Organizational and Financial Analysis of Polish Tobacco Control Program in 2000-2018.

In accordance with the provisions of the WHO Framework Convention on Tobacco Control (FCTC), each country shall promote and strengthen public awareness of tobacco control issues (Article 12). Many parties to the FCTC have adopted national tobacco control programs to organize their tobacco control activities. The aim of our study was to analyze the organization and funding of the Polish Tobacco Control Program in years 2000-2018. Document analysis of The Program and reports from its implementation were performed in accordance to the Agency for Health Technology Assessment in Poland (AHTAPol) recommendations and the WHO FCTC guidelines for Article 12 implementation. Spending was also analyzed. The study showed both inadequate planning of and funding for Polish Tobacco Control Program. The Program was developed without use of best practices detailed in the WHO FCTC guidelines as well as in national guidelines prepared by AHTAPol. The experience of Poland shows that although earmarking tobacco taxes has existed in the law, it has been largely ineffective due to the poor Tobacco Control Program design and insufficient funding resulting from a poor execution of the earmarking law. This may be a warning to other countries to strive to create law, compliance with which can be verified and controlled.

Legal Steps to Secure the Tobacco Supply Chain: A Case Study of Poland.

The threat of tobacco tax evasion and avoidance is the most commonly mentioned argument against tax hikes. Increasingly, the focus of legislators is on leaks in the tobacco crop supply chain, in which raw or cured tobacco that was never taxed finds its way to smokers. To study the process undertaken by Poland to secure the tobacco supply chain, we analyzed the 2013-2018 legislation around tobacco supply and interviewed a key stakeholder in the Government of Poland. We found that farmers and intermediary entities can trade tobacco only if registered with the government. Farmers are required to report the size of their fields and the weight of their crops to the state authorities. Each purchase within the supply chain is also reported by both the seller and the buyer for cross-validation. This has prevented manipulation within the system, while the mere threat of heavy fines related to an excise tax law violation and/or the administrative burden associated with becoming an excise tax payer (had the violation been prosecuted) has significantly contributed to securing the tobacco supply chain. The experience of Poland demonstrates that securing the tobacco supply chain is complicated but also a tractable problem. This case can be widely applicable to other countries.

Ocena gminnego programu ochrony zdrowia psychicznego. / Ocena gminnego programu ochrony zdrowia psychicznego.

OBJECTIVES: The aim of this article was to assess the structure of municipal Mental Health Program. METHODS: The subject of the analysis was the Gdansk Mental Health Program for the years 2016-2023. The program was verified through comparison with the model of health policy program, developed by the Agency for Health Technology Assessment and Tariff System. Particular attention was paid to the presence of all recommended components of a program and the precise definition of terminology, especially the formulated goals, expected results and efficiency measures. RESULTS: The evaluated program does not contain required components of the health policy program. Unfortunately, this affects its quality. The document reveals a lack of estimation of the program implementation costs. The main goals and specific objectives do not meet the SMART criteria. Among the measures of effectiveness included in the program, the product indicators of quantitative nature have the largest share. Additionally, there is a lack of information on how to measure quality results and determine impact indicators. Regarding the evaluation, the assessment of the quality of services, their effectiveness and durability of the intended effects were not taken into account. CONCLUSIONS: Structural recommendations for mental health programs are needed. They would increase the effectiveness of the planned activities. Such effect could be achieved by use of criteria for health policy programs expressed in the Act of 27 August 2004 on health care benefits financed from public funds. Mental health programs would benefit if they were consulted by public health specialists.

Youth Access to Electronic Cigarettes in an Unrestricted Market: A Cross-Sectional Study from Poland.

Background: Electronic cigarette (e-cigarette) use among youths in Poland has become very popular. The aim of this study was to identify the potential points of access to these products by students aged 16⁻17 years old before implementation of sales restrictions to minors in Poland in November 2016. Methods: A school-based, cross-sectional survey was administered in 2015⁻2016 in 21 secondary/technical schools across two regions of Poland. Analyses focused on 341 students aged 16⁻17 years old who reported their past 30-day use of e-cigarettes. Pearson Chi-square analyses were utilized to examine the associations between access-related items, e-cigarette use and demographics. Results: Among youth e-cigarette users, the most common access to their first e-cigarette was from a friend (38%), followed by purchasing from vape shops (26%). Similar patterns emerged when the students were asked about their access to the currently used e-cigarette. Most youths reported no difficulty in purchasing cartridges/e-liquid containing nicotine (90%). The majority of users (52%) reported buying such products in vape shops. Conclusions: Prior to implementing age-related sales restrictions, youth access to e-cigarettes and paraphernalia did not pose any significant barriers. Poland's introduction of a new age limit on e-cigarette sales may help to limit the number of youths who purchase e-cigarettes from vape shops.

Tobacco industry interference with tobacco control policies in Poland: legal aspects and industry practices.

BACKGROUND: Since 2006, when Poland ratified the WHO Framework Convention on Tobacco Control (FCTC), there have been efforts to improve tobacco control regulation in the country. At the same time, at the European Union level, Poland took part in discussions over revision of the Tobacco Tax Directive and the Tobacco Products Directive. This study aims to explore the tobacco industry's tactics to interfere with the creation of those policies. METHODS: Analysis of 257 documents obtained through freedom of information request. RESULTS: We identified three means that the tobacco industry used to interfere with tobacco control policies: creating a positive attitude, expressing a will to be a part of the policymaking process, and exerting pressure. We found that those tactics have often been used unethically, with the industry providing the government with ready legislation proposals, overstating its contribution to the economy and the government revenues, misrepresenting the illicit cigarette problem and misusing scientific evidence. The industry also used legal threats, including use of bilateral trade agreements, against implementation of tobacco control measures. The companies lobbied together directly and through third parties, with the cigarette excise tax structure being the only area of disagreement among the companies. The industry also pushed the Polish government to challenge tobacco control policies in countries with stronger public policy standards, including UK display bans and the Australian plain-packaging law. CONCLUSIONS: From an object of regulation, the tobacco industry in Poland became a partner with the government in legislative work. Implementation of provisions of Article 5.3 of the WHO FCTC could prevent further industry interference.