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EN
ObjectivesTobacco use is one of the most serious public health problems. Each year, it contributes to preventable disability and death of 8 million people worldwide. The aim of the study was to determine the change in the prevalence of tobacco and e-cigarettes use among Polish adults in the years 2010–2019 and the potential impact of legislative interventions on tobacco consumption in Poland.Material and MethodsThe research was based on an analysis of secondary data obtained from a cross-sectional study as part of the public opinion monitoring in Poland. The study was carried out in 2 editions (2010 and 2019) on representative samples of approximately 1000 Polish residents >18 years of age.ResultsThe proportion of traditional cigarette smokers decreased from 30.4% to 26.0% in the years 2010–2019 (p < 0.05). In the male group decreased from 40.3% to 31.0% (p < 0.001); among females, the values remained at the same level (21.3%). The greatest change in the percentage of current smokers was recorded in cities with ≥500 000 inhabitants (from 30.3% to 17.1%) and <100 000 inhabitants (from 31.5% to 24.6%) (p < 0.05). The total support for the new legal regulations increased from 73.9% to 89.8% (p < 0.001). The use of e-cigarettes in 2019 declared only 1.9%.ConclusionsThe percentage of adult traditional cigarette smokers decreased significantly between 2010 and 2019 (mainly among men). Among women, the percentage of cigarette smokers remained the same. The most significant declines in cigarette smoking were also observed among residents of the largest cities (≥500 000 inhabitants). During the same period, there was a further increase in the acceptance of legal restrictions on smoking cigarettes in public places. E-cigarette use among adults is a niche phenomenon in Poland, but it is much more prevalent among women than men.
EN
Objectives This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. Material and Methods Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 – February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. Results About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). Conclusions Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor’s encouragement and support, are crucial for successful smoking cessation in this vulnerable population. Int J Occup Med Environ Health. 2019;32(3):363–77
EN
High rates of tobacco use is still observed in working-age population in Poland. The present level of the state tobacco control has been achieved through adopting legal regulations and population-based interventions. In Poland a sufficient contribution of health professionals to the diagnosis of the tobacco-addition syndrome (TAS) and the application of the 5A’s (ask, advice, assess, assist, arrange follow-up) brief intervention, has not been confirmed by explicit research results. Systemic solutions of the health care system of the professional control, specialist health care, health professional trainings and reference centres have not as yet been elaborated. The tools for diagnosing tobacco dependence and motivation to quit smoking, developed over 30 years ago and recommended by experts to be used in clinical and research practice, have not met the current addiction criteria. In this paper other tools than those previously recommended − tests developed in the first decade of the 21st century (including Cigarette Dependence Scale and Nicotine Dependence Syndrome Scale), reflecting modern concepts of nicotine dependence are presented. In the literature on the readiness/motivation to change health behaviors, a new approach dominates. The motivational interviewing (MI) by Miller and Rollnick concentrates on a smoking person and his or her internal motivation. Motivational interviewing is recommended by the World Health Organization as a 5R’s (relevance, risks, rewards, roadblocks, repetition) brief motivational advice, addressed to tobacco users who are unwilling to make a quit attempt. In Poland new research studies on the implementation of new diagnostic tools and updating of binding guidelines should be undertaken, to strengthen primary health care in treating tobacco dependence, and to incorporate MI and 5R’s into trainings in TAS diagnosing and treating addressed to health professionals. Med Pr 2016;67(1):97–108
PL
Populację w wieku produkcyjnym w Polsce charakteryzuje wysoka częstość używania tytoniu. Obecny poziom kontroli tytoniu w Polsce osiągnięto poprzez działania legislacyjne i interwencje populacyjne. W Polsce nie ma jednoznacznych wyników badań potwierdzających dostateczny udział profesjonalistów medycznych w diagnozowaniu zespołu uzależnienia od tytoniu (ZUT) i stosowaniu krótkiej interwencji 5A (ask, advice, assess, assist, arrange follow-up – pytaj, poradź, oceń, pomóż, wyznacz kolejną wizytę). Nie ma też rozwiązań systemowych regulujących nadzór merytoryczny, opiekę specjalistyczną, akredytowany system szkoleń i pracę ośrodków referencyjnych. Eksperci rekomendują do stosowania w praktyce klinicznej i badawczej narzędzia do diagnozowania ZUT oraz gotowości i motywacji do zaprzestania używania tytoniu, utworzone ponad 30 lat temu, które nie spełniają współczesnych kryteriów uzależnienia. W niniejszej pracy przedstawiono inne narzędzia niż dotąd rekomendowane – testy stworzone w pierwszej dekadzie XXI w. (w tym Skalę Uzależnienia od Papierosów i Skalę Syndromu Uzależnienia od Nikotyny), które odzwierciedlają współczesne rozumienie uzależnienia. W literaturze przedmiotu w zakresie motywowania do zmiany zachowania zdrowotnego dominuje podejście stosowane w wywiadzie motywującym Millera i Rollnicka, skoncentrowane na osobie palącej i jej motywacji wewnętrznej. Na zasadach wywiadu motywującego opiera się krótka interwencja motywująca – 5R (relevance, risks, rewards, roadblocks, repetition – trafność, ryzyko, nagrody, bariery, powtórzenie), adresowana do osób pozbawionych motywacji do rzucenia palenia, rekomendowana przez Światową Organizację Zdrowia. W Polsce należy podjąć badania nad wdrożeniem nowych narzędzi diagnostycznych, zaktualizować niektóre obecnie obowiązujące wytyczne, dążyć do wzmocnienia roli podstawowej opieki zdrowotnej w leczeniu ZUT oraz włączyć zasady wywiadu motywującego i krótkiej interwencji 5R do programu akredytowanych szkoleń z zakresu rozpoznawania i leczenia ZUT. Med. Pr. 2016;67(1):97–108
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