Mateusz Zatoński

Alcohol taxation and premature mortality in Europe

www.thelancet.com Vol 385 March 28, 2015 1181 5 Popova LA. The results of the modern demographic policy in Russia. Int J Reg Devel 2014; 1: 26–38. 6 Zaridze D, Lewington S, Boroda A, et al. Alcohol and mortality in Russia: prospective observational study of 151 000 adults. Lancet 2014; 383: 1465–73. slowed and Lithuania’s mortality in men worsened. In 2008, alcohol prices were increased again in Poland and the rate of decreasing premature mortality returned to the same levels before 2002 (unpublished). The Russian Government announced that it would reduce the price of vodka by 16% in February, 2015. Similar to Poland, this decision follows a period of rapid improvements to health. After 50 years of stagnation, the health indicators of the Russian population, especially of young and middle-aged men, have been improving since 2005. As with Lithuania, Poland, and Finland, the decision to lower alcohol prices will probably contribute to halting this health transformation in Russia, especially because vodka consumption continues to be a key contributor to its high rates of premature mortality. Lithuania, Poland, and Finland increased alcohol taxes a few years after reducing them. We fi nd it diffi cult to understand why Russia would be willing to repeat the same mistakes as its neighbouring countries rather than learning from them.

Characteristics and correlates of electronic cigarette productattributes and undesirable events during e-cigarette use in sixcountries of the EUREST-PLUS ITC Europe Surveys

INTRODUCTION This study assessed characteristics and correlates associated with e-cigarette product attributes and identified correlates of experiencing undesirable events during e-cigarette use among adult smokers across six European Union (EU) Members States (MS) prior to the implementation of the Tobacco Products Directive (TPD) in 2016. METHODS We conducted a cross-sectional survey with a nationally representative sample of adult cigarette smokers from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) reporting e-cigarette use; randomly selected through a multistage cluster sampling design from June to September 2016. Stepwise logistic regressions were used to identify factors associated with use of flavors, noticing health warnings, mixing e-liquids, experiencing ‘dry puff’, e-liquid leaking during use and e-liquid spilling during refill. RESULTS Current daily or weekly prevalence of e-cigarette use among this sample of adult smokers was 7.5%. The most common attributes of e-cigarettes used included those that are flavored, contain nicotine, and are of tank style. Noticing health warnings on e-cigarette packaging and leaflets, respectively, was low (10.2% and 28%, respectively). Use of e-liquid refill nozzle caps, described as easy for a child to open, was associated with spilling during refill (OR=6.73; 95% CI: 2.02–22.37). Participants who adjusted occasionally or regularly the power (voltage) or temperature of their e-cigarette had greater odds of ever experiencing a ‘dry puff’ (OR=6.01; 95% CI: 2.68–13.46). Mixing different e-liquids was associated with leaking during use (OR=7.78; 95% CI: 2.45–24.73) and spilling during refill (OR=8.54; 95% CI: 2.29–31.88). CONCLUSIONS Ongoing evaluation of factors associated with e-cigarette attributes and of the correlates of experiencing e-cigarette undesirable events during use, related to product design, is crucial to monitoring the impact of the implementing Acts of the EU TPD.

Lung cancer mortality decline among middle-aged men and women in Poland and the UK

In the early 1990s Poland was the country with the highest levels of lung cancer in Europe, especially among men. According to an analysis published in the Lancet in May 2017 (GBD-2015-1), in the years 1990-2015 Poland had one of the fastest smoking prevalence declines in Europe. This was accompanied by a steady lung cancer decline, also one of the fastest in Europe, that began among men in 1990, and among women in 2005. This article analyses the pace of decline in lung cancer mortality in middle-aged (35-54-year-old) men and women in Poland and the UK. If current trends continue in both countries, optimal conditions for the eradication of lung cancer in both countries could be achieved in the years 2020-2030. KeY WOrDS: lung cancer, mortality, middle-aged men and women, Poland, UK. aDDreSS fOr cOrreSpOnDence: Witold A. Zatoński, Professor of Medicine, Health Promotion Foundation, Mszczonowska 51 Street, 05-830 Nadarzyn, Poland, phone +48 22 378 00 22, e-mail: wazatonski@promocjazdrowia.pl DOI: https://doi.org/10.5114/jhi.2017.7420

POLAND’S RAPID LUNG CANCER DECLINE IN THE YEARS 1990-2016. THE FIRST STEP TOWARDS THE ERADICATION OF LUNG CANCER IN POLAND

Authors’ contribution Wkład autorów: A. Study design/planning zaplanowanie badań B. Data collection/entry zebranie danych C. Data analysis/statistics dane – analiza i statystyki D. Data interpretation interpretacja danych E. Preparation of manuscript przygotowanie artykułu F. Literature analysis/search wyszukiwanie i analiza literatury G. Funds collection zebranie funduszy Summary Background. Persistently high incidence of ‘diseases of affluence’ (including cancer) motivates numerous research teams to look for causes of morbidity, as well as to search for preventive methods and effective therapeutic measures. The paper aims to present the literature on effects of selenium (Se) on prevention of gastrointestinal and lung cancer. Material and methods. Based on national and international literature, the paper presents information on the role of selenium (Se) in prevention of cancer – with special consideration given to gastrointestinal and lung cancer. Results. The results of national and international research show the importance of selenium in prevention and treatment of cancerous diseases, including digestive tract cancer and lung cancer. Numerous studies have shown that the risk of cancer for people with low selenium levels is twice as high as for people with high levels of selenium in blood serum. The most prominent relationship between low selenium level in serum and cancer is observed in gastrointestinal cancer, lung cancer, breast cancer in women, and prostate cancer. Conclusions. Many clinical and experimental studies carried out nationally and internationally gathered evidence which indicate the vital role played by selenium in prevention and treatment of diseases – especially of cancer. It should be emphasised that the intake of selenium in amounts necessary for proper functioning given numerous deficiencies (first in the soil, then in food products coming from selenium-deficient soil) – is merely the first step, as it has already been proven in numerous publications that carbohydrates (especially simple sugars, sweets, cakes, etc.) ‘destroy’ selenium in the human body.

Towards improved public health: Affecting alcohol and tobacco affordability and consumption in Poland through taxation

Alcohol consumption levels, as well as mortality and morbidity resulting from alcohol misuse, are at unprecedented levels in Poland. One of the most prominent factors very likely influencing this surge is the generally affordable prices of alcohol products. In 2015, Polish consumers could buy roughly twice as much beer, wine, and spirits with their disposable income compared to 2001. This increase in alcohol products affordability was one of the most pronounced among all high-income countries. One way to reverse these trends in affordability is through alcohol taxation. Cigarette taxes can serve as an example of a successful use of fiscal policy to reduce product affordability and advance public health goals. Significant cigarette tax increase resulted in higher cigarette prices and lower cigarette affordability. In Poland, from 2007 to 2015, significant declines in smoking rates and decreases in lung cancer rates were noted. Positive experiences with tobacco taxation should serve as guiding examples for governments to successfully utilise similar excise tax policy approaches in the control of alcohol-related diseases.

Framing the policy debate over spirits excise tax in Poland.

Industry lobbying remains an obstacle to effective health-oriented alcohol policy. In 2013, an increase in excise tax on spirits was announced by the Polish government. This article presents a qualitative analysis of the public debate that ensued on the potential economic, health and social effects of the policy. It focuses on how competing groups, including industry actors, framed their position and sought to dominate the debate. Online archives of five Polish national newspapers, two spirits trade associations, and parliamentary and ministerial archives were searched. A thematic content analysis of the identified sources was conducted. The overall findings were compared with existing research on the framing of the Minimum Unit Pricing (MUP) debate in the UK. A total of 155 sources were analysed. Two main frames were identified: health, and economic. The spirits industry successfully promoted the economic frame in their own publications and in the media. The debate was dominated by arguments about potential growth of the grey market and losses in tax revenue that might result from the excise tax increase. The framing of the debate in Poland differed from the framing of the MUP debate in the United Kingdom. The Polish public health community was unsuccessful in making health considerations a significant element of the alcohol policy debate. The strategies pursued by UK health advocates offer lessons for how to make a more substantial impact on media coverage and promote health-oriented legislation.