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(1) Background: Colorectal cancer (CRC) is a serious health problem in Poland as well as many European Union countries. The study aimed to describe factors that, from the patient’s perspective, could increase the attendance rate and regularity of participation in the colorectal cancer screening programme (SP); (2) Methods: The qualitative approach was applied. The study involved six focus interviews conducted with 24 respondents (12 women and 12 men) aged 40–49, who had at least one first-degree family member diagnosed with CRC and persons aged 50–65, living in five selected voivodships (provinces) of Poland. The collected data were thematically coded. Further, a comparative analysis was conducted, and aggregated statements were formulated; (3) Results: The inclusion of primary care clinics within the CRC SP organization was reported as a key factor in improving the attendance rate and regularity of patient participation in the programme. Particularly important factors included an invitation in the form of a personal letter or a phone call made by staff from primary care clinics; (4) Conclusions: Patients were confirmed to have clear expectations and preferences for the organizational conditions of the CRC SP. Preferences nature allows them to be treated as one of the potential criteria for selecting critical parameters of CRC SPs.

New tobacco and nicotine-containing products are gaining more popularity among young people. The aim of this study is to assess the prevalence in the perception of e-cigarettes and heated tobacco among young people in Poland and to assess the factors that are positively correlated with this perception. A cross-sectional study covering almost 12,000 adolescents aged 13–18 was carried out in January and February 2020. Data were collected through a detailed questionnaire recommended for monitoring tobacco use by adolescents. The results of the study showed that 52.2% and 61.9% of young people perceive e-cigarettes and heated tobacco products as less harmful compared to traditional cigarettes, respectively. The risk of perceiving these products as less harmful than smoking was higher among older adolescents, males, those who used these products, had a family member who used e-cigarettes/heated tobacco products and those who were exposed to tobacco advertising. Our study indicates the need to consider the coexistence of traditional smoking, e-cigarettes and heated tobacco and its impact on the assessment of the harmfulness of these products. More research is needed to better understand how perceptions of the harmfulness of e-cigarettes and heated tobacco affect their subsequent use.

Aim: To discover the relationship between adaptive and maladaptive perfectionism and professional burnout in laboratory diagnosticians in the Pomorskie [Pomeranian] Voivodship, Poland. Material and methods: The Oldenburg Burnout Inventory (OLBI) and the Adaptive and Maladaptive Perfectionism Questionnaire (PAD) were used in the descriptive cross-sectional study. Results: Previous research suggests that the phenomenon of occupational burnout among the professional group of laboratory diagnosticians seems to have a specific nature, different from burnout in other medical professionals. It is believed that extremely high job demands, insufficient personal resources, as well as certain personality characteristics (which can alter the perceptions and responses to job demands as well as the perception and use of resources), are essential to the development of professional burnout. Conclusions: In the age of the SARS-CoV-2 coronavirus pandemic, strict compliance with safety procedures when performing tests for virus infection through laboratory diagnostics is of especially great importance to the entire epidemiological situation.

There is general agreement among scholars and policymakers that efforts to reduce smoking and prevent nicotine use should be intensified and focused on the most vulnerable part of society—adolescents. Regardless of common knowledge about the health consequences of smoking, according to data from 2020, about 51% of children in Poland had their first contact with smoking at the age of 15 and older. The objective of this research is to investigate motivations to start smoking or vaping, patterns of using tobacco products, perceptions of smoking/vaping and smokers/vapers, as well as attitudes toward nicotine addiction. The broad aim is to reflect on youth perceptions of nicotine use. A qualitative approach has been applied, utilising focus-group interviews. The sample included six focus groups, consisting of smokers and non-smokers of both genders, situated in three different cities in Poland. The interviewees were adolescents ages 16–18, attending high schools, technical schools, or vocational education. Interviews were transcribed and further analysed using the thematic analysis approach. This research enhances previously reported results by revealing new insights into the strategies applied by adolescents to mitigate financial barriers arising from high costs of nicotine products, as well as highlighting methods used to avoid the traditional antismoking messages placed on packaging.

E-prescription is already used in many countries, improving the standard of patient care. Officially, from 8 January 2020 e-prescribing has been obligated in Poland. Physicians’ and pharmacists’ opinions on e-prescribing have been widely researched and reported in the literature. In contrast, patients’ perception has, to date, received little attention. For this reason, the aim of this study was to find the features and functionalities of e-prescribing that are desired by the public and influence the positive evaluation of this tool, according to patient opinion. In order to obtain data, a questionnaire was completed by 456 randomly selected adults. The obtained results indicated that only eight people (1.8%) did not know what e-prescription is. Of the remaining 448 individuals, 72.1% prefer e-prescription because it is more convenient for them. Most patients (62.1%) also recognize that e-prescribing makes it easier to purchase medications on behalf of another patient. Based on the study, it can be concluded that e-prescription is well evaluated by Polish patients. A large percentage of respondents were positive about obtaining prescriptions for continued treatment, without a personal doctor visit. Therefore, it is reasonable to maintain the possibility of such contact with a physician. The most popular, and preferred, method of receiving e-prescriptions is via SMS. However, it is necessary to offer different options for obtaining prescriptions, to meet the needs of different populations.

Even though smoking causes numerous threats to the developing foetus, it is the most common addiction in Polish women of reproductive age. Most studies undertake to examine the subject of opposing second-hand smoking or creating tools to reprimand pregnant women more effectively using a qualitative methodology. The study aimed to determine the profile of a pregnant woman who is willing to oppose the smoking of another pregnant woman. The research was conducted using an original multiple-choice questionnaire. The survey was shared on websites for expecting parents. Completed questionnaires were collected from 11,448 pregnant women. The Wald test for logistic regression was used for statistical analysis. Predictors of whether someone would draw another pregnant women’s attention to the fact that smoking is harmful were: intellectual work (OR 1.136, p-value 0.020) and currently being a student (OR 1.363, p-value 0.004), involvement of the child’s father (OR 1.377, p-value &lt, 0.001), contact with social campaigns (OR 1.150, p-value 0.005) and knowledge about the consequences of smoking, as well as talking to the midwife about the harmfulness of cigarettes during pregnancy (OR 1.655, 0.001). Interpersonal relationships leave scope for public health interventions. It is worth enhancing criticism against smoking by specialists through information and education campaigns.

OBJECTIVES: This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. MATERIAL AND METHODS: Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 - February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. RESULTS: About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). CONCLUSIONS: Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor's encouragement and support, are crucial for successful smoking cessation in this vulnerable population

Teen use of tobacco-related products is a significant public health concern. This study evaluated the predictors of e-cigarette use among secondary school students who were never cigarette smokers and ever cigarette smokers in Poland. Methods: This study examined a sample of Polish youths aged 13–19 (n = 19,241) attending 200 schools, 12 on average in each county. The study was a part of the National Health Program in Poland for 2016–2020. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. Results: Of all participants, 32.5% were ever cigarette users. Among the never cigarette users, 13.6% were deemed susceptible to e-cigarette use. Among the ever cigarette users, 60.6% were deemed susceptible to e-cigarette use. Of those susceptible to e-cigarette use, 68.2% were among the 32.5% ever cigarette users. The profile of e-cigarette use among never e-cigarette users also included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16–17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04), and living in big cities >500,000 inhabitants (OR = 1.4; p = 0.04). E-cigarette users among ever cigarette users were similar to never cigarette users in their opinion that e-cigarette use is less harmful than traditional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). Conclusions: The major determinant of e-cigarette use in this population was prior smoking. Additionally, the results revealed that fairly obvious predictors such as parental smoking and a belief in the less harmfulness of e-cigarette use are important determinants for smoking among never or ever e-cigarette users.

Introduction Europe’s Beating Cancer Plan aims to create a “Tobacco-Free Generation” by 2040. To generate meaningful public health policy to achieve this target, we must understand more clearly the determinants of youth smoking initiation. Aims and Methods We examine the determinants of cigarette-smoking initiation in Poland using survival analysis techniques and data from four youth smoking surveys: the 2003, 2009, and 2016 Global Youth Tobacco Surveys (GYTS) and the 2019 PolNicoYouth survey (number of person-period observations N = 164 807). Split-population duration models are employed. The hazard of smoking initiation is modeled as a function of cigarette prices, nonprice tobacco-control measures, and socioeconomic variables. Results Our study finds a negative and significant relationship between cigarette prices and the hazard of smoking initiation in all models (hazard ratio from 0.86 to 0.91). Lower hazards of smoking initiation were also associated with a comprehensive advertising ban (hazard ratio from 0.69 to 0.70) and with the introduction of pictorial warnings (hazard ratio from 0.65 to 0.68). Conclusions This study concludes that cigarette price increases, such as from higher cigarette excise taxes, could further significantly reduce cigarette youth smoking initiation in Poland. Removing promotional and advertising elements from cigarette packs and making the health warning more noticeable through plain packaging laws would further accelerate the reduction in smoking initiation. Implications The European Union is currently formally reconsidering the Tobacco Tax Directive. This makes this analysis of the impact of cigarette prices on youth smoking initiation both timely and germane. As ever more countries implement standardized cigarette packaging, findings here provide support for this measure that removes advertising elements from the packs and makes the health warning more noticeable.

Nosocomial infections pose a serious burden for hospitals, patients, and the entire society. The aim of the study was to assess the microbiological cleanliness of the hospital environment through quantitative and qualitative analysis of microbiological contamination of air and surfaces in inpatient treatment facilities, based on the example of a large clinical hospital in Poland. Data were collected between 2012 and 2018 in premises of a large teaching hospital in Gdansk using the sedimentation method and the impact method using the Aerideal apparatus (Biomerieux). In the analyzed clinical center, the microbiological cleanliness tests in most of the hospital rooms in the analyzed period showed an acceptable number of saprophytic microorganisms. Of all the tested samples, 1159 (21.8%) were positive, indicating the presence of microorganisms in the tested sample. Species potentially pathogenic for hospital patients were identified, constituting 20.8% of all positive samples (4.6% of all samples). Significantly higher proportion of microorganisms potentially dangerous to patients were isolated from sanitary facilities. Due to the potentially pathogenic microorganisms detected in the tested samples, the authors suggest that in the analyzed hospital, the areas requiring a specific level of microbiological purity should be designated and described, with [specifically] defined cleaning and disinfection protocols.

Background: E-prescribing is the most important achievement in the automation of the healthcare sector in Poland. Obligatory electronic prescribing came into force on 8 January 2020. This innovation significantly changes the work of doctors. Therefore, it is useful to identify the factors that have an impact on doctors&rsquo, acceptance levels for the new technology. Methods: This study employs a survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) method. Our questionnaire was completed by 144 family doctors in Poland during the technology implementation phase and the initial period of obligatory e-prescribing, between 1 December 2019 and 1 March 2020. Results: The results of the survey indicate that doctors do not believe that e-prescribing improves the effectiveness of their work. In addition, this attitude does not depend on the age of the respondent. We also found, regarding the influence of societal attitudes, that doctors only rarely consider the opinions of others in relation to their job. Conclusions: The implementation of new technologies in the healthcare system must be accompanied by consideration of how user-friendly the technologies are, and whether the users will have appropriate technical and financial support.

Background: E-prescribing is the most important achievement in the automation of the healthcare sector in Poland. Obligatory electronic prescribing came into force on 8 January 2020. This innovation significantly changes the work of doctors. Therefore, it is useful to identify the factors that have an impact on doctors’ acceptance levels for the new technology. Methods: This study employs a survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) method. Our questionnaire was completed by 144 family doctors in Poland during the technology implementation phase and the initial period of obligatory e-prescribing, between 1 December 2019 and 1 March 2020. Results: The results of the survey indicate that doctors do not believe that e-prescribing improves the effectiveness of their work. In addition, this attitude does not depend on the age of the respondent. We also found, regarding the influence of societal attitudes, that doctors only rarely consider the opinions of others in relation to their job. Conclusions: The implementation of new technologies in the healthcare system must be accompanied by consideration of how user-friendly the technologies are, and whether the users will have appropriate technical and financial support.

Background The problem of tobacco use among minors and in their immediate environment remains a significant challenge in Poland. Although Poland has passed smoke free law children are still being exposed to tobacco smoke. The purpose of this study was to analyze the phenomenon of tobacco use by children in City of Sopot and in their surroundings. Methods The cross-sectional study was conducted as part of the SOPKARD program for early detection of risk factors for civilization diseases in children and adolescents. A limited GYTS questionnaire was utilized to conduct the study. Data was collected from all the fifth grade students (9-11 yo) attending to Sopot primary schools in 2017 and 2018. Results The study involved 385 students (161 in 2017 and 224 in 2018). Only few students tried to smoke traditional cigarettes (3%) or use electronic e-cigarettes (2%). Despite the legal ban, 24% of students saw smokers in the school premises. In addition, 34% of children said that one or both of their parents smokes and that in only slightly more than ¾ of the houses smoking is completely prohibited. As many as 66% of students reported smoking incidents in the cars they travel. There were 16% students who think they could start smoking in the future. Conclusions The results suggest that Sopot children are still exposed to tobacco smoke inhalation. It happens in private, non-smoking areas (homes and family cars). It is worth conducting educational activities and considering legislative initiatives such as smoking ban in vehicles carrying children to stimulate parents to take care more of the health of their children. Key messages Although tobacco legislation in Poland protects people from passive smoking in public places children are still exposed in private premises. Ban on smoking should be extended to privates cars at minimum.

Background Even though vaccinations are referred to as one of the greatest achievements of modern medicine, they are constantly associated with the mood present in part of society denying their sense and effectiveness. The development of technology has moved discussions about vaccinations to the space of the internet. The study aims to analyze the arguments of vaccine-deniers of children use in social media. Methods All public comments from the leading Facebook page of opponents of vaccination on Facebook were collected, which were available there between 01/05/2019 and 31/07/2019. Then the comments were stored on a Google spreadsheet and analyzed quantitatively in terms of the content according to the modified method developed by Kata (Kata, 2010). Results 18685 comments were analyzed, of which 4042 contained content within the adopted criteria: 28.2% concerned conspiracy theories, 19.9% covered misinformation and based on unreliable premises, 14.0% related to the safety and effectiveness of vaccinations, 13.2% to non-compliance with civil rights, 10.9% own experience, 8.5% of morality, religion, and belief, and 5.4% of alternative medicine. There were also 1223 pro-vaccine comments, of which 15.2% were offensive, mocking or non-substantive. Conclusions A relatively large amount of content concentrated in terms of conspiracy theories and disinformation may indicate that this is a community characterized by a lack of trust in the scientific achievements of medicine. Surprisingly many comments related to one's own negative experiences with vaccinations, which contrasts with official statistics about side-effects. Vaccination promotion should refer to the arguments of vaccination opponents. Key messages The tendency of vaccine-hesitancy is strengthened by 'anti-vaccine' content in social media. To understand the individuals we need to understand what information he daily learns from the internet. It can be hard to maintain herd immunity, due to the prevailing misinformation on vaccination. To overcome this phenomenon, information campaigns must be dependent on the content in social media.

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&ndash, 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.

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.

Cel pracyOcena struktury gminnego programu ochrony zdrowia psychicznego.MetodaPrzedmiotem analizy był Gdański Program Ochrony Zdrowia Psychicznego na lata 2016-2023. Dokonano weryfikacji zawartości oraz analizy treści dokumentu w porównaniu z dostępnym wzorem programu polityki zdrowotnej, opracowanym przez Agencję Oceny Technologii Medycznych i Taryfikacji. Wzięto pod uwagę obecność wszystkich punktów zawartych we wzorcu oraz precyzję zawartych w nich określeń, zwłaszcza sformułowanych celów, oczekiwanych rezultatów oraz mierników efektywności.WynikiOceniany program nie zawiera wzorcowych elementów właściwych dla programów polityki zdrowotnej, co pod względem merytorycznym obniża jakość. W dokumencie ujawniono brak oszacowania kosztów realizacji programu. Sformułowane cele główne oraz cele szczegółowe nie spełniają kryteriów SMART. Wśród zawartych w programie mierników efektywności, największy udział mają wskaźniki produktu o charakterze ilościowym. Brakuje natomiast informacji na temat sposobów mierzenia rezultatów jakościowych oraz określenia wskaźników wpływu. W kwestii ewaluacji nie została wzięta pod uwagę ocena jakości świadczeń, ich efektywności oraz trwałości zamierzonych efektów.WnioskiPotrzebne są rekomendacje dla kształtu programów zdrowia psychicznego, co zwiększy skuteczność planowanych w nich działań. Efekt taki zostałby osiągnięty poprzez stosowanie do takich programów kryteriów i procedur wymaganych dla programów polityki zdrowotnej określonych w ustawie z dnia 27 sierpnia 2004 roku o świadczeniach opieki zdrowotnej finansowanych ze środków publicznych. Przy tworzeniu programów warto oprzeć się na wiedzy specjalistów z zakresu zdrowia publicznego.

Global mental health programs and interventions are increasingly adopting social inclusion as a key outcome measure and this reflects the emerging need for a global measure of social inclusion that was tested in diverse cultural settings (Baumgartner and Burns in Int J Epidemiol 43:354–364, 2014). This paper reports the results of adapting the Social and Community Opportunities Profile (SCOPE) developed in UK (Huxley et al. in Health Technol Assess 16:1–248, 2012) to Poland. The subjective and objective experience of social inclusion among 180 individuals with mental illness in Poland was measured using SCOPE-P. Participants were recruited through a non-probability sampling method in June–July 2017. Findings illustrated that (1) satisfaction with opportunities and perceived opportunities were positively correlated with overall social inclusion; (2) overall social inclusion was negatively correlated with discrimination, and (3) overall social inclusion was positively correlated with health conditions. This study provides further empirical evidence to support the use of SCOPE in a cross-cultural context.

Presently, a growing popularity of electronic cigarettes may be observed. Used as a means of obtaining nicotine they allow to substitute traditional cigarettes. The origins of substance use disorders are conditioned by dopaminergic signaling which influences motivational processes being elementary factors conditioning the process of learning and exhibiting goal-directed behaviors. The study concentrated on analysis of three polymorphisms located in the dopamine receptor 2 (DRD2) gene&mdash, rs1076560, rs1799732 and rs1079597 using the PCR method, personality traits determined with the Big Five Questionnaire, and anxiety measured with the State Trait Anxiety Inventory. The study was conducted on a group of 394 volunteers, consisting e-cigarette users (n = 144) and controls (n = 250). Compared to the controls the case group subjects achieved significantly higher scores in regard to the STAI state and the trait scale, as well as the NEO-FFI Neuroticism and Openness scale. Likewise, in the case of the STAI state for DRD2 rs1076560 significant differences were found. Furthermore, while comparing the groups (e-cigarette users vs. controls) we noticed interactions for the NEO FFI Neuroticism and DRD2 rs1076560. The same was observed in the case of interactions significance while comparing groups (e-cigarette users vs. controls) for the STAI trait/scale and DRD2 rs1799732. Findings from this study demonstrate that psychological factors and genetic determinants should be analyzed simultaneously and comprehensively while considering groups of addicted patients. Since the use, and rapid increase in popularity, of electronic cigarettes has implications for public health, e-cigarette users should be studied holistically, especially younger groups of addicted and experimenting users.

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 industry9s 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.

Objectives The aim of the work was to assess among pregnant women from small towns and villages in Poland: the prevalence of smoking, credibility of smoking, and influence of socioeconomic factors on smoking status. Methods The data came from 4512 interviews with women in different trimesters of pregnancy. The interviews were collected in 2007 and 2008 year in towns up to 8000 citizens in 12 voivodeships. Results Prevalence of smoking in the beginning of pregnancy was confirmed by 34.6 % of women. During the pregnancy 14.7 % of women declared quitting smoking and 19.9 % continued smoking. Cigarette smoking was most frequent in those with a primary education, unemployed, very low incomes in household, and having both smoking parents. In multifactorial analysis, risk of smoking was highest (95 % CI 1.74–6.06) for women that were divorced or not living with a partner compared with married. Conclusions Rates of active smoking among a population of pregnant women living in small towns in Poland are very high. Since the correlates of smoking during pregnancy are a low education level and a low economic status of the pregnant woman, these socioeconomic groups should be first priority targets.

Research shows that over 80% of smokers start their habit under the age of 18. A few years ago young people undertook risky behaviors related to nicotine initiation mainly by smoking cigarettes. Today, next to traditional tobacco products, electronic cigarettes are becoming more and more popular. Due to the prevalence of new forms of nicotine addiction, modification of anti-tobacco prevention programs is required. The purpose of the research was exploration - learning the opinions and attitudes of young people towards e-cigarettes. The qualitative study was conducted using the FGI method (focus group interview). The meetings were modereted by specially trained psychologists. 48 students participated in the meetings of six focus groups, divided by gender and smoking status (smokers/non-smokers). The participants are young people aged 15-19, attending high schools in Warsaw, Kielce and Lublin. In conversations, young people emphasized the impact of e-cigarettes in smoking initiation - it usually occurs at the age of 12-14. E-cigarettes are perceived as cigarettes “for younger”, non-addictive, less serious, providing more entertainment. 'Cloud chasing' is particularly popular. They perform social functions - they are helpful in establishing relationships. Teenagers do not see the harmfulness of e-cigarettes. Participants mentioned their advantages over traditional tobacco products - they can be smoked everywhere and do not leave an unpleasant smell. Some of the respondents admit to the simultaneous use of electronic and traditional cigarettes. Moreover, many parents allow children to smoke electronic cigarettes. Vaping have become a natural way to relaxation and socialization for adolescents. E-cigarettes do not have such a negative connotation as traditional tobacco products. Young people do not see them as harmful, which is a challenge for effective preventive measures. Key messages Adolescents do not see e-cigarettes as harmful, which is a challenge for effective preventive measures. Vaping have become more and more popular - it's natural way to relaxation and socialization for young people.