SERBIA LUNG CANCER SKYROCKETS IN NATION THAT LOVES TO SMOKE

by Vesna Peric Zimonjic

(IPS) BELGRADE -- Serbian health authorities say they plan to try to raise awareness about the health effects of smoking and the rising rate of lung cancer in a country where half the people smoke.

Eighty percent of lung cancer cases are caused by smoking; it usually proves fatal.

"Some 30,000 new cases of cancer are discovered in Serbia each year, and of that number 5,200 are lung cancers," Serbian Health Minister Tomica Milosavljevic told reporters.

"This has brought us to the top among European nations. We'll do everything in our power to define smoking as socially unacceptable and cut the number of smokers by half by 2015," he added.

Experts say this will be a daunting task in the nation of 7.5 million, where smoking is a long tradition.

According to the Belgrade-based Institute for Protection of Health, 36.3 percent of secondary school pupils, and 48 percent of university students, are smokers.

"This means that there is gross and constant health hazard even for those who do not smoke," the institute's Andjelka Dzeletovic told IPS. "These are the passive smokers, and they include young children and babies."

Serbia bans smoking in public spaces such as airports, hospitals, schools, theaters, banks or administration buildings. But people smoke all around these buildings.

Non-smoking cafeterias or bistros do not exist; owners say they would have no customers if they made them smoke-free.

"Smoking is still treated here as a vice, but it should be defined as an illness," says professor of sociology Aleksandar Jugovic.

"This calls for a change in traditional concepts among people, which will be very hard. Apart from that, people seem not to be aware that their monthly expenses on cigarettes are twice as high as those on bread and milk," he added.

Serbs smoke a billion 20-cigarette packs a year, according to the Health Ministry. Cigarettes are cheaper here than in neighboring countries and across Europe. A pack costs a dollar on average.

Over the past five years tobacco giants such as Phillip Morris and Japan Tobacco Industries have bought several local factories and turned them into regional production centers.

Serbian health authorities are now taking a quarter of tax income from cigarette sales for cancer prevention. Most of the funds will go for a screening campaign to detect lung cancer, and to launch a publicity campaign against smoking.

"Lung cancer leaves little chances of survival," Slobodan Cikaric, head of the Serbian Society for Cancer Prevention, told IPS. "So it has a high cost in human lives and high cost in administered medicine, with little effects, meaning almost no cure. The main cause of lung cancer remains smoking, apart from some hereditary factors."

Cancer in general is taking a high toll in Serbia, experts say. A significant reason is a low level of awareness.

"Statistically, it takes 182 days (on average) for a patient to see a doctor once he or she starts feeling bad," Dejan Vujovic from the Strategic Marketing Research Agency says.

The agency found that 80 percent of women with breast cancer visit the doctor when it is too late. Some 70 percent of people have no clue about a history of cancers in their families.

The Belgrade-based Institute for Oncology and the Health Ministry put the number of cancer patients in Serbia at 120,000. This describes the number diagnosed, operated on or treated, with the cancer under control. The number of cancer patients is rising by 3 percent to 5 percent a year.

The number of lung cancer victims in Belgrade in 2004 was three times that in 1990, according to official figures.

"One must take into account the economic circumstances in this country when the occurrence of cancers is dealt with," Ana Bekic from the Belgrade Oncology Institute told IPS.

"This is a country in transition, introducing a market economy. Studies in former Eastern European nations have shown that the transition process involved a decline in health services. In the 1990s, this happened in Slovakia and Hungary, which held the same records as Serbia now. It takes years to improve that."