The Analysis of Tobacco Consumption in Croatia - Are We Successfully Facing the Epidemic?

By Padjen, Ivan; Dabic, Marina et al. | Central European Journal of Public Health, March 2012 | Go to article overview

The Analysis of Tobacco Consumption in Croatia - Are We Successfully Facing the Epidemic?


Padjen, Ivan, Dabic, Marina, Glivetic, Tatjana, Biloglav, Zrinka, Biocina-Lukenda, Dolores, Lukenda, Josip, Central European Journal of Public Health


SUMMARY

Tobacco is the largest cause of morbidity and mortality. The aim of this study is to analyse several health and economically related indicators of tobacco consumption: smoking prevalence, standardized death rates (SDRs) from lung cancer and the proportion of GDP spent on tobacco in Croatia and other transitional countries - the Czech Republic, Slovakia, Poland, Hungary, Slovenia, Romania, and Bulgaria. The overall smoking prevalence in Croatia decreased by 5.2% during 1994-2005, more among females (-9.9%) than males (-0.3%). There is no significant difference in the smoking prevalence between Croatia (27.4%) and other countries. However, 33.8% of Croatian males smoked during 2002-2005, more than in Romania and the Czech Republic, and less than in Hungary and Poland. The prevalence of female smoking (21.7%) in Croatia is similar to the female smoking prevalence in Poland, the Czech Republic, and Hungary, but male smoking is predominant in all countries. The proportion of smokers among youth is above 20% and it is the highest in the Czech Republic (29.7%), followed by Hungary (26.7%), Slovenia (24.9%), Croatia (24.1%), and Poland (21.5%). The proportion of smokers among girls is higher than among boys in Slovenia, Hungary, the Czech Republic, and Croatia, contrary to Slovakia, Bulgaria, and Poland where boys smoke slightly more. There is no significant difference between the prevalence of smoking among girls in Croatia and Bulgaria, Poland, the Czech Republic, Hungary, Slovenia, and Slovakia. According to the SDR from lung cancer in males (70.3/100,000), Croatia is ranked high assuming the 3rd place, after Hungary (99.7) and Poland (72.0). With a SDR of 15.9/100,000 for females, Croatia is ranked slightly better - 5th place. Tobacco consumption continues to be a major public health problem in transitional countries. Croatia conducted several campaigns and programmes in the past. However, results reveal that current anti-tobacco strategies are ineffective in reducing the smoking prevalence among men and youth. Men do not smoke less than a decade ago and, despite the observed decline among women, increasing trends are observed among teenage girls. Croatia should apply a comprehensive approach that would include raising awareness of health risks, restriction of smoking in public places, higher taxing, implementing stricter bans on advertising and promotion of tobacco as well as supporting smoking cessation. This last measure is believed to bring about some results in the medium term in targeted population groups, provided that it is supported by all health professionals. Otherwise, we may expect progress at the population level in the field of social stigmatization of smoking and wider intolerance to second-hand smoke. The full impact of smoking on the population health is yet to be seen and in the future it will undoubtedly remain one of the major contributors to the poor public health situation in Croatia.

Key words: tobacco, Croatia, smoking prevalence, youth, lung cancer mortality

INTRODUCTION

Tobacco is the largest cause of morbidity and mortality in Europe. It is the 2nd major cause of death and the 4th most common health risk factor in the world. If this situation remains unchanged, tobacco is likely to cause around 1 0 million deaths each year in the next decade (1). Even though there has been increasing awareness of the harmful effects of smoking in the European Union (EU), the proportion of smokers is still high - approximately one third of the European population smokes and 650,000 deaths per year are smoking-related. It is of concern that almost half of these deaths is registered in the population aged 35-69 years, which is well below the average life expectancy (2). Reduction of mortality and morbidity caused by this global pandemic is a public health priority. Only a comprehensive approach seems to be efficient. Thus, the EU anti-smoking strategy includes a wide spectrum of smoking prevention and cessation activities, such as health education measures, improved consumer information and assistance as well as restrictions on tobacco advertising and marketing (3-6). …

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