Against odds, doctor helps Poland start to kick habit

Focus on damage to health, economy leads to reforms

March 27, 2002|By Bill Glauber | Bill Glauber,SUN FOREIGN STAFF

WARSAW - For three decades, Witold Zatonski sought to stamp out Poland's fatal addiction to cigarettes.

In a nation of smokers, he was a nicotine noodge, a rebel doctor advancing a singular cause: to get Poland to kick a habit.

With the old Communists, this wily clinician talked pure science. With the new capitalists, he added an economic twist, saying the nation's health and wealth were going up in smoke.

"They thought I was a little crazy, a fanatic," Zatonski said of those long-ago meetings with government bureaucrats, some of whom, he added, puffed away on cigarettes while he made his pitch.

But the "fanatic" won - and so did Poland's national health - as the country moved into the forefront of Eastern Europe's fight back against Big Tobacco.

"I love smokers," Zatonski said. "I know smokers are similar like I am. I am doing this with love for them."

For a lot of Polish smokers, though, Zatonski's efforts as the de facto head of Poland's anti-smoking lobby created something of an obstacle course, especially by the old standards of Eastern Europe, where people lighted up cigarettes almost everywhere.

Over the past seven years, Poland has moved aggressively against tobacco products. Smoking is banned from schools, health care facilities and workplaces, although there are smoking areas for workers. Legislation forced manufacturers to slap warning labels on cigarette packs, abolished tobacco advertising and sponsorship of sporting and cultural events, and jacked up cigarette taxes.

Marlboros at $1.50 a pack may not seem all that expensive by American standards, but a Polish worker on an average salary works 56 minutes for that one pack of 20 cigarettes, according to the World Health Organization.

The payoff for Poland? Declining rates of smoking.

And a lot of the credit for this transformation in a society's mores and health belongs to Zatonski.

He works at the Maria Sklodowska-Curie Memorial Center and Institute of Oncology, which teems with health-care workers and patients, some of whom seem to be searching for a miracle.

Zatonski directs the hospital's Epidemiology and Cancer Prevention Department. He's 59, barrel-chested and amiable. During an hourlong interview he moves between his office and a conference room, bearing old case studies while also telling old war stories of life on the front lines against tobacco.

He points to a bunch of old cigarette packs, including one heralding the old Solidarity trade union, which helped bring down communism in Poland. Lesser known is that Solidarity once threatened a national strike if the then-state owned tobacco companies raised the price of cigarettes.

He talks of his mother, who died at 62 from emphysema connected with smoking.

Zatonski says his life and career are in "two parts." In that first life, he was a clinician who treated patients, including those suffering from cancer. He read and traveled widely, forging links with medical colleagues in the West, including the United States.

"I met crazy Americans who told me what I was doing was rubbish," he said. "They told me I had to be concerned with public health to diminish people's exposure to tobacco smoke. Because we loved Americans, I was taking this message very seriously."

But taking that anti-smoking message back to Poland - his "second life" - proved a daunting task. Smoking wasn't such a big-deal in pre-World War II Poland, but the habit spread after the war, with cigarettes viewed as symbols of prosperity and freedom. To smoke was to feel free, to feel Western.

By the early 1980s, Poles were the world's heaviest smokers, with more than 60 percent of the population lighting up daily - about 15 million people. That number has dropped to 9 million.

The nicotine addiction fit in nicely with a Communist regime that needed the influx of cash from the state-owned tobacco companies.

Few, it seemed, wanted to listen to Zatonski's simple message.

"I said Poles are dying because they are smoking. It is an important social as well as an important health phenomenon. I was trying to show this to the Polish population, to tell them what was wrong. People were not believing that tobacco was causing disaster."

Before the fall of the Berlin Wall in 1989, Zatonski dealt mostly with government officials, scientists and several thousand adherents of the Polish Anti-Smoking Society, which he led. But with the rise of democracy throughout Eastern Europe, Zatonski's no-smoking campaign gathered steam: "You could carry your message to the general public. More and more people wanted to hear that message."

But even as Zatonski was publicizing his cause, Western tobacco companies were buying into the Eastern European market. Poland was a prize because of its ample supply of smokers.

But they didn't count on Zatonski.

Zatonski courted attention any way he could, going so far as to write President Bill Clinton that "we need your jeeps, your computers, your technology, your democracy. We don't need cigarettes."

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