On the occasion of the International Day without Cigarettes established by the World Health Organisation, the Polish Cancer Society and the Institute for Patient Rights and Health Education call on policymakers to take immediate steps to reduce the availability of cigarettes to minors.
Cigarette smoking is the main carcinogen for more than a dozen types of cancer. The most common cancer in Poland is lung cancer, which is at the same time characterised by a high mortality rate - it is detected only at high stages of development. According to KRN data, for more than 10 years it has been the first cause of death among women and the second among men. Cigarette smoking is also a factor that exacerbates complications in the severe course of COVID-19 and even contributes to millions of premature deaths worldwide due to COVID-19. The systematic increase in the consumption of various types of stimulants, which has intensified during the pandemic, should be the impetus for decision-makers to take decisive action. Failure to take immediate steps will have long-lasting consequences severely burdening the health system with the costs of treating tobacco-related diseases.
Numerous studies indicate that initiation and development of nicotine dependence mostly occur at a young age, when the willingness to experiment and vulnerability to addiction is highest. In Poland, this is facilitated by low prices of tobacco products, which are readily taken up by minors. More than half of all minors start their nicotine consumption by smoking cigarettes or rolling tobacco cigarettes[1]. The report 'Tools to reduce youth smoking', produced by the Department of Public Health and Social Medicine at the Medical University of Gdansk on behalf of the Ministry of Health, shows that low cigarette prices are significantly associated with a higher likelihood of youth smoking initiation in Poland.[2] The risk ratios estimated in the report indicate that even a 10% increase in the price of cigarettes would reduce the risk of starting to smoke at any time of observation by an average of 10 to 15.6%. The authors of the report point out that an increase in the price of cigarettes not only directly affects young people's consumer decisions, but also reduces peer pressure. This is because young people are less likely to share their cigarettes with their peers when cigarette prices rise. An additional factor exacerbating these behaviours has been the reduction in social contact associated with the COVID-19 pandemic[3].
In Poland, 8 million people smoke regularly, yet only about 0.07% smokers use the treatment system for nicotinism [4]. The number of services related to the treatment of this addiction, financed by the National Health Fund, has only amounted to about 4,600 to 6,100 per year in recent years. This indicates a negligible interest of smoking patients in specialist therapy for a chronic and relapsing disease such as nicotinism. In addition, in light of the data made available by the NHF, the number of functioning addiction treatment clinics dropped significantly from 260 to 171 between January 2015 and October 2020.[5]
The authors of this appeal face the suffering of cancer patients on a daily basis. They have been involved in helping oncology patients for years. The Polish Cancer Society works to improve the detection of cancer at an early stage and to improve the results of cancer treatment in Poland. The activities of the Institute for Patient Rights and Health Education are primarily aimed at supporting systemic solutions aimed at improving the situation of patients and increasing civic awareness of pro-health attitudes.
We recognise that the complete eradication of nicotinism from society is a difficult and time-consuming task, which is why we emphasise the need to protect minors from falling into nicotinism. Wide access to specialised counselling, pharmacotherapy and harm reduction programmes is also essential. The absolute priority should be to take immediate action to gradually eliminate by far the most harmful and widespread form of nicotine intake in society, which is cigarette smoking.[6].
We therefore call for a systemic approach to reduce the affordability of the cheapest, and therefore most readily available, tobacco products and to tighten penalties for the sale of tobacco products to minors.
[1] https://www.pzh.gov.pl/wp-content/uploads/2020/06/RAPORT-TYTO%C5%83-M%C5%81ODZIE%C5%BB-GRUDZIE%C5%83-2019-WERSJA-FINALNA-www.pdf
[2] http://zdrowie.gov.pl/fn/aktualnosc-3871-raport_ws_narzedzi_zmniejszajacych.html
[3] Quantitative research report 'Nicotine consumption' prepared by CBOS for the Bureau of Chemical Substances, November 2020.
[4] https://gis.gov.pl/wp-content/uploads/2018/04/Postawy-Polak%C3%B3w-do-palenia-tytoniu_Raport-Kantar-Public-dla-GIS_2019.pdf
[5] https://ezdrowie.gov.pl/portal/home/zdrowe-dane/zestawienia/swiadczenia-w-poradniach-zwiazane-z-uzaleznieniem-od-tytoniu
[6] https://europa.eu/eurobarometer/surveys/detail/2240