Tobacco control collapse in Poland after 2015. Alarming increase in cigarette consumption

Introduction:
In early 2000s the World Health Organization pointed Poland as an example to the rest of the world in the area of tobacco control. This was achieved by implementing a comprehensive tobacco control regime that resulted in declining smoking rates. Two of its most important elements were the anti-tobacco promotional policy included in national Anti-tobacco Programme and the steady increase of the excise taxes. This changed in 2016 when the tobacco control regime was significantly modified. The aim of the study was to analyse consequences of policy changes on the trends in registered cigarette sales, cigarette consumption and real price of cigarettes.

Material and methods:
Data on registered cigarette sales were obtained from the National Statistical Office and the Ministry of Finance. Trends were analysed using Joinpoint regression analysis.

Results:
Trend of registered cigarettes sales in Poland was decreasing until 2016. In 2016 cigarette sales reached 41.6 billion and then the trend reversed. In 2022 cigarette sales reached 50 billion thus it increased by 20% (APC 2016-2022 = 3.1, 95% CI: 1.1-5.3). Registered cigarette consumption per capita (15 years and more) in Poland corresponded to the sales data. It declined by 56% from 2,845 in 1999 to 1,259 cigarettes per capita in 2015. Then it started to increase reaching 1,563 cigarettes per capita in 2022 (increase by 24%). Real price of cigarettes was rising steadily since 2001 to 2015 (APC 7.0, 95% CI: 6.4-7.5, p < 0.001). Since 2015 to 2020 the level was frozen, and in 2020 it started to decline reaching 7.5 PLN in 2022.

Conclusions:
It seems necessary to immediately return to the Anti-tobacco Programme in Poland including i.e. anti-promotional pricing policy towards cigarettes. New strategies should be planned using Poland’s successes and experiences in tobacco control from the past.