Vladimir M Shkolnikov1,2, Elena Churilova3, Dmitry A Jdanov4,3, Svetlana A Shalnova5, Odd Nilssen6, Alexander Kudryavtsev7, Sarah Cook8, Sofia Malyutina9, Martin McKee8, David A Leon6,8. 1. Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany. Shkolnikov@demogr.mpg.de. 2. National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038. Shkolnikov@demogr.mpg.de. 3. National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038. 4. Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany. 5. National Medical Research Centre for Preventive Medicine, Petroverigskiy pereulok 10, Moscow, Russian Federation, 101990. 6. UiT the Arctic University of Norway, 9037, Tromsø, Norway. 7. Northern State Medical University, Troitskiy Avenue 51, Arkhangelsk, Russian Federation, 163000. 8. London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK. 9. Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Sciences, Vladimirovsky spusk 2a, Novosibirsk, Russian Federation, 630003.
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.
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.
Authors: Hasse Melbye; Jennifer K Quint; Sarah Cook; Anne Elise Eggen; Laila A Hopstock; Sofia Malyutina; Marina Shapkina; Alexander V Kudryavtsev Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-05-14
Authors: Charlotte Arena; Christine Holmberg; Volker Winkler; Philipp Jaehn Journal: Int J Environ Res Public Health Date: 2021-12-24 Impact factor: 3.390
Authors: Elena Churilova; Vladimir M Shkolnikov; Svetlana A Shalnova; Alexander V Kudryavtsev; Sofia Malyutina; Odd Nilssen; Tiina Laatikainen; David A Leon Journal: BMC Public Health Date: 2021-12-07 Impact factor: 3.295
Authors: Sergi Trias-Llimós; Sarah Cook; Anne Elise Eggen; Alexander V Kudryavtsev; Sofia Malyutina; Vladimir M Shkolnikov; David A Leon Journal: Int J Equity Health Date: 2022-04-15
Authors: Sergi Trias-Llimós; Lisa Pennells; Aage Tverdal; Alexander V Kudryavtsev; Sofia Malyutina; Laila A Hopstock; Olena Iakunchykova; Yuri Nikitin; Per Magnus; Stephen Kaptoge; Emanuele Di Angelantonio; David A Leon Journal: Sci Rep Date: 2020-11-27 Impact factor: 4.379