Piotr Wojtysiak

Effective protection from exposure to environmental tobacco smoke in Poland: The World Health Organization perspective

Tobacco is the single greatest preventable cause of death in the world today, killing approximately half of the people who use it. Several strategies have been proved to reduce tobacco use. However, more than 50 years after the health effects of smoking were scientifically proven, and more than 20 years after evidence confirmed the hazards from exposure to second-hand smoke, few countries have implemented effective and recognized strategies to control the tobacco epidemic. This paper summarizes the World Health Organization recommendations for effective protection from exposure to environmental tobacco smoke along with the existing tobacco control programs and legislation in force in Poland.

Implementation of smoke-free homes in Poland.

OBJECTIVES Exposure to environmental tobacco smoke (ETS) constitutes a threat to the health of many people. In order to diminish ETS exposure, countries (including Poland) implemented legal restrictions of smoking in public places and worksites. Currently more attention is also paid to reduce overall and residential ETS exposure by voluntary smoke-free home policy adoption. The aim of current analysis was to evaluate the prevalence and determinants of implementing smoking bans at place of residence among economically active males and females in Poland. MATERIAL AND METHODS Data from cross-sectional, household study - Global Adult Tobacco Survey (GATS 2009-2010) were analyzed. The logistic regression model was applied for appropriate calculations. RESULTS Out of 3696 studied subjects only 37.1% adopted total smoking ban within the home. Decreased likelihood of adopting total smoking bans was associated with current smoker status, low education attainment, lack of awareness on adverse health consequences of ETS, low level of support for tobacco control policies, and cohabitation with a smoker in both genders. Having smoke-free homes was also linked with age in women, place of residence and work smoking policy in indoor areas in men. CONCLUSIONS Targeted activities to encourage adopting voluntary smoke-free rules among groups least likely to implement 100% smoking bans in the home and activities to decrease social acceptance of smoking in the presence of nonsmokers, children, pregnant woman are urgently needed.

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products—A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13–19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.

Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland

BackgroundTobacco-free school environment as well as non-smoking teachers and school personnel provide positive role models for children and young people. In Poland, smoking should be banned in colleges, schools, educational establishments and educational care facilities. However, for the existing law to be effective, awareness of all people in school curriculum and enforcement of the law are crucial. The aim of the study was to evaluate tobacco use patterns, knowledge and attitudes towards tobacco as well as availability of tobacco control training among school personnel in a rural area in Poland. Moreover, compliance with tobacco control policies and their enforcement were assessed.MethodsThe study was carried out in Piotrkowski district between November 2014 and May 2015 in accordance with the Global School Personnel Survey (GSPS) methodology. Sixty schools participated in the survey (92% of the schools from the region) with involvement of 1044 teachers and 500 non-teaching staff (the response rate – 83.1%). The multivariate linear regression analyses were applied to study factors linked to the need for anti-tobacco training dedicated to the youth and teachers’ knowledge as well as activities to educate the students about tobacco use and its prevention.ResultsAbout 24% of the school personnel were current and 9% were ex-smokers. Significantly more teachers than the non-teaching staff indicated that the schools had a policy prohibiting tobacco use among students. In addition, 6% of the study participants indicated everyday violations of the tobacco control policy by the school personnel. More than 80% of the teaching personnel indicated the need for training dedicated to the youth to prevent their tobacco use. In the multivariate linear regression model, longer duration of working experience predicted higher levels of knowledge and more activities performed to teach the youth about tobacco use and its prevention. The smokers comparing to the non–smokers perceived the need for anti- tobacco training among the youth less strongly.ConclusionsIn order to make it possible for the inhabitants of Piotrkowski district to work and learn in tobacco smoke free environment there is an urgent need for taking actions aiming at increasing effectiveness of enforcing applicable tobacco control regulations in educational units. The necessity for systematic training dedicated to the youth to prevent their tobacco use, including accurate preparation of teachers, also needs to be highlighted.

Residential exposure to environmental tobacco smoke, and its associates: Findings from the Global Adult Tobacco Survey in Poland.

OBJECTIVES Expanding the information on exposure to environmental tobacco smoke (ETS) at home and its associates is of great public health importance. The aim of the current analysis was to evaluate associates of exposure to environmental tobacco smoke among economically active male and female adults in Poland in their place of residence. MATERIAL AND METHODS Data on the representative sample of 7840 adults from the Global Adult Tobacco Survey (GATS) carried out in Poland in the years 2009 and 2010 were applied. The Global Adult Tobacco Survey is a nationally representative household study. The logistic regression model was used for relevant calculations. RESULTS The exposure to environmental tobacco smoke in the place of living affected 59% of studied subjects. Out of non-smokers 42% of males and 46% females were exposed to the ETS in the at home. Increased risk of residential ETS exposure was associated with low education attainment, lack of awareness on adverse health consequences of second hand smoke (SHS), low level of support for tobacco control policies, living with a smoker. One of the factors associated with the ETS exposure was also the approval for smoking at home of both genders. The residential ETS exposure risk was the highest among males (odds ratio (OR) = 7.1, 95% confidence interval (CI): 6.1-13.8, p < 0.001) and females (OR = 8.1, 95% CI 6.5-11.8, p < 0.001) who declared that smoking was allowed in their place of residence compared to respondents who implemented smoking bans at their place of residence. CONCLUSIONS Campaigns to decrease social acceptance of smoking and encourage adopting voluntary smoke-free rules at home might decrease the ETS exposure and reduce related risks to the health of the Polish population. Educational interventions to warn about adverse health effects of the ETS should be broadly implemented particularly in high risk subpopulations.

Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people.

Heaviness of smoking among employed men and women in Poland

OBJECTIVES At least 50% of smokers die prematurely. Those who smoke heavily are at an increased health risk. The purpose of the current report was to evaluate socio-demographic correlates of heavy smoking among employed men and women. MATERIAL AND METHODS Data derive from the representative, household study - the Global Adult Tobacco Survey conducted in Poland over the years 2008-2010. RESULTS Of 14 000 households selected for the survey, 7840 sampled individuals completed the interviews. Among 1189 daily smokers, the rate of heavy smokers was 63.5% in males and 43% in employed females (p < 0.001). The study showed that age and age at the smoking onset were significantly associated with heavy smoking among both genders. Among males and females the heavy smoking rate was the highest in the subjects that started smoking at the age between 14-17 years compared to those who started smoking at the age ≥ 21 years (odds ratio (OR) = 3.3, 95% confidence interval (CI): 2-5.5, p < 0.001 and OR = 2.7, 95% CI: 1.4-5.3, p < 0.0001, respectively). The men with house rules that prohibited smoking with some exceptions were 2.4 times more likely to be heavy smokers in comparison with those having rules which completely prohibited it (p < 0.01). The men working in workplaces where smoking was prohibited in all indoor areas were at lower odds of heavy smoking relative to those working in areas where smoking was allowed everywhere (OR = 0.5, 95% CI: 0.3-0.9, p < 0.05). Among the men, there was also an association between job features and heavy smoking, which was not observed among the women. CONCLUSIONS These findings should be taken into account while developing tobacco control measures addressed to economically active population.