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?

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.

Impact: Cigarette consumption dropped �0 percent between �990 and �998, and the number of smokers
declined from �4 mill

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