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Meta-Analysis
. 2020 Mar 23;20(1):378.
doi: 10.1186/s12889-020-08464-4.

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

Vladimir M Shkolnikov  1   2 , Elena Churilova  3 , Dmitry A Jdanov  4   3 , Svetlana A Shalnova  5 , Odd Nilssen  6 , Alexander Kudryavtsev  7 , Sarah Cook  8 , Sofia Malyutina  9 , Martin McKee  8 , David A Leon  6   8
Affiliations
Meta-Analysis

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

Vladimir M Shkolnikov et al. BMC Public Health. .

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.

Keywords: Anti-smoking measures; Educational differences; Forest plots; Male-female gap; Tobacco epidemic.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Age-specific prevalence of current smoking adjusted for education in Russian and international surveys
Fig. 2
Fig. 2
Age-standardized prevalence of smoking in RLMS by education and for the total population in 1996–2016. Note. Values and significance levels for the linear trends’ slopes from meta-regression are shown on the panels
Fig. 3
Fig. 3
Educational differences in smoking (ORs low vs. high) adjusted for age in RLMS, 1996–2016
Fig. 4
Fig. 4
Educational differences in female smoking (ORs low vs. high) by age group in RLMS, 1996–2016
See this image and copyright information in PMC

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