Abstract
BackgroundThe study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. We present an in-depth analysis based on an unprecedentedly large array of survey data.MethodsWe examined pooled micro-data on smoking from 17 rounds of the Russian Longitudinal Monitoring Study of 1996–2016, 11 other surveys conducted in Russia in 1975–2017, and two comparator surveys from England and the USA. Standardization by age and education, regression and meta-analysis were used to estimate trends in the prevalence of current smoking by gender, age, and educational patterns.ResultsFrom the mid-1970s to the mid-2000s smoking prevalence among men was relatively stable at around 60%, after which time prevalence declined in every age and educational group. Among women, trends in smoking were more heterogeneous. Prevalence more than doubled above the age of 55 years from very low levels (< 5%). At younger ages, there were steep increases until the mid-2000s after which prevalence has declined. Trends differed by educational level, with women in the lowest educational category accounting for most of the long-term increase. We estimate that the decline in male smoking may have contributed 6.2% of the observed reduction in cardiovascular deaths among men in the period 2008–16.ConclusionsThe implementation of an effective tobacco control strategy in Russia starting in 2008 coincided with a decline in smoking prevalence among men from what had been stable, high levels over many decades regardless of age and education. Among women, the declines have been more uneven, with young women showing recent downturns, while the smoking prevalence in middle age has increased, particularly among those with minimal education. Among men, these positive changes will have made a small contribution to the reduction in mortality seen in Russia since 2005.
Highlights
The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence
We examined the age-standardized prevalence of current smoking, using the European standard population of 1976 which ensures numerical comparability with prevalence estimates provided by the World Health Organisation (WHO) “Health for All” Database [19]
We excluded from this table those studies that had a narrow age range (IFS1 and IFS2, Study on global AGEing and adult health (SAGE), Stress Aging and Health in Russia (SAHR)), as a statistical adjustment for age would not yield comparable estimates
Summary
The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. Later than most other countries, in 2008 Russia ratified the Framework Convention on Tobacco Control [3] From this point on there has been an acceleration in policies aimed at reducing smoking. In 2013 a comprehensive Federal Tobacco Control Law came into force [4] This included a 100% smoke-free policy in all public places, with the World Health Organisation (WHO) giving Russia a score of 7 on a scale of zero to 10 for compliance, a continued incremental increase in the tax on tobacco products, restrictions on tobacco advertisements (with the WHO scoring Russia as 10 out of 10 for compliance), promotions, and sponsorship (scoring 8–10 for compliance in most categories), and strengthened anti-tobacco campaigns in various media outlets [5]
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