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Smokers Seeing the Warning Signs

For the past year, the World Health Organization has been working on the first-ever comprehensive tobacco survey for Russia, the Global Adult Tobacco Survey 2009. The report, planned for release later in the year, will reveal a lot of interesting new statistics on smoking trends in the country.

Statistics that can already be released confirm that the number of smokers continues to be high. A total of 33.8 percent of Russian adults smoke on a daily basis. Among men, this figure is 60.2 percent (30.6 million), while women are steadily catching up at a current rate of 21.7 percent (13.3 million). Moreover, 51.4 percent of all adults reported having been exposed to second-hand smoke in public places in the preceding 30 days of the survey.

These are disconcerting figures for the overall health of the population. It is a cause for optimism nevertheless that despite the high smoking rates, there is growing awareness among the population of the various dangers of tobacco smoke. More than 60 percent of current smokers are interested in quitting, and 81.9 percent of adults know that exposure to second-hand smoke causes serious illness in nonsmokers.

While in most West European countries the prevalence of smoking among both men and women has stabilized or is falling, in Russia it has shown an upward trend since 1991. Smoking among boys and girls is also high and rising, with over a third of adolescents using tobacco products. The diminishing gender gap in smoking habits is especially evident in this younger generation of smokers: Smoking prevalence among boys 13 to 15 years of age is close to 30 percent, while among girls of the same age it is close to 25 percent.

The National Tobacco Control Strategy is close to being finalized. The survey will — for the first time — provide evidence-based nationally representative data on adult smoking and related patterns in Russia. The survey targeted all Russian adults at 15 years or older, and was conducted in 60 out of the 83 regions, resulting in a 91.1 percent coverage of the total population. It was conducted in close collaboration with the State Statistics Service, the Pulmonary Research Institute and the Health and Social Development Ministry.

The damaging impact of Russia’s high rates of tobacco use is clear. Tobacco is the second-highest risk factor — after alcohol — for men, contributing to an average life expectancy that is below the average of the 53 countries of the WHO European region. Russia has one of the highest cancer mortality rates in the European region, and it is also one of the 22 countries in the world with a high burden of multi-drug resistant tuberculosis, a disease that is closely associated with tobacco use.

Tobacco-related harm has also contributed to the low birth rate recorded in Russia in recent years. Smoking reduces fertility and is a leading cause of poor pregnancy outcomes, including miscarriage, low birth weight, complications during labor and prenatal death.

There is thus a clear need, and ample opportunity, to significantly improve public health in Russia through targeted and comprehensive interventions to reduce tobacco use. The Russian government has made a serious commitment to tobacco control, among others by ratifying the WHO Framework Convention on Tobacco Control in 2008.

Parties to the convention are obliged to implement evidence-based measures to reduce tobacco use and its terrible toll in health, lives and money. Russia has already taken many steps to amend its current tobacco control legislation, and a further strengthening of it is needed.

Zsuzsanna Jakab is director of the Copenhagen-based WHO regional office for Europe.

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