Warsaw, 20 May 1997 (RFE/RL) -- World Health Organization statistics prove what any visitor to Poland will notice instantly: Poles are the heaviest smokers in the world.
No one smokes like Poles. Until the government clamped down recently, Poles never refrained from smoking in tiny cramped elevators, or even lighting up in hospital wards and doctors' waiting rooms.
In the 20 years between 1972 and 1992, Poland zoomed from 11th place to first in world cigarette consumption. Figures for 1990-1992 (the latest available) show Poles consume an average of 3,620 cigarettes per person each year. In a country like the United States, for example, where anti-smoking campaigns have been going on for decades, the per-capita figure is 26 percent lower than in Poland.
But even in the home of the world's heaviest smokers, there are the first signs that attitudes are changing. Tadeusz Parchimowicz, spokesman for the Polish Health Ministry, bluntly declares that: "Smokers have become terrorists."
That may be overstating the case, but it sums up the official government attitude. A year ago Poland enacted the toughest anti-tobacco law in any of the former Communist countries of Eastern Europe or the former Soviet Union, aimed at making smokers pariahs in Polish society. The World Bank has praised it as a "courageous" move.
But Poland's anti-smoking crusaders are up against longtime entrenched attitudes and behaviors when they try to discourage smoking.
"We still have a barbaric attitude towards smoking," says Witold Zatonski, a Polish cancer specialist who has emerged as the unofficial leader of Central and Eastern Europe's anti-smoking movement.
Heavy smoking is taking a deadly toll in high rates of lung cancer and heart disease. Lung cancer kills half of all Polish men who die before reaching 65.
And -- bad news -- more women are still taking up the habit.
"Polish women are starting to smoke like men and they are starting to die like men, of lung cancer," says Parchimowicz.
The aims of the anti-smoking law are to prevent young people from starting to smoke and to protect the lungs of non-smokers against second-hand smoke -- a revolutionary idea in this part of the world.
The law forbids smoking in public buildings and private office buildings, unless the employer sets aside one designated smoking room with its own separate ventilation system.
Last month the Polish parliament voted to go ahead with the next step -- requiring unambiguous health warnings, such as "smoking causes cancer" and "smoking causes heart attacks." They will have to take up 30 percent of surface of every cigarette package, and be prominently displayed in advertising. Tobacco advertising is banned on television and radio, in cinemas, youth and children's publications, and at hospitals, schools and sporting events.
Parchimowicz says that Poles have already gotten used to not smoking on city trams, and must now accept that they can't smoke on inter-city trains, either.
"It should be like in Canada. If you want to smoke, buy a car and drive by yourself," he says.
At the same time that Poland is trying to discourage smoking, Western cigarette manufacturers, driven by the drastic decline in smoking in North America, are targetting Eastern Europe as a fertile field for future growth.
East Europeans consume more than 700 billion cigarettes each year -- 40 percent more than U.S. smokers -- and experts say the number is rising.
Gary Giddings, a British researcher who has studied the global tobacco market says Eastern Europe "is booming. It is still relatively untapped."
Tobacco companies -- including U.S. giants R.J. Reynolds and Philip Morris, Britain's BAT Industries and Germany's Reemstra -- are more active in Central and Eastern Europe than anywhere else in the world, buying up local cigarette factories and advertising heavily.
In the early days of its implementation, the results of Poland's anti-smoking law are mixed. Poland's cigarette manufacturers report that cigarette sales dropped last year by about eight percent compared to 1995 -- and that consequently the jobs of more than 60,000 Poles in the tobacco industry are at risk.
But Zatonski calls this alarmist propaganda aimed at overturning sections of the law. He argues that the tobacco companies are still telling their shareholders abroad that Poland is a booming market.
Parchimowicz at the health ministry concedes that "the law itself will not change much, but the law helps others to change attitudes." He says there is evidence that more young people are resisting the lure of the Marlboro man, and fewer youths are taking up smoking.
Zatonski agrees that the prevalence of smoking among the Polish population has dropped off in the last 15 years, and that the fraction of men in the population who have never smoked is increasing.
With Poland starting at such a low level, any progress is important, says Zatonski.
"Compared with America or Canada we are still a barbaric country, but we are going faster than any other East European country," he says.
(This is part four of a four-part series about health in Central and Eastern Europe. See Condition: Serious -- Health In The East