Bulgaria struggles to kick chain-smoking habit

Milena hates herself for it, but she lights another cigarette anyway.

She and her husband think it may have been her smoking habit that killed their unborn child several weeks ago.

"I'm so ashamed. I don't know why I can't stop after all this," said the 28-year-old. "My doctor told me to quit, but she said if it was too hard, I should just cut down to three a day."

Like many Bulgarians, Milena is torn between long-standing traditions in this hard-smoking Balkan nation and a gradual shift in awareness toward what doctors in developed countries have said for decades: smoking kills.

As more western countries move to impose all-out bans on smoking in public, EU aspirant Bulgaria - once a world-leading tobacco producer - is moving forward with its first attempts to cut through the haze.

Smoking is now forbidden in hospitals, schools, museums, day care centers and theaters. Bus and taxi drivers can no longer smoke at the wheel, and offices must have smoking lounges.

But in a country where half of the population smokes and doctors, teachers and clerks have long grown accustomed to puffing away at work, the new rules, which came into effect on Jan. 1, are proving hard to enforce.

The law has also drawn criticism ranging from the expected - such as bar owners fearing financial ruin - to bizarre complaints by doctors in defense of smokers' rights.

"Our society does not realize the risks of smoking, and we continue to be unreasonably tolerant toward smokers - the one group which causes the main health risks in our country," said Deputy Health Minister Lubomir Kumanov.

TOBACCO MINDSET

According to the World Health Organization, Bulgaria was the world's largest exporter of cigarettes before the fall of communism 16 years ago.

A packet of cigarettes costs less than a euro ($1.31), and in 2003, the state tobacco monopoly Bulgartabak sold 25 billion cigarettes - half-a-pack a day for each of Bulgaria's 8 million people.

Data is not clear, but different figures indicate 40 to 55 percent of adult Bulgarians smoke.

That rate is also still rising, especially among women, as tobacco majors - facing increasing pressure from regulation and lawsuits in the West - target the former eastern bloc.

Smoking-related disease kills around 30 Bulgarians a day and causes around a third of all deaths of men between the ages of 35 and 69, which experts say could double in the next 20 years.

"It's extremely important that Bulgaria and its neighbors tackle smoking now. If they don't, the burden of disease will become immense," said Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine.

Despite the huge costs to Bulgaria's ailing healthcare sector, the government spends nearly nothing to raise awareness of the negative effects of smoking.