Вплив законодавчих змін у сфері охорони здоров‘я щодо тютюнопаління на захворюваність та смертність від серцево-судинної патології серед населення України

Abstract

Smoking is at one of the first places among the factors of lifestyle that negatively affect human health, including indicators of the respiratory, reproductive, digestive and cardiovascular systems. A relationship between smoking and morbidity, prevalence and mortality from cardiovascular diseases (CVD), taking into account the age structure of the Ukrainian population, was a subject of the study. These diseases were selected as an indicator of the negative effects of smoking. Objective: We identified the trends in the variability of cardiovascular pathology among the population under the influence of both active and passive smoking, established the degree of relationship between these indicators and assessed «cause-effect» relationships as well. Materials and methods: The data analysis was performed on the basis of the official state statistics and own retrospective genetic monitoring data. Results: In Ukraine, since 2009, current legislation significantly restricts smoking in public places. Due to the reduction of smoking intensity, the above measures were expected to lead to a reduction in the incidence (mortality) from CVD during a long period after the enactment of legislative changes. The share of smokers in Ukraine (age 12+) for the period 2013-2016 is lower by 17.4% (t=4.6; p<0.01) than for the period 2004-2012. The share of the smokers in Ukraine (age 12+) for the period 2013-2016 is lower by 17.4% (t=4.6; p<0.01) than for the period 2004-2012. At the same time, there was a decrease in the proportion of those who smoke 1-5 or more 20 cigarettes a day. From 2009 to 2016, the incidence of CVD decreased by 23%, and the mortality rate from CVD decreased by 9%. This decrease was due both to a decrease in the number of smokers (almost by 32%) and to a decrease in cigarette sales (at least by 39%). The relationship between a decrease in the proportion of smokers in the population and a decrease in morbidity and mortality from cardiovascular disease (p<0.05) has been established. Conclusions: The enactment of the Law of Ukraine on Tobacco Control had a positive systemic effect, its impact affected the reduction of morbidity and mortality of the population of Ukraine from cardiovascular diseases, which significantly improved the demographic situation.