It is important to estimate effectiveness and results achieved by measures implemented within the ‘Clean Air’ Federal project as regards public health in cities included into it. The aim of this study was to analyze changes in levels of ambient air pollution and airborne health risks in cities included into the ‘Clean Air’ Federal project in dynamics over 2020–2022 and to estimate whether the measures aimed at reduction of emissions were adequate to risk rates and factors. The study relied on analyzing the results of field observations over ambient air quality within social and hygienic mon-itoring. Monitoring covered priority chemicals that made 95 % contributions to impermissible health risks according to dis-persion calculations. Risk assessment was performed as per standard algorithms and indicators. Adequacy of air protection and correctness of its orientation were estimated in Norilsk as an example city. The study established that levels of harmful chemicals in ambient were higher than hygienic standards over the analyzed period in all the cities participating in the project. We did not detect any significant reduction in ambient air pollution; there were no positive trends in health risks rates either. In 2022, a risk of respiratory diseases under chronic exposure was ranked as high (hazard index or HI 10.5÷43) in Chelyabinsk, Mednogorsk, Norilsk, Krasnoyarsk, Lipetsk, and Chita; it was ranked as ‘alerting’ in Bratsk, Chita, Novokuznetsk, Magnitogorsk, and Omsk (HI 4.0÷5.8), A permissible risk was identified over the analyzed period only in Cherepovets (HI<3). So far, reductions in emissions of pollutants declared by economic entities have not ensured absence of impermissible health risks in 11 out of 12 cities. Ungrounded orientation to a 20 % reduction in emissions of all the economic entities included in the experiment and failure to consider risk indicators when setting quotas for emissions can lead to absence of any substantial effects for public health in the analyzed cities. In some cases, this may even result in excessive spending on activities that do not have any significant influence on a sanitary-hygienic situation.