska-Curie
Memorial Cancer Center and Institute of Oncology and WHO Collaborating Centre, Warsaw, 2001.