Changes in attitude to smoking in the Czech Republic


News agencies reported last week that New Yorkers could breathe a little more easily now as the city's stiff new anti-smoking laws took effect last Sunday. Smokers grumbled as they had to huddle outside in the cold to puff on their cigarettes. The new law, pushed by Mayor Michael Bloomberg, an ex-smoker himself, outlaws smoking in bars and restaurants and imposes stiff fines. Some bar and restaurant owners fret that the ban will scare off customers; others hope more non-smokers will visit now that the air is clearer. Curious to find out how such a ban would go down with owners of Czech pubs - where a thick cloud of smoke is part of the experience - I visited a typical Czech smoky pub in the Prague district of Zizkov and asked the bartender what he thought of the idea of a ban on smoking in restaurants.

"I'm definitely against it. No one will come to the pub if smoking is not allowed inside. I think those Americans have gone crazy. If our politicians approve this I will go and protest. No, I'm against it, that's a sure thing."

However, doctors and anti-smoking activists would surely welcome such a measure. Dr. Eva Kralikova is an expert on giving up smoking and she recently published a second, extended edition of her book "Jak prestat kourit", or "How to Quit Smoking".

"What I would prefer to see is a ban on smoking in all public places including restaurants. There could be a long time for its implementation, let's say five years or ten years or something like that, but this is the only thing we can do. And it is what has worked in other countries with a very low prevalence of smoking, such as California or Scandinavian countries, or other countries where the prevalence of smoking is very low."

In the past decade or so the attitude to smoking has changed significantly in this country. While smoking was socially quite acceptable in the 1980s and it was generally allowed in the workplace, over the years smokers have been pushed out into special rooms or simply outside public buildings. Most recently, the town hall in the northern town of Jablonec nad Nisou banned all smoking on its premises and smokers who take breaks outside the building during the day now have to work overtime to make up for the lost time.

In recent years, Czech legislation on smoking, too, has been changing in order to be in harmony with that of the rest of the developed world. Last Wednesday, after much debate, the Senate finally passed a lower house-approved bill, banning almost all tobacco advertising in the Czech Republic. Under the new law, billboards advertising cigarettes are to disappear from Czech streets as of July 1st, 2004. Tobacco advertising will be allowed only in tobacconists' shops, and tobacco companies will be allowed to sponsor Czech motor racing only until 2007.

But according to anti-smoking experts, tobacco advertising is not the only peril. Doctor Eva Kralikova told me about a recent government bill which originally stipulated the ban of single cigarette sales. That article was abolished, allegedly because thirty six jobs would be saved in the unemployment-stricken North Moravian district of Karvina, where single cigarettes are packed.

"Concerning single cigarette sale, it is another law which has not been approved by parliament yet. It was just a governmental proposal. It originally stipulated that cigarettes could be sold only in twenty-piece packs, but in its current version it is allowed to sell single cigarettes if they have a package. Which is the case of the so-called "kusovka". It is a single cigarette which costs about four crowns and, unfortunately, we hear from our patients that they relapsed back to smoking because of buying these single cigarettes. Or it is the case with children that, while they would not buy a pack of twenty cigarettes, they will buy one single cigarette. So this is the reason why this should be banned as well but is not at the moment."

The government-proposed bill also contains some suggestions which, according to Eva Kralikova, may be controversial.

"The government bill suggests banning smoking at bus stops. In my opinion, this is controversial and I can imagine someone standing at the bus stop and holding the cigarette outside the roof and saying he is not smoking under the roof."

In this country, 23,000 people die each year of smoking related diseases, that is about sixty people a day. Smoking is responsible for one fifth of all deaths every year. The non-governmental organisation Czech Coalition Against Tobacco tries to offer assistance to smokers who wish to kick their habit, and also organises various events in order to promote a non-smoking lifestyle. The most recent was one called "Pet mest spravne volby" or "Five towns of the right choice". The activists toured around five towns and cities of Bohemia, marched through their streets and offered fruit to smokers in exchange for their cigarette packs. After touring the cities of Plzen, Hradec Kralove and the towns of Ceske Budejovice and Liberec, the event culminated in Prague where I joined the march of young people dressed up in bizarre costumes.

"Yes, I'm wearing a white doctor's uniform and we are trying to persuade some smokers not to smoke any more. We are going to march through the streets of Prague, and we are going to the town hall and we are going to give a petition to the mayor."

I also spoke to the organiser of the event, Dr. Katerina Langrova, of the Czech Coalition Against Tobacco.

"This is an event called "Five towns of the right choice" and we are trying to address smokers and to persuade them to quit smoking. We are offering advice on how to do it or what is the best way to do it. There are three kinds of costumes: there are large cigarettes, about 2.5 metres high, which are leading the march. There are also the costumes of chemists who are offering oranges instead of cigarettes as a symbol of health, and there are medical students who can give advice, who know where smokers can go for other advice or help."

During the five-day event the team travelled 1,100 kilometres, walked around forty kilometres and approached around 3,500 smokers both in the streets and workplaces. The medical students on the team spent twenty-four hours talking to smokers and the group gave away one hundred kilograms of oranges. The "Five towns of the right choice" event was part of a one-year campaign called "One year of the right choice", which will include a number of events, opinion polls and also efforts to coordinate the activities of all organisations helping smokers quit around the Czech Republic.