Initiatives for smoking

and COPD control

- selected projects

Health Promoting Hospitals Network

Małgorzata Czajkowska-Malinowska

Kujawy-Pomorze Center of Pulmonology in Bydgoszcz, Poland

Breath of Hope Foundation in Bydgoszcz, Poland

Member of International COPD Coalition (ICC)

InitiativesInitiatives for smoking for smoking controlcontrol

• Projects for pre-school and primary school children,

parents and grandparents – protection from passive

smoking

• Projects for secondary school children (age 16-17) –

„Leaders Prevention”

• „Anti-smoke Projects” for schools and regional hospital –

Kujawy-Pomorze Center of Pulmonology in Bydgoszcz

• Annual projects organized for the whole Bydgoszcz

community:

– May Days without Tobacco Smoke - 27-31 of May

– Celebration of the International Smoke-out day – Quit-smoking

competition

InitiativesInitiatives for smoking for smoking controlcontrol

• Projects for pre-school and primary school children,

parents and grandparents – protection from passive

smoking

• Projects for secondary school children (age 16-17) –

„Leaders Prevention”

• „Anti-smoke Projects” for schools and regional hospital –

Kujawy-Pomorze Center of Pulmonology in Bydgoszcz

• Annual projects organized for the whole Bydgoszcz

community:

– May Days without Tobacco Smoke - 27-31 of May

– Celebration of the International Smoke-out day – Quit-smoking

competition

IntroductionIntroduction

National surveys in adult Polish population demonstrated

• > 60% smoke daily at the presence of children

• > 30% smoke at the presence of pregnat women

• 27% of women at childbearing age smoke

It has serious impact on children’s health in Poland.

The pilot study conducted in Bydgoszcz in May 2001

showed that 77% of children aged 7-9 are at risk of

passive smoking at their homes.

GeneralGeneral projectproject backgroundbackground

The intervention pilot program coordinated by the „Breath

of Hope” Foundation was developed in two local

communities, towns of Bydgoszcz and Ciechanów.

The program was a part of the WHO/US EPA international

project

„Clearing the air from tobacco smoke pollution: creating

healthy and safe environments for children”.

AimsAims

1. To increase the number of totally smoke-free

schools and kindergardens

2. To increase the number of smoke-free homes

with small children

3. To increase the cessation rate in women of

childbearing age.

The main idea of theprogram was:

• children are supposed to protect their Tymeks fromtobacco-smoke

• just as the parents shouldprotect their children

The City Mayor should in turnprotect all the citizens.

The symbol of this project is a specially

designed teddy-bear called Tymek-

Niedymek (available as a plush toy, piggy-

bank, logo on t-shirts etc.).

• The population of Szwederowo district was targeted.

• The coordination team consisted of:

District Council representatives, Priest, Director of a local

Culture Center, Principals of District Schools and

Kindergartens, teachers, school pedagogue, journalist,

pediatrician, gynecologist, midwife, police and municipal

guard representatives

• Lectures, educational film on hazards of smoking shows

for students, parents and teachers in kindergartens,

primary and secondary schools

• Discussion on hazards of smoking included into the

regular pre-marital counseling in local parishes

• Training for doctors and nurses on minimal intervention

technique

• Mass spirometric examination combined with doctor’s

advice for the population of the District and teachers from

the schools participating in the program

• Cessation Clinic opened for the citizens of the District and

for teachers working at the schools and kindergartens

included into the program

• Media campaign with messages about the program, experts interviews,

radio and Tv spots and reports, press articles and notes, press

conferences.

• Media involved:

Local TV3 station, National TV Channel 2,

Local radio stations: „Radio PiK” and „PLUS”,

daily newspaper „Gazeta Pomorska”,

local theatre

district Cultural Centre

• Education materials were prepared and distributed health (advisory kit,

leaflets, posters, toys, gadgets)

Primary school kids in presence of their parents have just received the

task of protecting their Tymeks from tobacco smoke

Anti-smoking street parade of 600 children on WHO No TobaccoDay – Bydgoszcz No Smoking Days with handing a petition on appointing smoke-free areas to Bydgoszcz Mayor

Children from Kindergarten included in the program

hand the Big Tymek to the president of Bydgoszcz

Spot telewizyjny Spot telewizyjny „„Nie pal przy mnie Nie pal przy mnie

proszproszęę”” –– emisja w TVP3 58 emisja w TVP3 58 -- krotniekrotnie

ResultsResults

Program Program participationparticipation

• The intervention included 3 870 children,

• 253 teachers and educators, around 50 doctors, nurses,

psychologists, health promotors

• The program included 8 kindergartens, 9 primary schools,

4 gymnasiums and 2 high schools

BehavioralBehavioral

changeschanges

• 93% of participating children discussed with their parents

the anti-smoking issues

• 72% asked parents not to smoke in their presence

• 68% of 950 parents filled a written declaration not to smoke

around their children and to make their homes smoke-free

33,00%

77,00%

42,00%

58,00%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Baseline study After 1 year of program

realisation

children from smoke-free homes

children at risk of ETS at home

InstitutionalInstitutional

changeschanges

• All participating schools introduced a program of settingthe school free from tobacco smoke

• all kindergartens and primary schools, 1 gymnasium and 1 highschool introduced a total ban of smoking on theirpremises. (The only smoking primary school headmasterquited smoking due to the program

• Soon after the street parade of 600 children, the City Council appealed via all local media to the Bydgoszcz citizens to obey anti-smoking laws and not to smoke in thepresence of children

• The president of Breath Of Hope Foundation was invited to present the proceedings and results of the program at the

City’s Health and Education Commission meeting

ResultsResults andand

futurefuture

• local coalition for children’s health protection was

created;

• program will to be continued as it proved effective in

reducing the children exposure to the enforced passive

smoking in their homes

• Realisation of the program turned out to be more difficult

as far as involving medical professionals and outpatient

clinics was concerned. This points to the need of

targeting also the medical professionals with educative

campaigns.

TheThe ParadeParade on on thethe StreetsStreets ofof Bydgoszcz: Bydgoszcz: 40004000 childrenchildren carriedcarriedandand releasedreleased 4000 4000 blackblack baloonsbaloons symbolisingsymbolising thethe 4000 4000 thousandthousand

chemicalschemicals presentpresent inin tobaccotobacco smokesmoke..

The International

Smoke-out Day

Smoke-out Day

The Parade on

the Streets of

Bydgoszcz –

children carry

posters with

names of

chemicals

present in

tobacco smoke

• Durign the Smoke-out Parade the group of 56 volounteers

polled 1216 subjects – 38% (462) smokers and 62% (754)

non-smokers

– 42% (511) of the polled believed that the smoke-out

campaign suported smokers in making decision to quit

– 72% (876) supported introduction of a total ban on

smoking in public places;

– 21% (256) were against it

– 7% (84) were not sure

F U N D A C J A

NADZIEI

CelebrationCelebration ofof InternationalInternational SmokeSmoke--out day out day

„„QuitQuit--smoking competitionsmoking competition””

• 189 persons have returned the „I don’t smoke anymore”coupons printed in local newspapers (Gazeta Pomorska, Express Bydgoski, Gazeta Wyborcza)

F U N D A C J A

NADZIEI

Clippong from Gazeta Pomorska about

the „I don’t smoke anymore”

competition titled: „The right decision

Winner of „I din’t smoke anymore”

receiving the main prize

Since1999 annual

Bydgoszcz Days without

Tobacco Smoke (27-31 May)

have been organized

The main objectiveThe main objectivess

of the program wof the program wereere

•• to increaseto increase

smokingsmoking--cessation ratecessation rate

in Bydgoszczin Bydgoszcz

• to educate the citizens of

Bydgoszcz on health,

social and economic

consequences of smoking

•

• enforcing the execution of the

anti-smoking law

• demanding, creating

and respecting smoke-free areas in

our city

• quit smoking and stay cigarette-free

program

• creating an effective local coalition for

promoting of healthy life-style in our

society

• involve as many locals as possible in

promoting and carrying-out of our

program

InitiativesInitiatives for COPD for COPD controlcontrol

• Activity of COPD treatment school with

the help Boehringer Ingelheim Company

– Workshop for physicians about COPD

(presentation of guidelines) - 268

physicians participated

– Local COPD patients group – currently 321

subjects

– Monthly educational meetings for patients

– Free consultations for patients

– Psychological advice

InitiativesInitiatives for COPD for COPD controlcontrol

• Spirometric Workshop for physicians

• Spirometric Workshop for nurses who carry out

Project of Early Diagnosis of COPD

• Workshop for family doctors “How to help your

patient to quit smoking?” (on implementation of

minimal anti-smoking intervention) organized in

co-operation with Polish Respiratory Society

• Celebration of World COPD Day in cooperation

with local authorities

InitiativesInitiatives for COPD for COPD controlcontrol

• spirometry as a tool for early diagnosis of COPD

– Measurements at local TV station and spirometry

presentation on air

– Measurements at local publishing houses and

radio

– At the Meeting of Local Council in Bydgoszcz

– At the Meeting of Regional Kujawy-Pomorze

Council

• Free telephone line– practical information about

COPD and smoking cessation

Spirometry and smoking cessation advice

in high risk group

Effects of repeated spirometry

and smoking cessation advicein COPD group

55%49,3%

46,80%41,20%

26%19,4%

13,60%7,20%

19%

31,3%

39,60%

51,60%

0%

20%

40%

60%

80%

100%

current smokers temporary

cessation

permanent quitters

after 1 year

after 2 years

after 3 years

after 4 years

Effects of repeated spirometry

and smoking cessation advice

in Control group

73% 68,5%68,40%

62,20%

19% 17,5%

10,10%11,60%

8%14,0%

21,50%

26,20%

0%

20%

40%

60%

80%

100%

current smokers temporary

cessation

permanent

quitters

after 1 year

after 2 years

after 3 years

after 4 years

World COPD Day 2004 conference for patients,

physicians, nurses, journalists, politicians and local

authorities.

World COPD Day 2004

„Don’t Ignore COPD”

Patients’ representative

The President of Bydgoszcz

World COPD Day 2005

Concert of J. Strauss

Chamber Orchiestra in

Opera House in Bydgoszcz

World COPD Day 2006

Breathless not Helpless!

World COPD Day 2006 Breathless not Helpless!

Reading and signing patients’ petition

" About tobacco smoke influence "- humorous story of Cechov- Mieczysław Giedrojć - Teatr Małych Form, Bydgoszcz

Media campaignMedia campaign

• press conferences, press articles,

interviews (press, radio, TV)

• COPD patients on TV and radio

• Documentary about patients with respiratory

failure treated with oxygen at home

• TV programs and short films about COPD and

hazards of passive and active smoking

• Production and broadcasting of anti-smoking TV-

and radio - spots

Age

FEV1%