Time trends in smoking in Russia in the light of recent tobacco control measures: synthesis of evidence from multiple sources

Abstract

Background 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 present an in-depth analysis based on an unprecedentedly large array of survey data. Methods We 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. Results From 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. Conclusions The 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.

Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

“…The participation rate in KYH was 48%, although the educational profile as the participants was similar to that of the cities from which they came 15 . Moreover, the risk factor data is consistent with what previously observed, including smoking and blood pressure levels 41 , 42 . In the Tromsø Study the participation rate was 65% and risk factor prevalences we used from the Tromsø Study are comparable those from the HUNT Study in the county of Nord-Trøndelag, Norway 43 , 44 .…”

Chronic Obstructive Pulmonary Disease (COPD) in Population Studies in Russia and Norway: Comparison of Prevalence, Awareness and Management

“…This is surprising given historically very high smoking prevalence among Russian men. 7 Despite recent declines in smoking in Russia, 28 we did find here that the prevalence of current smoking and pack-year history was higher among the Russian than the Norwegian men. However, there was also a high prevalence of ex-smokers in the Norwegian sample therefore the current lung function damage in this sample could be attributable to higher levels of smoking in Norway in the past.…”

Mortality in Russia Since the Fall of the Soviet Union

“…For many years, about 60% of Russian men reported themselves as regular smokers, which was one of the highest male smoking rates in the world. Smoking prevalence is significantly lower among Russian women (10-12 percent), although the share of women who smoke increased from the mid-1990s until the mid-2000s, particularly among less-educated women (Shkolnikov et al 2020). Male smoking rates started declining around 2007 and, as of 2016, had fallen by more than 10 percentage points, a remarkable decline in smoking prevalence in less than a decade among a population whose smoking rate had not changed in several decades.…”

“…Tobacco control policies have received less attention in the literature, but these policies also have a significant impact on male mortality rates in Russia. Recent estimates indicate that smoking accounted for 26% of all male deaths in Russia in 2001 (and only 3% of female deaths; see Shkolnikov et al 2020). Denisova (2010), using individual-level panel data from the Russian Longitudinal Monitoring Survey for 1994-2007, found that the negative impact of smoking on longevity in Russia is comparable to the effect of alcohol consumption on longevity.…”