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OBJECTIVES: Monitoring tobacco use is one of the most important tobacco control interventions recommended by the World Health Organization. This study aimed to assess the prevalence of cigarette smoking, e-cigarette use, and heated tobacco use in a nationwide sample of adults in Poland, as well as to identify factors associated with smoking, e-cigarette use, and heated tobacco use. MATERIAL AND METHODS: This nationwide crosssectional survey was carried out in February 2-4, 2024 using the computer-assisted web interviewing method. The study questionnaire included 17 closed questions on smoking, e-cigarette use, and heated tobacco use. A sample of 1080 adults was selected using a non-probability quota sampling method. RESULTS: Data were collected from 1080 adults, age M±SD 48.4±15.5 years, 53% females. Past 30-day smoking was declared by 30.4% of adults in Poland, including 24.5% of daily smokers. Ever e-cigarette use was declared by 33% of respondents, and 20.6% had ever tried heated tobacco. Past 30-day e-cigarette use was declared by 15.2% of adults, wherein 5.9% were daily e-cigarette users. Past 30-day heated tobacco use was declared by 10.9% of respondents, wherein 4.9% were daily heated tobacco users. One-tenth of adults were dual users (cigarette and e-cigarette or heated tobacco), and 6.5% were past 30-day triple users. Age 40-59 years, having less than higher education, and bad economic status were significantly associated with daily smoking (p < 0.05). Age 18-39 years, having less than higher education, and active occupational status (employment/ self-employment) were associated with daily e-cigarette use (p < 0.05). Age 18-39 years and active occupational status were associated with daily heated tobacco use (p < 0.05). CONCLUSIONS: This study provides comprehensive epidemiological data on the current prevalence of smoking, e-cigarette use, and heated tobacco use. The introduction of e-cigarettes and heated tobacco products evoked changes in social behaviors related to nicotine use. Int J Occup Med Environ Health. 2024;37(3).
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Patient-centered care requires close collaboration among multiple healthcare professionals, including physician-pharmacist collaboration (especially as a part of pharmaceutical care). This study aimed to assess pharmacists' perceptions of physician-pharmacist collaboration as well as to identify factors associated with the willingness to provide pharmaceutical care services in Poland. This questionnaire-based survey was carried out in 2022 among community pharmacists from one of the largest franchise chain pharmacy networks in Poland. Completed questionnaires were received from 635 community pharmacists (response rate of 47.9%). Almost all the pharmacists agreed with the statement that there is a need for physician-pharmacist collaboration (98.2%), and 94.8% declared that pharmacists can help physicians in patient care and pharmacotherapy. Most pharmacists (80%) believed that physicians were not aware of the competencies of pharmacists resulting from Polish law. Patient education (89.9%), detection of polypharmacy (88%), and detection of interactions between drugs and dietary supplements (85.7%) were the most common tasks in the field of pharmaceutical care that can be provided by a pharmacist. Females were more likely (p < 0.05) to declare the need for physician-pharmacist collaboration. Age and location of the pharmacy were the most important factors (p < 0.05) associated with pharmacists' attitudes toward physician-pharmacist collaboration.
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Since 1 June 2023, a nationwide HPV vaccination program was implemented in Poland. This study aimed to identify factors associated with public awareness of the national HPV vaccination program among adults in Poland and willingness to vaccinate children against HPV. This cross-sectional study was carried out between 14 and 17 July 2023 among 1056 adults in Poland. A self-prepared questionnaire was used. Among the respondents, 51.3% had heard about the free HPV vaccination program. The major source of knowledge on the national HPV vaccination program was TV (62%). Only 31.9% of respondents correctly indicated girls and boys aged 12 and 13 as the HPV-vaccination-eligible population. Willingness to vaccinate children against HPV was declared by 63.3% of respondents. Female gender (OR: 1.42; 95% CI: 1.11-1.81; p < 0.01), age 35-64 years (p < 0.05), having higher education (OR: 1.43; 95% CI: 1.11-1.84; p < 0.01), and living in cities with more than 500,000 residents (OR: 1.51; 95% CI: 1.01-2.28; p < 0.05) were significantly associated with higher odds to hear about the national HPV vaccination program. Age 50 years and over (p < 0.05), having higher education (OR: 1.43; 95% CI: 1.09-1.88; p < 0.05), living in cities with more than 500,000 residents (OR: 1.80; 95% CI: 1.14-2.83; p < 0.05), and no children under 18 in the home (OR: 1.39; 95% CI: 1.01-1.89; p < 0.05) were significantly associated with willingness to vaccinate children against HPV.
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Implementation of eye care behaviors may reduce the risk of eye symptoms and diseases. This study aimed to assess eye care behaviors and identify factors associated with eye care practices among adults in Poland. This cross-sectional survey was carried out between 9 and 12 December 2022 on a nationwide random quota sample of adults in Poland. The study questionnaire included a set of questions on 10 different eye care behaviors. The study population included 1076 participants with a mean age of 45.7 ± 16.2 years, and 54.2% of participants were females. The most common (30.2%) eye care behavior was the use of good lighting indoors, and 27.3% used sunglasses with a UV filter. More than one-fifth of participants declared taking regular screen breaks and limiting screen time. Less than one-tenth of participants used dietary supplements with lutein, beta-carotene, or zinc. Out of 12 factors assessed in this study, self-reported knowledge of eye diseases was the most important factor associated (p < 0.05) with eye care behaviors. There were no economic or educational gaps (p > 0.05) in the implementation of most of the eye care behaviors among adults in Poland. This study revealed a low level of implementation of eye care behaviors among adults in Poland.
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Luteína , beta Caroteno , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Estudos Transversais , Polônia/epidemiologia , Suplementos NutricionaisRESUMO
Public knowledge and awareness of eye diseases may influence individuals' behaviors toward the use of eye care services and prevention methods. The objective of this study was to assess the awareness of common eye diseases and their risk factors among adults in Poland as well as to identify factors associated with knowledge of eye diseases. This nationwide cross-sectional web-based survey was carried out in December 2022 on a representative sample of 1076 adults in Poland. Most of the respondents had heard of cataracts (83.6%), glaucoma (80.7%), conjunctivitis (74.3%), and hordeolum (73.8%). Awareness of dry eye syndrome was declared by 50% of respondents, and 40% were aware of retinal detachment. Among the respondents, 32.3% had heard of AMD, and 16.4% had heard of diabetic retinopathy. A lack of awareness of glaucoma was declared by 38.1% of respondents, and 54.3% declared a lack of awareness of risk factors for AMD. Gender, age, and the presence of chronic diseases were the most important factors (p < 0.05) associated with awareness of common eye diseases and risk factors for glaucoma and AMD. This study demonstrated a low level of awareness of common eye diseases among adults in Poland. Personalized communication on eye diseases is needed.
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Oftalmopatias , Glaucoma , Adulto , Humanos , Estudos Transversais , Polônia , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Oftalmopatias/complicações , Glaucoma/complicações , Fatores de RiscoRESUMO
Perceptions of the harmfulness of tobacco products may be a determinant of smoking behaviors. This study aimed to: (1) assess the perception of harmfulness of various tobacco products and e-cigarettes in Poland as well as (2) to assess the awareness of the health effects of using tobacco and e-cigarettes. A cross-sectional survey was conducted in 2019 with a nationally representative sample of 1011 individuals aged 15 and over. In the studied group, 22.3% were smokers. Smokeless tobacco was most likely to be perceived as less harmful than cigarettes (25%), followed by water pipe (24.5%), heated tobacco products (22%), e-cigarettes (21.6%), slim cigarettes (17.1%), flavored cigarettes (except menthol ones) (16.1%), menthol cigarettes (15.6%) and cigarillos (12.6%). In this study, 10% of respondents denied that smoking causes serious diseases. Most of the respondents (88.9%) were aware that smoking causes lung cancer (88.9%), but only 70.4% were aware that smoking causes stroke. Smokers compared to non-smokers were less likely to declare that smoking causes a stroke (OR: 0.43, 95%CI: 0.31-0.59; p < 0.001) or myocardial infarction (OR: 0.41, 95%CI: 0.29-0.60; p < 0.001). There were no significant differences (p > 0.05) in the perception of harmfulness of various tobacco products and e-cigarettes by gender, age, or occupational status.
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Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Estudos Transversais , Humanos , Percepção , Polônia/epidemiologiaRESUMO
Aim: The presented cases are related to failure of due diligence found in the binding decisions of medical disciplinary boards in three centres in Poland, showing in what percentage of the cases the patient died, and answering the question of whether the number of deaths changed, and if yes, then why. Material and methods: The material for this study was collected as a result of the analysis of disciplinary files from 410 final and binding cases before the regional boards in Warsaw, Poznan, and Lodz in 2015-2018, which covers 12.5% of Poland's total caseload. Results: During the 4 years of decisions studied, one can observe only a minimal downward trend in the number of cases relating to failure of due diligence by physicians in diagnosis and treatment. Patient deaths occurred mainly in such medical fields as surgery, neurology, cardiology, and obstetrics, in 2015-2016 - a total of 28 n Warsaw, 23 in Lodz, and 8 in Poznan. Conclusions: A reduction in the number of such cases coming up before medical disciplinary boards is primarily the consequence of the growing involvement of the law enforcement/public prosecutors' offices for offences involving medical error. Currently, the legal awareness of Polish patients or, in this case, their families is focused not so much on the fact that a case has to be brought for potential medical error but on which path to take the case so as to win damages, compensation, or an annuity from the physician or from the medical establishment.
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Monitoring of tobacco use is one of the key tobacco control activities. This study aimed to assess the current prevalence and patterns of tobacco and e-cigarette in Poland as well as to investigate socioeconomic factors associated with cigarette smoking and e-cigarette use. This cross-sectional study was carried out in 2019, on a representative nationwide sample of 1011 individuals aged 15+ in Poland. Daily tobacco smoking was declared by 21.0% of participants; 1.3% of participants were occasional tobacco smokers, and 10.7% were former tobacco smokers. Heated tobacco was used by 0.4% of participants. Ever e-cigarette use was declared by 4.0% of participants and 1.4% were current e-cigarette users. A higher proportion of daily smokers was observed among men than women (24.4% vs. 18.0%; p < 0.0001). The age group 30 to 49 years, of a lower educational level and living in a medium-sized city (between 20,000 and 500,000 residents), was significantly associated with current daily smoking. This is the most up-to-date study on the prevalence of smoking in Poland. Further tobacco control activities are needed to reduce tobacco use in Poland.
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Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Adulto JovemRESUMO
Physicians play a key role in combating tobacco use. This study aims to evaluate the knowledge, attitude, and behaviors toward smoking cessation and vaping cessation interventions among physicians in Poland; to identify factors shaping physicians' behaviors toward smoking and vaping cessation interventions; and to assess differences in the tobacco cessation interventions recommended for cigarette smokers and users of electronic cigarettes (e-cigarettes). A questionnaire-based survey was conducted in 2018 among physicians attending mandatory public health training courses delivered at the School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland. The questionnaire included 25 questions related to tobacco product use and smoking cessation interventions. Data were obtained from 423 physicians (64.3% female; mean age 32.0 ± 5.8 years) with response rate of 84.6%. Current cigarette smoking was declared by 7.8% of participants; 1.9% of participants were e-cigarette users and 1.9% used heated tobacco. Smoking cessation interventions were offered more often to patients who smoked cigarettes than those who used e-cigarettes (p < 0.001). Physicians' behaviors toward smoking cessation and vaping cessation interventions were associated with (p < 0.05) physicians' smoking status and self-declared knowledge about smoking cessation methods. Among physicians in Poland, discussion of smoking cessation was not common behavior and limited mainly to identification of smoking status.
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Atitude do Pessoal de Saúde , Fumar Cigarros , Padrões de Prática Médica , Abandono do Hábito de Fumar/métodos , Vaping , Adulto , Feminino , Humanos , Masculino , Médicos , Polônia , Fumantes , Inquéritos e Questionários , Tabagismo/terapiaRESUMO
The article presents basic legal regulations concerning the restriction of a patients' autonomy (patients who suffer from or are suspected of tuberculosis). Furthermore, the main responsibilities of a doctor suspecting or diagnosing a disease have been shown, including the issue of using direct coercion towards patients evading compulsory treatment and other legally defined obligations. The article also presents changes made by the newest alteration of law on the prevention and fight against infections and septic diseases.
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Direitos do Paciente/legislação & jurisprudência , Assistência Centrada no Paciente/legislação & jurisprudência , Autonomia Pessoal , Tuberculose/diagnóstico , Tuberculose/terapia , Feminino , Humanos , Masculino , Direitos do Paciente/ética , Relações Médico-Paciente , Polônia , Tuberculose/prevenção & controleRESUMO
Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures, particularly in areas such as pharmaceuticals, are highly regressive. The health status of the Polish population has improved substantially, with average life expectancy at birth reaching 80.2 years for women and 71.6 years for men in 2009. However, there is still a vast gap in life expectancy between Poland and the western European Union (EU) countries and between life expectancy overall and the expected number of years without illness or disability. Given its modest financial, human and material health care resources and the corresponding outcomes, the overall financial efficiency of the Polish system is satisfactory. Both allocative and technical efficiency leave room for improvement. Several measures, such as prioritizing primary care and adopting new payment mechanisms such as diagnosis-related groups (DRGs), have been introduced in recent years but need to be expanded to other areas and intensified. Additionally, numerous initiatives to enhance quality control and build the required expertise and evidence base for the system are also in place. These could improve general satisfaction with the system, which is not particularly high. Limited resources, a general aversion to cost-sharing stemming from a long experience with broad public coverage and shortages in health workforce need to be addressed before better outcomes can be achieved by the system. Increased cooperation between various bodies within the health and social care sectors would also contribute in this direction. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; they describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.