Psychiatric symptomatology and personality in a population of primary care patients.

INTRODUCTION AND OBJECTIVE: Psychiatric disorders (and their high rates of prevalence) in primary care have been widely analyzed, but the problem of underdiagnosis remains unresolved. This becomes increasingly more important in rural health centres in the face of lack of epidemiological data from these centres. The aim of this study is focused on the relationship between general health, psychiatric symptomatology and personality characteristics in the context of an adequate diagnosis. MATERIALS AND METHODS: 518 primary care patients in 6 Polish urban clinical centres were studied using (in order of administration): a sociodemographic questionnaire, the General Health Questionnaire (GHQ-28) and Eysenck Personality Questionnaire (EPQ-R). RESULTS: The investigated sample was representative for urban primary care patients. The findings confirmed a significant association between neuroticism and general health. The strongest relation with current functioning and mental distress of the patients (GHQ general score) was observed in case of symptoms of anxiety and insomnia. The symptoms of depression may be the most difficult to identify (psychiatric symptoms assessed using GHQ sub-scales). CONCLUSIONS: According to the GHQ assumptions and confirmed by the presented study, sub-threshold psychiatric symptomatology affects the functioning of primary care patients and their general health. This correlates with personality factors. Improving adequacy of diagnosis becomes extremely important, as it may often be the only chance for appropriate therapy of mental problems for people living in rural areas due to lower availability of specialistic mental services. Further epidemiological studies concerning rural primary care and prevalence of the spectrum of mental disorders need to be conducted.

Preferred and undesirable products in the dietary habits of women.

BACKGROUND: Proper nutrition, especially for elderly women as well as for women after mastectomy, is one of the basic conditions of maintaining physical health and mental well-being. OBJECTIVES: The comparison of dietary habits of women of various ages and various levels of physical activity. MATERIAL AND METHODS: The investigated group consisted of 90 women: 20 students of the Faculty of Physiotherapy at the Academy of Physical Education in Wroclaw, 25 students of University of the Third Age at the Academy of Physical Education in Wroclaw, 25 visitors of the sanatorium in Jedlina Zdrój, and 20 women after mastectomy. The authors' questionnaire was applied to assess the adherence of the dietary habits of the women in the researched groups to the rules of proper nutrition on the basis of the consumed products. RESULTS: The highest average dietary preferences expressed in questionnaire points were revealed among the students of the University of the Third Age (4.13) and the women after mastectomy (4.10). Lower numbers of questionnaire points were noted among the visitors of the sanatorium (3.78) and the students of the Academy of Physical Education (3.60). CONCLUSIONS: A significant correlation of BMI and the average number of questionnaire points was revealed in the group of women after mastectomy and the students of the University of the Third Age and a clear correlation in the group of students. A significant correlation between the average of questionnaire points and the age of the women was observed in the first two groups. Applying the authors' questionnaire makes it possible to assess conscious application and adherence to the rules of proper nutrition on the basis of preferred and undesirable products consumed.

The quality of primary health care for chronically ill patients: a cross-sectional study.

BACKGROUND: Patients with at least one chronic disease requiring regular contact with their GP, additional tests and systematic use of medicines constitute one of the challenges for the future of primary medical care. To date, no studies have been published describing the most important factors in increasing the quality of care for the chronically ill. OBJECTIVES: To evaluate correlations between patients' characteristics and their assessments of the quality of health care and to identify the primary factors influencing the quality of care for chronically ill patients. MATERIAL AND METHODS: The sample for the current analysis included 232 chronically ill adult patients of primary care clinics in Poland. The patients' opinions regarding subjective and objective examinations, their participation in clinical decision-making processes, psychosocial factors, contact with the doctor in emergency situations and confidence in the doctor were investigated. RESULTS: The strongest correlations defining the quality of care for the chronically ill were identified as the occurrence of hypertension (0.248, p < 0.001), the patient's gender (0.271, p < 0.001), the patient's level of education (0.169, p < 0.01) and the patient's age (0.155, p = 0.018). The results of the ANOVA test were statistically significant (p < 0.05) for the occurrence of myocardial infarction, hypertension, type 2 diabetes, psoriasis, multiple sclerosis, the doctor's gender, the patient's gender, age and education. CONCLUSIONS: The areas that the participants gave the highest ratings to are subjective and objective examinations, kindness and willingness to help. The strongest correlations between high assessments of the quality of care provided for chronically ill patients at primary care clinics were observed in the following variables: gender, age, level of education, frequency of visits, therapy conducted by a doctor at a specialist clinic, arterial hypertension, COPD and/or myocardial infarction.

Management of familial heterozygous hypercholesterolemia: Position Paper of the Polish Lipid Expert Forum.

Heterozygous familial hypercholesterolemia (HFH) affects on average 1 in 500 individuals in European countries, and it is estimated that HeFH in Poland may affect more than 80,000 people. Cardiovascular mortality in individuals with FH between 20 and 39 years of age is 100 times higher than in the general population. HFH is a relatively common lipid disorder, but usually still remaining undiagnosed and untreated. A very high risk of cardiovascular diseases and a shortened lifespan in patients with this condition require early diagnosis and intensive treatment. The aim of the position paper was to present the importance and scale of this problem in Poland, which has not been raised enough so far, as well as the recommendations of diagnosis, treatment and prevention methods.

Quality of life and acceptance of illness among patients with chronic respiratory diseases.

The purpose of this study was to determine quality of life (QoL) and acceptance of illness in patients with chronic respiratory diseases. The study involved 315 adult patients of the mean age of 63.9±15.7 years. The World Health Organization Quality of Life Instrument Short Form and the Acceptance of Illness Scale were used. The mean score for QoL was 2.0±1.3. The highest scores were obtained in the Social Relationship Domain (13.9±2.7) and the lowest in the Environmental Domain (10.5±2.2). The strongest correlations within QoL domains were noted between Physical and Psychological Domains: r=0.611 (p<0.001), Psychological and Social Domains: r=0.605 (p<0.001). The overall degree of illness acceptance was low (26.0±7.8). The strongest correlations were observed between illness acceptance and Physical: r=0.591 (p<0.001) and Psychological Domains: r=0.450 (p<0.001). We conclude that illness acceptance can be augmented by improving the patient's clinical state and by the provision of psychological support and QoL by improving the Psychological and Environmental Domains.

Immune response to influenza vaccine in hemodialysis patients with chronic renal failure.

Chronic renal failure and dialysis belong to contraindications to vaccination with live vaccines. The objective of this study was to evaluate the humoral response to influenza vaccination consisting of the formation of antibodies against hemagglutinin and neuraminidase in patients undergoing chronic hemodialysis due to chronic renal failure. The study included 173 patients treated at a dialysis station in the Silesian region in Poland. The patients were assigned to the following groups: Group A-71 hemodialysis patients, mean age 65.4 ± 14.5 years; mean time of dialysis therapy 38.9 ± 31.7 months, vaccinated against influenza; Group B-39 hemodialysis patients, mean age 64 ± 13.5 years; mean time of dialysis therapy 45.0 ± 45.2 months, not vaccinated against influenza; and Group C-63 healthy patients, mean age 44.1 ± 21.2 years, vaccinated against influenza - control group. The vaccinated patients (Groups A & C) received a single dose of Agrippal influenza vaccine (Novartis) containing hemagglutinin from three strains of the influenza virus: A/Brisbane/59/2007 (H1N1), A/Brisbane/10/2007 (H3N2), and B/Brisbane/60/2008. The serological response to vaccination was assessed from antihemagglutinin (anti-HA) and antineuraminidase antibody assays (anti-NA). We found that the protection level of antibodies (protection rate) against H1 was only 40% among the vaccinated hemodialysis patients, as opposed to 65% in controls. The level of anti-H3 antibodies was similar in both groups of vaccines; 68% in dialysis patients and 75% in controls. The level of anti-HB antibodies was higher in the dialysis patient than in controls; 70% vs. 38%, respectively. The response rate to H1 antigen a month after vaccination was almost twice lower in the hemodialysis patients than in healthy controls vaccinated against influenza; 37% vs. 65%, respectively. We conclude that there is a rather insufficient serological response in the group of hemodialysis patients vaccinated with a single dose of influenza vaccine.

[Alcohol intake and tobacco smoking among students of medical schools]. / Spozycie alkoholu i palenie tytoniu wsród studentów wyzszych uczelni medycznych.

PURPOSE OF THE STUDY: To determine the level of alcohol intake (including risky drinking) and tobacco smoking among students of higher medical schools, as well as the level of students' knowledge about epidemiology and consequences of alcohol abuse. MATERIAL AND METHODS: The study was conducted in 2010-2012 and involved 1054 students of medical school. The majority of the participants were female (82.3%). Average age of respondents was 25.13 years (SD = 6.64, median = 24). The questionnaire was to determine the students' knowledge of alcohol abuse, short version of AUDIT and questions about tobacco smoking. RESULTS: The average 100% alcohol intake in Poland was correctly identified by 32.0% (318) of students. The alcohol level in blood which indicates the state after alcohol intake was correctly determined by 57.2% (571) of respondents. Tobacco was the choice of 13.8% (138) of students as the main health risk factor and cause of premature deaths in Europe, alcohol was chosen by 17.8% (177). Cirrhosis was recognized correctly by 52% of students (521) as the most frequent disease caused by alcohol in European men. Regarding the question about the biochemical indicators helpful in diagnostics of alcohol abuse only 27.6% (275) indicated correctly: MCV and GGT. In short version of AUDIT 32.2% (238) of women gained 4 points and above, 56.2% (91) of men gained 5 points and above. Among women: 3.5% (28) have 14 and above standardized portions of an alcoholic drinks during week. Among men: 6.5% (11) have 28 and above standardized portions of an alcoholic drinks during week. Non-smokers represent 20.6% (205) of respondents. A majority (39.4%, 82) indicate they smoke not more than 5 cigarettes per day. The students first began smoking in secondary (21.7%, 45) and high school (45.9%, 95). Smokers statistically significantly more often (p<0.001) drink alcohol. More than four times higher percentage of smokers (10.0% vs 2.3% non-smokers) drink in a day when they drink 10 or more standardized portions of an alcoholic drink (p<0.001). Those who drink at least once a month drink 6 standardized portions of an alcoholic drink statistically significantly more often (p<0.001)were smokers (21.8% vs 10.8% non-smokers). Smokers were more than four times more likely (13.4%) than non-smokers (3.2%) to drink 6 standardized portions of an alcoholic drink once a week. During the majority of weekdays, 6 standardized portions of an alcoholic drink were taken by 2.48% (5) of smokers (vs 0% non-smokers). CONCLUSIONS: A high percentage of students in medical schools drink riskily. Especially the risky drinking was observed among smoking students. The level of knowledge gained by respondents about alcohol abuse is still insufficient. Programs that promote avoiding tobacco smoking and alcohol abuse are necessary among children during the first years of education (in primary school and earlier).

[Antibiotics in primary care]. / Antybiotyki w podstawowej opiece zdrowotnej.

Discovered in the forties of the twentieth century antimicrobial agents have changed the world. Currently, due to their overuse, we are threatened by the increasing resistance of bacteria to antibiotics, and soon we may face a threat of inability to fight these pathogens. For that reason, the world, European and national organizations introduce antibiotics protection programs. In Poland since 2004, the National Program of Protection of Antibiotics is being held. The concept of rational antibiotic therapy is associated not only with the appropriate choice of therapy or antimicrobial dosage but also with a reduction in costs associated with a refund of medicines. Antibiotics are prescribed mostly by primary care physicians (GP), and about one fifth of visits to family doctor's office ends with prescribing antimicrobial drug. These trends are probably related to both the difficulty in applying the differential diagnosis of viral and bacterial infection in a primary care doctor's office, as well as patient's conviction about the effectiveness of antibiotic therapy in viral infections. However, although patients often want to influence the therapeutic decisions and ask their doctor for prescribing antimicrobial drug, the right conversation with a doctor alone is the critical component in satisfaction with medical care. Many countries have established standards to clarify the indications for use of antibiotics and thereby reduce their consumption. The next step is to monitor the prescribing and use of these drugs and to assess the rise of drug resistance in the area. In Poland, the recommendations regarding outpatient respiratory tract infections treatment were published and usage of antimicrobial agents monitoring has begun. However, lack of publications covering a broad analysis of antibiotic therapy and drug resistance on Polish territory is still a problem. Modem medicine has yet another tool in the fight against bacteria--they are bacteriophages. Phage therapy is unfortunately still an experimental therapy and its use has many limitations. To preserve antibiotics healing abilities, we must follow the rules of rational antibiotic therapy, and primary health care is a place where the physician can significantly contribute to deterioration or protection of antibiotics.

The impact of telehome care on health status and quality of life among patients with diabetes in a primary care setting in Poland.

BACKGROUND: Telehome care has been proposed as a solution to the challenges of providing effective and affordable care for patients with diabetes. METHODS: A total of 100 adult patients with type 2 diabetes-divided between insulin and noninsulin requiring-was enrolled in a randomized, controlled trial aimed at investigating the effects of telehome monitoring. The experimental group (n = 50) received an in-home wireless glucose monitor and transmitter, whereas the control group (n = 50) was instructed to follow the conventional arrangement. RESULTS: There was an overall reduction in HbA1c values in both experimental and control groups after 6 months. A significant difference in HbA1c values between the groups was observed only among the noninsulin-requiring patients (decline from 6.95% ± 0.82% to 6.66% ± 0.86% in IB vs. 7.21% ± 2.02% to 7.2% ± 1.86% in IIB; p = 0.02). The experimental group reported considerably less hyperglycemic and hypoglycemic events. The profile of the patient who benefited the most from telemonitoring consisted of older, more educated patient who had acquired the disease relatively recently, and who spends most of the time at home. The experimental group had higher overall scores on quality of life measures and sense of control over diabetes. There was a positive association between educational attainment and ability to use the telemonitoring system without help (p = 0.045). CONCLUSIONS: Although not conclusive because of the small sample and short observation period, the study suggests that telehome monitoring is an effective tool in controlling type 2 diabetes in a primary care setting.

[Spreading of smoking habit among students of the Public Medical Higher Professional School in Opole in 2006-2009]. / Rozpowszechnienie palenia tytoniu wsród studentów Panstwowej Medycznej Wyzszej Szkoly Zawodowej w Opolu w latach 2006-2009.

Smoking is the most widespread addiction and for years is a basic addiction hazard among youngsters. The beginning of nicotine addiction is occult, during time runs as habit and biological nicotine addiction. The health consequences are seen after time. Children have their first contact with cigarettes in their own families and the problem of smoking is the consequence of following adults' example. The risk of smoking addiction rises because of negative influence of background and because of the need of being approved among men of the same age. The objective of the study was the analysis of spreading of smoking among students of PMWSZ in Opole during years 2006-2009.688 students of nursery and obstetrics faculty were investigated. Among them 175 (25.4%) were smokers and 513 (74.6%) were non-smokers. More than half of smokers (61.2%) started smoking in secondary grammar school. 110 (62.9%) of them tried to overcome their addiction. These failed attempts confirm the necessity of multi-aspect anti-nicotine help given by health professionals: doctors, psychologists, addiction therapeutics and pedagogues.

[Level of tobacco smoking amongst 6th year students of Wroclaw Medical University]. / Poziom palenia tytoniu wsród studentów VI roku Akademii Medycznej we Wroclawiu.

Prevention of tobacco smoking amongst youths and young adult could limit deaths because of illness tobacco related to 2050. The assessment of the level of smoking was the aim of examinations amongst medical students. An anonymous questionnaire containing questions on the subject of tobacco smoking was carried amongst 6th year students of the Medical Department of Wroclaw Medical University in the academic year 2008/2009. Two hundreds then students took part in the study. 62% of examined came from the provincial capital, the 11.4% from the town with the population above 100 hundred of inhabitants, 22.4% of towns with the population below 100 hundred of inhabitants and 3.8% of students--from country centers. 14.8 % respondents admitted to smoking cigarettes, 75.2% were non-smoking persons, 10% were smokers but ceased smoking cigarettes in the sequence of a few last years. Amongst smokers--the most (59% of students and 71% of students) is smoking to 5 cigarettes per day. The most students (56% of women and 60% of men) began smoking in the secondary school. In studied group 67.6% (142) examined is claiming that the anti-tobacco advice should give family doctors, and 43% thinks that a patient which isn't able to cease the smoking in spite of strong motivation should be seen by a family doctor. The percentage of smokers amongst medical students didn't take turns in the sequence of two last years, however amongst smokers--biggest percentage is smoking to 5 cigarettes per day. The students most often begin smoking in the secondary school. The straight majority of the medical students is paying attention, that family doctors should take up giving the anti-tobacco advice and helping patients which isn't able to cease the smoking in spite of strong motivation. The ones smoking the small number of cigarettes and which began smoking in the secondary school are predominating amongst smokers. Overbalancing percentage of examined is located anti-tobacco therapy into competence of a family doctor.

[The students of Public Higher Medical Professional School in Opole spreading anti-tobacco advice]. / Studenci Panstwowej Medycznej Wyzszej Szkoly Zawodowej w Opolu wobec poradnictwa antytoniowego.

Smoking tobacco in our society is the primary risk factor in the emergence of many diseases, including cardiovascular and cancer, elevating the risk of mortality before 65 years of age. Very important is the fact that this is a removable, which can be completely eliminated. The smoker health could be in better conditions and also other people from his environment. A man who is messed up is the sick man who, while having the motivation to stop smoking, need a comprehensive and specialized medical treatment. Respondents nursing and midwifery students in Opole PMWSZ most important in providing advice to patients students choose family doctors (34.1%) and internists (17.9%). According to the respondents, patients who, despite a strong motivation to stop smoking can not, should find help in specialized anti-tobacco clinic (27.8%), substance abuse treatment clinic (16.5%), and psychological counseling (11.4%). Half of the surveyed students (51.35%) declared the ability to advice patients, while only 18.7% of respondents correctly answered the question what is the minimum intervention of tobacco control, 56% of respondents claimed that it is information to the patient of the consequences of smoking. Important in reducing the health effects of smoking is to prepare health workers to diagnose the problem of addiction and comprehensive professional treatment.

[Acting in the framework of the nicotine addiction prevention--the level of knowledge amongst 6th year students of Wroclaw Medical University]. / Postepowanie w ramach profilaktyki uzaleznienia od nikotyny--poziom wiedzy wsród studentów VI roku Akademii Medycznej we Wroclawiu.

It was stated explicitly that smoking was increasing the risk of the death about 25-40% because of cardiovascular diseases, about 30-40% because of malignant tumors and is causing about 70% of deaths from illness of the respiratory system (no cancerous). It was also proved that basic means increasing the effectiveness of taken attempts to limit the smoking were useful and easy to apply by every doctor independently of the medical specialty. An anonymous questionnaire containing questions on the subject of the realization of problems connected with the tobacco addiction in the route of medical studies was carried amongst 6th year students of the Medical Department of Wroclaw Medical University in the academic year 2008/2009. 210 students took part in the study. 62% of examined came from the provincial capital, the 11.4% from the town with the population above 100 hundred of inhabitants, 22.4% of towns with the population below 100 hundred of inhabitants and 3.8% of students--from country centers. Only 78% of students is claiming that problems concerning nicotinism were being brought up on the university. 56.7% of examined is judging that he is able to give an anti-smoking advice to a patient. The correct answer in the question about the Fagerströma test and describing physical addiction gave 47% of students, only 39.5% examined--in the question about the assessment of motivation test (the Schneider scale), and 37.2% of students responded to the question what is consists in minimum anti-tobacco intervention. An insufficient frequency of bringing up the problem of smoking on medical studies is visible harmfulness, a consequence is a lowering knowledge amongst students. Little over 3 of students is confirming students that problems concerning the nicotinism were being brought up during studies (mainly during classes in the field of internal medicine), however every sixth of examined students is declaring the knowledge in the case of the patient addicted to the nicotine and every fourth has the knowledge. The preparing graduates of the Medical Faculty for the participation in realization of basic schedules of the promotion of the health and the diseases prevention is developing unusually pessimistically towards above data, the fight against the nicotine addiction is filling one of the essential positions, independently on the medical specialty.

[The attitude of the nursing students of Public Higher Medical Professional School in Opole towards the smoking problems in Poland]. / Postawy studentów pielegniarstwa Panstwowej Medycznej Wyzszej Szkoly Zawodowej w Opolu wobec problematyki palenia tytoniu w Polsce.

Cigarette smoking has been main reason of the Polish society health hazard and one of the most widespread unhealthy element of the human life style. Aim of the study is to evaluate the attitude of the nursing students of Public Higher Medical Professional School in Opole towards the smoking problems in Poland. Most of respondents considered the nicotinism problem in Poland as very important--3 of them evaluate importance of problem on the scale of 0 - 10, estimated it from 8, 9 and 10 points. 74.3% of respondents support the opinion to put the total injunction from smoking at public areas into practice. According to respondents, the most effective forms to express a non-smoking lifestyle is to promote the idea of the total injunction from smoking at public areas and the promotion of the nonsmoking people at the mass media.

[The nursing students of Public Higher Medical Professional School in Opole spreading non-smoking lifestyle]. / Studenci pielegniarstwa Panstwowej Medycznej Wyzszej Szkoly Zawodowej w Opolu wobec promowania niepalenia.

The promotion of health is a science and art of helping people to change their environment and lifestyle to a health friendly one, in order to strengthen and build up their wellbeing. Smoking cigarettes is a most disadvantageous element of a lifestyle. Important elements of promotion of non-smoking lifestyle, by our students, as future Health Service members, are: promoting of smoke-free environment, encouraging of non-smoking fashion, education of health consequences of smoking cigarettes, motivation to quit smoking, advisement in the field of smoking addiction treatment. Public health and health promotion, these are classes where smoking cigarettes' problem has been discussed mostly. Over 90% of students' respondents claim that were able to give a nonsmoking advice to any patient. Because of the awareness of health threats caused by smoking cigarettes and because of the role of education in prevention and addiction fighting, over 82.4% of students were convinced that every doctor should ask every patient, about his/her attitude towards smoking cigarettes.

[Cigarette smoking in medical personnel and evaluation of this problem by smoking and non-smoking patients]. / Palenie papierosów przez personel medyczny i ocena tego problemu przez palacych i niepalacych pacjentów.

Cigarette smoking is a problem in all environments, including health service workers. It increases the number of ill people and accelerates death. The aim of this study was to diagnose the problem of smoking in medical staff and evaluation of this problem by patients. Research was made in hospitals and out-patient clinics in Opole by using an anonimous questionnaire. Along years there has been a decrease of smoking initiation age: 60-years-old-women had their first cigarette in 70% after them finished 18 years old, while most 30-year-old-women had it before. Every year the level of education in medical staff grows up, but the number of smokers in them does not fall down. It is still common to smoke in non-smokers and pregnant woman presence in spite of knowledge about passive smoking. Also pregnancy is not always strong argument to complete quit smoking, among medical staff as well. Smoking medical personnel has definitely negative evaluation by non-smoking patients (70%), a bit less negative it is seen by smoking patients. As the research showed, promotion of nonsmoking workers by employers could be a motivation to quit smoking.

[Opinion of students of the Medical Department of Wroclaw Medical University on the subject of the fight against tobacco addiction]. / Opinia studentów Wydzialu Lekarskiego Akademii Medycznej we Wroclawiu na temat walki z nalogiem palenia tytoniu.

Problem of prophylaxis of nicotine-related diseases and leading of programs of the fight against tobacco addiction are being given out to be shared nominative case of main plans led in the framework of health care in majority of European countries. An anonymous questionnaire containing questions concerning students' opinion on the subject of the fight against tobacco addiction was carried amongst students of the 6th year of the Medical Department of Wroclaw Medical University in the academic year 2007/2008. 177 students took part in the study (64% of women, 34% of men). 72.4% of students came from cities with the population above 100 hundred of inhabitants. 64.4% of students is regarding problem of nicotinism in Poland as important. 62.2% of students think that promoting not-smoking in media is most effective method. 76.7% of students is justifying total smoking ban in public places and is behind accepting such regulations in Poland. 1.14% of students is against smoking ban in public places regarding it as limiting their freedom. Majority of students thinks that nicotinism is an essential problem in Poland. Dominating percentage examined thinks that promoting not-smoking in media is most effective method. Majority of students is justifying a total smoking ban in public places and is behind accepting such regulations in Poland. Only scarce percentage examined is against a smoking ban in public places regarding it as limiting their freedom. Undoubtedly students notice problem of tobacco smoking in Poland as important, at the same time rarely taking into consideration keeping anti-tobacco programs on the level of health care--are handing responsibility for realization of these programs to media or government organizations. Students are supporting regulations introducing a ban on smoking in public places.

[Realization of problems related with tobacco addiction under medical studies]. / Realizacja zagadnien zwiazanych z nalogiem palenia tytoniu w trakcie studiów medycznych.

Quitting by current smokers is therefore the only way in which tobacco-related mortality can be reduced in the medium term. An anonymous questionnaire containing questioners on the subject of the realization of problems connected with the tobacco addiction in the route of medical studies was carried amongst students of the 6th year of the Medical Department of Wroclaw Medical University in the academic year 2007/2008. 177 students took part in the study (64% of women, 34% of men). 72.4% of students came from cities with the population above 100 hundred of inhabitants. 8.5% of students isn't regarding the nicotine addiction as illness. 94.4% of students is claiming that problems concerning nicotinism were being brought up on the university. 81.7% of students is judging that he is able to give an anti-smoking advice to a patient. 89.8% of students think that every doctor should ask each patients opinion about smoking cigarettes independently of whether he is an ill or healthy person. It is surprising that persons not regarding nicotine addiction as illness are still amongst students of 6th year of the Medical Department. Not all examined also confirmed that they had met with discussing the problem of nicotinism during medical studies. Majority examined thinks that he is able to give an anti-smoking advice to a patient. Dominating percentage examined thinks that every doctor should ask each of patients' opinion about smoking cigarettes independently of whether he is an ill or healthy person. Knowledge is being passed down to students on the subject of nicotine addiction during main subjects realized during medical studies. However this knowledge seems insufficient in spite of high self-assessment of students.