Marcin Rutkowski

Epidemiological survey and antitobacco intervention in Polish 400 Cities Projec

Cardiovascular diseases (CVD) represent the principal cause of death in Poland. The main reasons are high prevalence and low detectability of main risk factors: arterial hypertension, diabetes and hyprelipidaemia.
Also smoking is one of the main CVD risk factor. Polish 400 Cities Project consists of the following modules:
1. social marketing preceding screening tests and education,
2. medical intervention – screening tests,
3. education for local leaders regarding health promotion and CVD prevention,
4. antitobacco intervention,
5. educational intervention for children: training program for teachershealth promotion among pupils,
6. training programs for doctors and nurses,
7. education for patients with newly-detected diseases.
Antitobacco module contains the following interventions:
1) social marketing via mass media,
2) education among children in schools,
3) education for smoking patients with newly-detected diseases,
4) training program for doctors: treatment of nicotinism,
5) training program for local representatives: elaboration of local antitobacco program,
6) in 2006 new module – antitobacco intervention for pregnant women.
In years 2003–2006 screening tests were performer among 92378 adults. Tobacco smoking was reported by 12.3% of woman and 21.9% of men, mainly in the age group 25–45 (W 21.1%; M 28.5%). Data from intervention among children show that among 24,005 ten years old boys and girls, 5.7% girls and 12.8% boys say “yes” for the question “have you ever smoke” in the questionnaire interview. In years 2006–2008 the main antitobacco module was antitobacco intervention for pregnant women. The purpose of the research was to measure phenomenon of active and passive smoking among pregnant women in the smallest cities with surrounding villages. The aim was also to trace social features associated with smoking and develop the strategy for future antitabacco interventions. The research was conducted along with intervention based on American College of Obstetricians and Gynecologists 5 A’s model tailored for pregnant women adjusted to Polish organizational limitations. The model include 1) asking about tobacco smoking during every contact with pregnant women, 2) advising not to smoke or avoid passive exposure, 3) assessing the determination to make a quit attempt, 4) assist with the trial, 5) arrange next meeting with the focus on the problem. During the research 919 pregnant women were questioned and examined with micro Co device. Among that number were 22% of active smokers and 31% exposed on passive smoking in their home or work. The prevalence of smoking were higher among lower educated – 46% of women with only primary school compared with 7% of women with university diploma. Smoking was more frequent among women with lower per capita personal income. 80% of smoking pregnant women were motivated to make a quit attempt.