Poland’s journey to effective tobacco control – a brief memoir

I first came to Poland in the Autumn of 1990. It was a time of great change – communist system has recently fallen apart and democracy was on the doorstep, the countries to the East of Poland which had been under Soviet domination for generations were now free, and even the countries of Central and Eastern Europe, including Poland, did not have the specter of the Soviet Union hovering over their daily lives.

A Nation in Turmoil

And yet, at that time, Poland – perhaps in spite of the dizzying events that began in the late 1980’s, or perhaps because of them – was a nation of contradictions. There was rampant anxiety about an uncertain future and there was immense optimism about the potential for Poland taking its rightful place on the world stage. There was hope that a society that had been dominated by a system of government that did little to promote individual freedom could now express itself and there was concern that freedom itself was so fragile that it could again be taken away. I came to that Poland of contradictions at the invitation of Dr. Witold Zatoński of the Marie Skłodowska- Curie Cancer Center, to participate in the first of what became a series of ground-breaking conferences devoted to improving the health of the Polish people, as well as the newly freed countries of the former Soviet Union. Our focus was to be on alleviating the health burden of cigarette smoking which, in 1990, was the largest preventable cause of premature death in Poland and the former Soviet republics [1, 2]. The task before us was formidable – over 40% of Polish men were dying prematurely from smoking-attributed diseases [3], Poland was in the early stages of moving to a market economy which was opening the doors in Poland, and the nations further to the East, to the multinational tobacco companies, tobacco advertising was rampant, on trams, billboards, and even clothing, and there was little in the way of organized Polish public health response to the economic and health costs of tobacco use.

Flickers of Hope

While the health conditions in Poland in 1990 were very discouraging – there were exceedingly high rates of lung cancer, cardiovascular diseases, liver cirrhosis, infant mortality, and sudden deaths from a variety of external causes (e.g. accidents, poisoning, etc.) – there was some reason for optimism. The Solidarity movement in the 1980’s had demonstrated, to a Polish citizenry unfamiliar with the concept, that advocacy was an option...


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