Almost every third adult Pole smokes cigarettes, according to the latest report of the Polish Academy of Sciences. The percentage of smokers increased to 28.8%, and the sale of cigarettes by 20%. compared to 2015. The Ministry of Health admitted that it would not meet the target of 5 percent. percentage of smokers in 2030. During the 36th World No Tobacco Day, experts are alarming that the lack of a strategy to combat cigarette addiction is the main cause of concern in the coming years.
– A recent report of the Polish Academy of Sciences showed that 29 percent. Poles smoke cigarettes every day and this is a very high percentage. It has remained at a similar level for years and we do not have great success on the battlefield with this addiction. We also failed to stop smoking in the next generation. Young people also smoke – not as much as before, but it is still a dozen or so percent and this is probably the biggest failure we have suffered – says Newseria Biznes, prof. dr hab. n. med. Andrzej Fal, president of the Polish Society of Public Health, head of the Department of Allergology and Lung Diseases, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw.
According to the latest report of the National Institute of Public Health – National Institute of Hygiene (NIZP-PZH) on nicotine initiation among young Poles, more than half of Polish teenagers (62 percent) have already had nicotine initiation. For every second of them, a cigarette was the first product with nicotine in their lives (55.6%). For every third (32.3%), the initiating product was a liquid e-cigarette. Young people are the least likely to reach for tobacco heaters (0.2%) and nicotine pouches (0.1%).
– Unfortunately, this is probably the result of the lack of a unified policy. We do not use medical and preventive measures or fiscal tools in health policy, such as imposing excise duty on the most harmful products. We also do not use education, and without it little can be done in prevention – adds prof. Andrew Fal.
This year marks 20 years since the ratification of the WHO Framework Convention on Tobacco Control. This year’s signatory conference will be held in Panama and will provide an opportunity to take stock of what has been achieved so far in the fight against cigarettes.
– WHO, both in the framework convention and in subsequent actions regarding quitting tobacco addiction, behaves like a typical political organization – some things they do not want to say completely. So we set ourselves a goal, while the tools are more enigmatic. At national level, many countries have shown that more can be done – says the president of the Polish Society of Public Health. – Following their example, because this is the right example, if we want to have a tobacco-free, smoke-free society, our delegation in Panama should first of all present the concept of a uniform exit system over 15 years, economic preference for less harmful products, allowing harm reduction where absolutely we fail to wean people who already smoke or drink.
Statistics show that about 80,000 people die every year because of smoking. Poles, which corresponds to the population of a medium-sized city. Meanwhile, according to the report “Reducing cigarette smoking and e-cigarette use, especially among the young generation of Poles” by experts from the Committee of Public Health of the Polish Academy of Sciences, in 2022, 30.8% of Poles admitted to smoking on a daily basis. men and 27.1 percent. women. Importantly, in the last few years this percentage has started to grow – according to the CBOS survey conducted in 2019, 26% of the population smoked cigarettes. adult Poles (21% regularly and 5% occasionally).
Experts point out that in Poland, the existing strategies of fighting nicotinism – health campaigns, excise duty increases, withdrawal of menthol products from the market or drastic photos on cigarette packs – turned out to be ineffective. In their opinion, we lack comprehensive fiscal, legal, health or educational tools that would effectively discourage smoking or enable smokers to take treatment as part of addiction therapy.
– Smoking is not only a mental but also a physical addiction, it is a very difficult habit to eliminate. Addiction treatment requires not only good diagnosis, but also psychotherapy, pharmacotherapy, and possibly other measures that can reduce the damage caused by habitual smoking. Psychiatrists here are best placed to help smokers because they treat addiction in general – says prof. dr hab. n. med. Joanna Rymaszewska, psychiatrist from the Medical University in Wrocław.
According to the WHO, around 1.3 billion people worldwide smoke cigarettes and this number will not decrease significantly in the next few years. Statistically, only a few patients treated for nicotine addiction definitively quit it – the vast majority of them return to smoking after a period of abstinence. According to the latest Eurobarometer of the European Commission, almost half of smokers in the EU (49%) do not intend to quit smoking at all.
However, there are countries that have been very successful in the fight against cigarettes. In Europe, this includes Sweden, where 5.6 percent smoke cigarettes, and the UK, where 13 percent smoke. society (almost twice less than the EU and global average). Both of these countries a few years ago opted for a different strategy to combat smoking, the so-called harm reduction policies aimed at minimizing the social and health effects of smoking, and encourage smokers to choose less harmful products than cigarettes.
Harm reduction is nothing more than slowly weaning the patient off the addictive drug. explains prof. Joanna Rymaszewska. – If the patient is addicted to drugs, we cannot suddenly wean him off them, because most of them will develop an acute withdrawal syndrome. The same is true for patients addicted to nicotine. We cannot suddenly wean them from this relationship, because the costs of withdrawal will be too high and the relapse will be very fast. Fortunately, there are options that can reduce the damage caused by smoking cigarettes, with a gradual reduction of nicotine intake, but without tar.
In mid-April. In 2017, the UK authorities announced that under the “Swap to stop” program, they intend to give away one million e-cigarettes to smokers, thanks to which by 2030 the percentage of smokers in the UK is to fall below 5%. E-cigarettes are officially recommended in the UK as a way to gradually quit smoking, next to, for example, gum or patches. Also, the spokesman for the Polish Ministry of Health, Wojciech Andrusiewicz, in one of the recent interviews in the media, admitted that e-cigarettes are “healthier” than traditional cigarettes, although he noted that they are not harmless and long-term research should be awaited.
Health ministries and government agencies in the United States and New Zealand also expressed support for alternatives to cigarettes. They show smokers that alternative products to cigarettes, although still harmful, are associated with lower health risks than smoking cigarettes and can be a way to gradually quit nicotine addiction.
– The harm reduction model is an approved therapeutic process for addiction recovery, approved by the FDA, which is the institution that approves virtually all pharmacological agents that we use in medicine – says prof. Joanna Rymaszewska. – This is a recognized method that we should introduce, and even cover with reimbursement, and certainly controlled access for people already addicted.
A comprehensive plan to fight addictions for 2023-2025 – based precisely on the risk minimization strategy – at the end of April this year. also adopted by the government in the Czech Republic. Our southern neighbors will also recommend the use of alternative forms of nicotine delivery: e-cigarettes, tobacco heaters and nicotine sachets. One of the tools will be the excise tax, which, according to the declarations of the Czech government, is to reflect the degree of health risk associated with the use of individual products. The authorities of this country announce that they will actively promote this approach within the European Union.
– Many countries have very good, innovative approaches to fighting addictions, including smoking, which is the most deadly. The Czechs have recently published a two-year document, which is part of a long-term plan to quit smoking, which talks about prevention and harm reduction among those who are unable to undergo prevention or have been subjected to it too late. I think it would be good if we could learn from our neighbors – says prof. Andrew Fal.
“We don’t have to break down the doors that are already open. It is worth using the experience of our close neighbors, such as the Scandinavians, who have drastically reduced the incidence of lung cancer. They just proposed harm reduction through the use of oral nicotine, which has reduced smoking to almost nothing – adds a psychiatrist from the Medical University of Wrocław.
Experts point out that no product with nicotine is indifferent to health. Therefore, the best solution and the first recommendation of doctors is always to quit smoking permanently. Only when a patient addicted to nicotine refuses to quit the addiction and pharmacological drugs do not work on him, some of the scientific societies in Poland, including the Polish Psychiatric Association, recommend nicotine substitution using alternatives.
