This week, we will examine a case study about smokers in Poland. As noted in the Center for Global Development and Jassem, Przewozniak, & Zatonski (2014), prior to 1989, Poland had the highest rate of smoking in the world, with three-fourths of all men aged 20–60 smoking every day at a rate of 3,500 cigarettes per person per year. It should be noted that 30% of all women smoked every day, as well. This behavior resulted in a life expectancy of about 60 years due to the highest rates of lung cancer in the world and all-time high levels of smoking-related cancers and cardiovascular and respiratory disease.

To prepare for this Discussion, you will be required to read Case 14 by the Center for Global Development and complete readings in Stanhope and Lancaster, then respond to the following questions:

  • What happened to change the culture of smoking in Poland?
  • Understanding that we all have bias when discussing health issues and precipitating factors, what social and political factors allowed cigarette smoking to become a part of the Polish culture?
  • Reflecting on your own practice, how do you overcome cultural bias? Do you find it more difficult to deal with some groups than others? How do people use the cultural information that they learn about others? Do you think this leads to stereotyping? Does cultural knowledge influence or change your practice and interaction with others?
  • References: attached and 

By Day 3

Post your response to this Discussion.

Support your response with references from the professional nursing literature.

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Curbing TobaCCo use in Poland �

nly two major causes of death are growing
worldwide: AIDS and tobacco. While the
course of the AIDS epidemic is uncertain, one
can be more sure that current smoking pat-

terns will kill about 1 billion people this century, 10 times
more than the deaths from tobacco in the 20th century.1
Much of this burden will fall on poor countries and the
poorest people living there. While smoking rates have fall-
en in rich countries over the past two decades, smoking is
on the rise in developing countries.2 Currently, more than
three quarters of the world’s 1.2 billion smokers live in
low- and middle-income countries, and smoking-related
deaths are estimated to double in number by 2030.

As Poland’s story shows, there is reason to hope that
concerted efforts to tackle the growing smoking prob-
lem in low- and middle-income countries can succeed.
In many instances, this will likely take a very high level
of political commitment—enough to counter the sig-
nificant economic influence of the tobacco industry—as
well as state-of-the-art communication strategies to
induce major shifts in attitudes toward smoking.

Lighting Up: Dangers of Tobacco

Smoking causes an astonishingly long list of diseases,
leading to premature death in half of all smokers. To-
bacco is implicated in numerous cancers including blad-
der, kidney, larynx, mouth, pancreas, and stomach. Lung

Case 14

Curbing Tobacco Use in Poland

Geographic area: Poland

Health condition: in the �980s, Poland had the highest rate of smoking in the world. nearly three quarters
of Polish men aged 20 to 60 smoked every day. in �990, the probability that a �5-year-old boy born in Po-
land would reach his 60th birthday was lower than in most countries, and middle-aged Polish men had one
of the highest rates of lung cancer in the world.

Global importance of the health condition today: Tobacco is the second deadliest threat to adult health
in the world and causes � in every �0 adult deaths. it is estimated that 500 million people alive today
will die prematurely because of tobacco consumption. More than three quarters of the world’s �.2 billion
smokers live in low- and middle-income countries, where smoking is on the rise. by 2030, it is estimated
that smoking-related deaths will have doubled, accounting for the deaths of 6 in �0 people.

Intervention or program: in �995, the Polish parliament passed groundbreaking tobacco-control legisla-
tion, which included the requirement of the largest health warnings on cigarette packs in the world, a ban
on smoking in health centers and enclosed workspaces, a ban on electronic media advertising, and a ban
on tobacco sales to minors. Health education campaigns and the “great Polish smoke-out” have also
raised awareness about the dangers of smoking and have encouraged Poles to quit.

© Translational lung cancer research. All rights reserved. Transl Lung Cancer Res 2014;3(5)

In the 20th century, tobacco smoking was the leading
health burden and the major cause of death in the world.
It is estimated that around 100 million people died from
smoking-attributed diseases at that time (1). The epidemic of
cigarette smoking in the past century was mostly continued
in developed countries. Recent estimates show that
currently 1.2 billion people use tobacco worldwide, mostly
in developing countries. Based on current trends in tobacco
exposure, 8 million people will die every year by 2030 from
different forms of tobacco (2). Since the 1960s, smoking
rates and its health consequences have gradually decreased
in rich countries and have rapidly increased in developing
countries, including the region of Central and Eastern
Europe (3). Poland, being at the time part of the communist
bloc, was among countries with particularly high tobacco
consumption. In the mid-1970s and early 1980s, 65% to
75% of Polish men aged 20 to 60 smoked cigarettes every
day (4). In consequence, Poland faced a catastrophically high
level of premature mortality among young and middle-aged
adults. By 1990, over 40% of Polish men died prematurely
from smoking-attributed diseases (5). The health impact
of smoking, including cancer, was particularly high in poor

and uneducated groups of society (6). At that time, effective
tobacco-control measures, such as increasing taxes on
tobacco products, ban on tobacco advertising and promotion,
health warnings on tobacco products and advertisements, as
well as establishing “non-smoking” areas, were already well
known in Europe and worldwide. However, Poland was one
of the largest tobacco producers in Europe, and this state-
run industry was a source of high revenues (7). Hence, in
view of the difficult economic situation of the country, the
government did not undertake any real tobacco-control
legislative measures, and sparse tobacco-control regulations
were ineffective because of a lack of their enforcement.

After the fall of the communist system [1989-1990] and
the introduction of a market economy, the tobacco industry
in Poland was extensively privatized and in over 90% of
cases became the property of multinational corporations. In
view of the dramatic decline in the prevalence of smoking in
North America, Poland, along with other Eastern European
countries, became a fertile field for future growth and a
strategic target of the international tobacco companies. In
1990, it was planned to increase cigarette sale in Poland by
10-20% by 2000 (8). In the first half of 1990, new attractive

Review Article

Tobacco control in Poland—successes and challenges

Jacek Jassem1, Krzysztof Przewoźniak2, Witold Zatoński2

1Department of Oncology and Radiotherapy, Medical University of Gda