The Health Promotion Foundation’s appeal on International No Smoking Day 2017

This year, the International No Smoking Day falls on Thursday, November 16th

Just 30 years ago, the average Pole smoked more cigarettes than a citizen of any other country. Poland had the highest incidence of tobacco-related diseases in the world, especially lung cancer, a disease which occurs almost exclusively among smokers. The Health Promotion Foundation (HPF) was set up in November 1991 with the aim of halting this lung cancer epidemic. The HPF launched the Great Polish Smokeout campaign, conducted under the patronage of the Foundation’s Honorary President Cardinal Józef Glemp, and supported by Pope John Paul II. This initiative played a significant role in the health education of Poles. The HPF was also one of the main initiators of the pioneering anti-tobacco law passed by the Polish parliament in 1995, which established a national program to combat tobacco-related diseases, and that introduced, among other provisions, restrictions on the advertising and promotion of cigarettes, especially among children. This law also required the health service to provide free treatment of tobacco addiction [1]. Thanks to these activities extraordinary progress has been made in Poland and millions of Poles have quit smoking. It was estimated that in the 1980’s there were around 15 million smokers in Poland. In 2016 still around 8 million Poles smoked. The number of ex-smokers is beginning to exceed the number of current smokers. Sales of cigarettes have fallen from over 100 billion cigarettes in 1990 to about 40 billion in 2016. This has led to a fantastic improvement in health. Mortality rates in middle-aged men have dropped from 60/100,000 in 1990 to 20/100,000 in 2016. Mortality due to lung cancer has fallen by two thirds, and Poland has become the leader in the fight against lung cancer in the world.
Today, we are entering the final phase of the fight against tobacco-related diseases. We need to further speed up our health-related activities. Despite the great progress that was made in the last quarter of a century, there are still about 5 million men and about 3 million women smoking in Poland. Every day, smoking causes the premature death of 1096 smokers. More than 60% of smokers declare that quitting smoking is the most important decision they want to take in the coming months. Our research shows that in 2016 over 30% smokers, i.e. 2.5 million Poles, attempted to break the habit [2]. To help them succeed in the fight for their better health, we need to create the best conditions for them to quit. Tobacco dependence is a disease listed in the International Classification of Diseases and Health Problems [3]. In Poland, it is increasingly being treated with anti-tobacco drugs. Their annual sales amount to over 1.5 million packs a year in Poland, and in 2016 Poles spent almost PLN100 million on them from their own pockets [4]. Studies show that these drugs significantly increase the chances of quitting smoking, and that they are most effective if their use is properly controlled by a doctor. The Health Promotion Foundation seeks to involve doctors in the treatment of tobacco addiction by providing training for physicians and other health professionals. The Health Promotion Foundation is continuing a long tradition of cooperation with the Catholic Church aimed at improving the health of Poles. In our health promotion activities, we are mobilized by and honoured with the support of Cardinal Kazimierz Nycz, the Metropolitan of Warsaw. In recent days the Holy See has also reminded the world that “no profit can be legitimate if it threatens human life”, and Pope Francis has decided to ban the sale of cigarettes in the Vatican from 2018. The Vatican is the first country in Europe to ban cigarette sales. Pope Francis has demonstrated the role that a state can play in the fight against the carcinogenic, addictive, health destroying products. Despite Poland’s significant progress in this respect in recent years, it is important for tobacco control activities to once again become a priority for the Polish government. In this way, it will save thousands of Poles every year from premature death. We expect that in the pre-Christmas period and in early 2018 hundreds of thousands of Poles will make an effective attempt to quit smoking. Poland should again be the leader in the fight against tobacco-related diseases and strive to become a country free of tobacco smoke.

Witold A. Zatoński

The Great Polish Smokeout is a wise and necessary program that serves the interests of Polish families and the entire national economy

For over thirty years I have witnessed the activities undertaken by Prof. Witold Zatoński to dramatically reduce smoking in Poland. Initially, some people regarded his effort with indifference and a lack of faith in the usefulness of such a campaign. With determination and the strength of argument, however, Prof. Zatoński persisted, as anyone who has had the honour to know this extraordinary man and his co-workers can confirm. The prolongation of Poles’ lives in recent decades is largely due to lifestyle changes among people convinced by medical, social and economic arguments that smoking brings huge losses to families, society and the country. In their pursuit of freedom from smoking for Poles, it is extremely important that the organizers of this program have won the support and cooperation of many outstanding personalities of Polish and international scientific, cultural, spiritual and economic life. Successive changes in economic and social policy, as well as legal regulations, have enlarged the zones of freedom from tobacco smoke in Poland. This success story is especially helpful as we become increasingly aware that air pollution from other sources in our country very often, and in some places constantly, exceeds acceptable standards. Polluted air, water and soil is a nightmare we all must seek to avoid. The protection of these precious natural resources is our shared responsibility, our undeniable duty. I believe that the campaigns run by the Health Promotion Foundation have helped change the habits of hundreds of thousands of Poles. In many circles of Polish society, smoking is now seen primarily as an unfortunate addiction. The constant, long-term mobilization of society and authorities, and the actions carried out by eminent representatives of the world of science and culture, have shifted public perception. This great work to help heal Polish society must continue. In order to create an attractive alternative to life with cigarettes, we must first protect against the evil that is our children’s cigarette smoking. It is essential that all parents know that true love and responsible parenting do not tolerate poisonous clouds of smoke. We need to build broad agreement favouring healthy lifestyles. We cannot hope to succeed as a country in this competitive world without first focusing on the health of our citizens. Hundreds of pro-health initiatives undertaken by local governments, non-governmental organizations and schools supported by the Catholic church, as well as state authorities, provide examples which should be nurtured and replicated. I wish Prof. Zatoński and his colleagues further successes. With great pleasure I will continue to support the Foundation’s activities, because I regard this as a civic and patriotic duty.

Krzysztof Pietraszkiewicz

Commentary on the Appeal of the Foundation

As an activist and volunteer of the Health Promotion Foundation, I am pleased to have been among that small minority who initiated and for many years have conducted that effective and most recognizable pro-health educational campaign, the Great Polish Smokeout. Its success is largely due to the fact that a large number of people became involved in fulfilling.
this idea of living in a world free of tobacco smoke. Activities conducted over many years preparing the public’s mind for the idea of the campaign’s successive stages involved not only the propagation of scientifically proven information about the health effects of tobacco use, but also the social and economic impact; convincing Poles that tobacco dependence is a disease (tobacco addiction syndrome) that needs to be diagnosed and treated appropriately. For this, one needs to prepare (train) doctors and nurses. A favourable climate helped us to bring together many social authorities: scientists, politicians, journalists, artists, athletes, etc.
In my opinion, the most important thing was to create a mass, social movement for improving public health. The effect of these actions is not only (most importantly): a decline in the number of smokers, and an increase in those who have broken with tobacco addiction, and consequently an improvement in the health of Poles, but also the fact that we had significant influence on the establishment of the Law on Prevention of the Health Effects of Tobacco Use.
It must be said that the conditions for launching such activities in the early 1990s were not easy. This was the beginning of the era of predatory capitalism, the main forerunner of which was the tobacco industry, with its aggressive modern advertising of the “product” and large financial expenditures for that purpose. Incentives to buy cigarettes were attractive prizes, including gold bars and luxury cars. Our conviction about the (scientifically proven) soundness of our actions lent us zeal. Even then, many doctors and scientists, worldly wise people, already knew the truth about the effects of tobacco use, but it was only the Health Promotion Foundation that was able to launch massive efforts to reduce cigarette smoking, wean people from the addiction and improve public health. And I’m proud of that. I join in the Appeal of the Foundation, as it is necessary to effectively continue the actions taken, so as not to lose the current positive trend in the nation’s health.

Janusz Marek Jaworski

Sales of cigarettes prohibited in the Vatican. No profit can be justified at the cost of human life

On November 9th, 2017, Pope Francis introduced a ban on sales of cigarettes in the Vatican. The Pope made this decision because of his desire to protect the health of its citizens. From the beginning of 2018, one will not be able to legally buy cigarettes in the Vatican. Spokesman for the Holy See Greg Burke explained that “the Holy See cannot contribute to practices that are clearly harmful to health.” In his message, he quoted data issued by the World Health Organization (WHO), which estimates that worldwide some 7 million people die each year from smoking. Until now, employees and retirees of Vatican institutions (and often also their families and friends) could buy tobacco products at discounted prices in the Vatican’s duty-free shops. The sale of duty-free tobacco products has been a significant source of income for the Holy See. “But no profit can be justified if human life is the cost,” added Burke. The Pope has decided that the Holy See cannot participate in activities that are “obviously bad for people’s health.”
By a decision of John Paul II, smoking was already prohibited in the offices of the Holy See and the Vatican City as early as 2002. Currently, with this decision by Pope Francis, the Vatican joins a small group of countries that prohibit smoking. In Bhutan there is a strict total ban on smoking and since 2005, sales of tobacco products have been prohibited.

Katarzyna Wijatkowska, Witold A. Zatoński

Disclosure

Authors report no conflict of interest.

References

1. Ustawa z dnia 9 listopada 1995 r. o ochronie zdrowia przed następstwami używania tytoniu i wyrobów tytoniowych (Dz.U. z 1996 r. Nr 10 poz. 55) [Law from 9 November 1995 regarding the protection of health from the consequences of using tobacco and tobacco products, 1996, no. 10, pos. 55].
2. Data from International Tobacco Control Poland study.
3. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization, Geneva 1992.
4. Zatoński W. Droga do zdrowia. Historia przeciwdziałania epidemii chorób odtytoniowych w Polsce [The path to health. History of fighting tobacco-related diseases in Poland]. Cancer Center and Institute, Warsaw 2003.