Smoking epidemic in Krakow

Elimination of tobacco smoking is an important measure to support health and increase life expectancy. Availability of local data on smoking prevalence and health consequences of smoking is of crucial importance for any anti-smoking campaign. The aim of the present paper is to: 1) describe prevalence of smoking in population of middle-aged residents of Krakow, 2) assess a smokingrelated total mortality risk, and 3) evaluate an excess total mortality attributed to smoking. The study was based on data from Polish part of the HAPIEE Project (Health, Alcohol, Psychosocial Factors in Eastern Europe), a prospective study initiated in 2002. Krakow residents at age 45–69 years were randomly selected within age and gender strata from population registers. Out of initial 10,728 participants, 4857 men and 5127 women were included to the present analysis. Out of them 1630 (34%) men and 1330 (26%) women were current smokers, and 1763 (36%) men and 1077 (22%) women were former smokers. Altogether 71% men and 48% women were ever-smokers. Mean follow-up time was 61 (SD = 10.6) and 62 (SD = 8.0) months for men and women respectively. During the follow-up period there were 294 (6.1%) deaths in men and 135 (2.7%) deaths in women. In total 51,345 person-years were observed. After adjustment to the main cardiovascular risk factors (age, education, BMI, systolic blood pressure , total cholesterol, physical activity and alcohol consumption) more then 3 times higher hazard ratio (HR = 3.3, 95% CI: 2.25–4.99) for currently smoking men and 2 times higher hazard ratio (HR = 2.2, 95% CI: 1.29–3.39) for women compared to non-smokers were observed. In ever-smokers the hazard ratios were as follows: HR = 2.6, 95% CI: 1.78–3.71 for men and HR = 1.8, 95% CI: 1.17–2.69 for women. Among former smokers, the lowest hazard ratio was observed in those who quit smoking more than 15 years ago. In total, 53% of all deaths in men and 18% of all deaths in women were attributed to smoking. In conclusion, implementation of an effective intervention program on smoking cessation should be one of the main targets of public health and preventive medicine in Krakow