Search

Early life is a crucial window of opportunity to improve health across the life course. The prospective cohort study design is the most adequate to evaluate the longitudinal effects of exposure, the notification of changes in the exposure level and evaluation of the simultaneous impact of various exposures, as well as the assessment of several health effects and trajectories throughout childhood and adolescence. This paper provides an overview of the Polish Mother and Child cohort (REPRO_PL), with particular emphasis on Phase IV of this study. REPRO_PL is conducted in central Europe, where such longitudinal studies are less frequently implemented. In this population-based prospective cohort, which was established in 2007, three phases covering pregnancy (I), early childhood (II), and early school age (III) periods have already been completed. Phase IV gives a uniform opportunity to follow-up children during adolescence in order to evaluate if the consequences of prenatal and early postnatal exposures still persist at the age of 14. Moreover, we will be able to investigate the associations between simultaneous exposures to a broad spectrum of environmental factors, adolescents' health and neurobehavioral outcomes, and their trajectories within life, which is a novel framework of high scientific, public health and clinical priority., This study was supported by the grants from the National Science Centre (Nos. 2014/15/B/NZ7/00998, 2017/25/B/NZ5/02338, and 2021/41/B/NZ7/04341). MG acknowledges the support from the IDAEA-CSIC Severo Ochoa Excellence Programme through the Grant CEX 2018-000894-S funded by MCIN/AEI/10.039/501100011033.

The objective of this study was to evaluate compliance with the ban on tobacco and e-cigarette products advertising at point of sale (POS) before and after amendment of the Polish Tobacco Control Act. Data were collected, using an observation checklist, between March and October 2014 (n = 1450 POS) and between March and October 2019 (n = 1320 POS). Ban on tobacco and e-cigarette advertising at POS is commonly violated in Poland. In all POS, at least one form (including tobacco products display) of tobacco advertising was found in 2014 and in 2019. The most common types of tobacco advertising in 2014 were change and counter mats (61%, 42%), posters (38%) and illuminated banners (37%). In 2019, a decrease in promoting tobacco products in the form of mats (p ≤ 0.001), posters and boards (p &lt, 0.001) but an increase in video screens were observed (from 8% in 2014 to 30% in 2019, p &lt, 0.001). A significant increase in the presence of any e-cigarette ads, including e-cigarette displays, illuminated banners and video screens, was observed in 2019 as compared to 2014 (90% vs. 30%, 89% vs. 20%, 31% vs. 2%, 31% vs. 0.5%, 0.001). The minimum age or a no-sale-to-minors signs for tobacco and e-cigarettes were not sufficiently placed in POS to comply with the Act. Poor enforcement of the ban on tobacco and e-cigarette ads at POS provides the tobacco industry with an opportunity to promote their products using unlawful ways. There is a need to educate the public, retailers and civil society with respect to their legal responsibilities and roles.

Alcohol consumption at a level exceeding existing recommendations is one of the leading risk factors for death and disability worldwide. The aim of the study was to identify correlates of alcohol drinking among a socially-disadvantaged population in Poland. The cross-sectional study covered 1644 adult social assistance beneficiaries from the Piotrkowski district (rural area in central Poland). A detailed questionnaire filled in during a face-to-face interview allowed for the collection of socio-demographic, lifestyle-related (including alcohol consumption) and health status data. About 42% of the participants, including 67% of the men and 30% of the women, exceeded the recommended level of alcohol consumption. In the adjusted model, the men tended not to follow recommendations for alcohol consumption more frequently than the women (OR = 4.5, p &lt, 0.001). The higher odds of not following alcohol-related recommendations were also observed for the subjects declaring having a permanent or temporary job compared to the unemployed participants (OR = 1.2, p = 0.04). A lower healthy lifestyle index (indicating an unhealthy lifestyle related to a diet, body mass index (BMI), physical activity, and tobacco smoking) was associated with not following recommendations for alcohol consumption (OR = 1.1, p = 0.04). Our study indicates that being men, having a permanent or a temporary job, and coexistence of other unfavorable lifestyle-related factors are important correlates of not following recommendations for alcohol consumption among the beneficiaries of government welfare assistance.

As part of cardiovascular disease prevention, the performance of BMI determination, blood pressure measurement, biochemical tests, as well as a lifestyle-related risk assessment are recommended. The aim of this study was to evaluate the correlates of blood pressure and cholesterol level testing among a socially-disadvantaged population in Poland. This cross-sectional study was performed between 2015 and 2016 among 1710 beneficiaries of government welfare assistance. Face-to-face interviews conducted by trained staff at each participant&rsquo, s place of residence allowed for completion of questionnaires that covered socio-demographic, health and lifestyle-related information. Sixty-five percent of the participants declared a blood pressure and 27% of them cholesterol level testing at least once within the year proceeding the study. A higher chance of having blood pressure testing was observed among the women (OR = 1.5, p = 0.002) and people with high blood pressure (OR = 3.9, p &lt, 0.001). The women (OR = 1.4, p = 0.04) and older people (OR = 1.9, p = 0.02, OR = 2.6, 0.001, OR = 2.7, p = 0.002, for the following age groups: 30-39, 40-49, 50-59 years respectively), the respondents who declared health problems such as heart attack (OR = 3.0, p = 0.04), high blood pressure (OR = 2.3, 0.001) and type 2 diabetes (OR = 3.3, p = 0.004) and those with a family history of chronic diseases (OR = 1.5, p = 0.03) had a higher chance of cholesterol level checking. Higher healthy lifestyle index, indicating that the study participants have followed almost all of the studied lifestyle-related recommendations, was a significant correlate of cholesterol level testing (OR = 1.7, p = 0.006). Actions that promote lifestyle changes, blood pressure, and cholesterol level testing should take into account the needs of the disadvantaged population and should especially target men, people with existing chronic diseases, and those with unfavorable lifestyle characteristics. With respect to the socially-disadvantaged population, the social assistance institutions and outpatient clinics are the best places to conduct activities promoting a healthy lifestyle. The most commonly applied strategies to promote lifestyle changes can cover risk assessment, increasing awareness, emotional support and encouragement, as well as a referral to specialists.

The aim of the study was to assess whether general practitioners (GPs) monitor and evaluate the health behavior of their patients in the field of a diet, physical activity, and weight control, and whether they provide appropriate counselling as part of this evaluation. Predictors of those activities among physicians were also determined. The cross-sectional study was conducted in the Piotrkowski district among 200 GPs. The questionnaire covered socio-demographic data and lifestyle characteristics of the physicians, their role as healthy lifestyle providers, and whether they assess lifestyle characteristics of their patients and perform healthy lifestyle counselling. More than 60% of the GPs did not evaluate lifestyle features during their patients&rsquo, examination. In total, 56% of the GPs provided healthy lifestyle recommendations among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations, and 73% of GPs provided recommendations to patients with chronic diseases related to lifestyle. The study showed that the chance to assess lifestyle characteristics of the patients was significantly higher for the GPs who believed that they were obliged to do so (OR = 6.5, p = 0.002). The chance to recommend a healthy lifestyle among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations was 5.9 times higher among the GPs working in the public sector (p &lt, 0.001) and 16.3 times higher for these who believed that they had sufficient knowledge to provide the advice (p = 0.02). The following predictors of providing a healthy lifestyle counselling among patients with diagnosed chronic lifestyle-related diseases were identified: conviction that a GPs is obligated to provide it (OR = 4.4, p = 0.02), sufficient knowledge (OR = 8.7, p = 0.01), and following health recommendations by themselves (OR = 3.9, p = 0.04). Conclusions: The identified predictors are crucial for the development of appropriate strategies aiming at increasing GPs&rsquo, involvement in preventive measures and consequently at improving the population&rsquo, s health.

The goal of this cross-sectional survey was to assess the level of knowledge on harmful effects of environmental tobacco smoke (ETS) exposure and active smoking among socially-disadvantaged people in Poland. The study was conducted among 1817 respondents aged 18&ndash, 59 years, who used aid services from local social care institutions in Piotrkowski district. Majority of the participants were aware of the fact that smoking may cause serious diseases and lung cancer (92%). However, those percentages were lower for awareness of ETS and health risk (69.4%) and for awareness of smoking/ETS-associated risk of stroke and heart attack (57%, 68%). The male respondents and smokers had much higher odds of lacking knowledge that smoking causes serious diseases and lung cancer compared to the females (OR = 1.47 and OR = 1.86, p &lt, 0.05) and non-smokers (OR = 2.35 and OR = 2.31, 0.001). In addition, those with temporary jobs and the unemployed had a higher risk of lack of knowledge on smoking and lung cancer risk (OR = 2.14 and OR = 1.66, 0.05) as well as ETS and the risk of stroke (OR = 1.52 and OR = 1.51, 0.05) as compared to those with permanent jobs. The smokers who were aware of four health consequences of smoking indicated an intention to quit smoking within the next month more frequently when compared to those who did not have the knowledge on all of the analyzed harmful effects of tobacco use (19.7% vs. 13.1%, 0.05). There is a need to improve knowledge on the dangers associated with active and passive smoking among socially disadvantaged populations.

Epidemiological studies have suggested an association between maternal antioxidant levels during pregnancy and development of allergic diseases in their offspring. The aim of the study was to determine plasma vitamins A and E concentration in the 1st trimester of pregnancy, at delivery and in cord blood and to search for a relationship with allergy in up to 2-year-old children who were prenatally exposed or not exposed to tobacco smoke. The study participants included 252 mother-child pairs from Polish Mother and Child Cohort. Vitamin concentrations were measured using the HPLC-UV method, smoking status&mdash, as saliva cotinine level using the HPLC-MS/MS technique. Children&rsquo, s health status was assessed using a questionnaire and pediatricians/allergists examination. Cord plasma vitamin concentrations were significantly lower than their levels in maternal plasma in the 1sttrimester and at delivery (p &lt, 0.001). Significantly higher concentrations of vitamin E have been shown to occur during the 1st trimester of pregnancy in plasma of the women who have actively/passively smoked cigarettes compared to the non-smokers (p &lt, 0.02). Multivariate analysis with inclusion of a variety of confounding factors have not indicated any statistically significant associations between &beta, carotene, vitamins A and E and the risk of food allergy, atopic dermatitis and wheezing in their children up to 2 years of age. The interaction between smoking during pregnancy and vitamins levels on the risk of allergy was not statistically significant (p &lt, 0.4). The relationship between plasma concentration of vitamins A and E, and the risk of allergy in their young children has not been demonstrated.

The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people.

The developing fetus is especially vulnerable to environmental toxicants, including tobacco constituents. The aim of this study was to assess the impact of environmental tobacco smoke (ETS) exposure during pregnancy on child neurodevelopment within the first two years of life. The study population consisted of 461 non-smoking pregnant women (saliva cotinine level

A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required.

Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0, p &lt, 0.001, OR = 2.0, 0.05, ever users: OR = 2.2, OR = 2.2, 0.01), alcohol consumption (never users: moderate drinking OR = 2.9, binge drinking OR = 2.2, 0.01, ever users: moderate drinking OR = 4.2, 0.001), cigarette smoking (never users: OR = 14.1, ever users: OR = 11.3, 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8, 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7, OR = 2.7, ever users: OR = 5.4, OR = 4.4, 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1, ever users: OR = 2.9, 0.01), and secondary school students (ever users: OR = 5.6, 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4, 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes (p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers (p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13–19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.