Trends in smoking in Russia during a time of economic transition

Background Changes in smoking prevalence, particularly an increase in women, were predicted to follow the aggressive campaigns of multinational tobacco companies in transitional Russia. However, such changes have not yet been demonstrated unequivocally.

Methods We used data from 10 rounds of the Russia Longitudinal Monitoring Survey (1992-2003), consisting of more than 3,000 men and 4,000 women in each round, to examine smoking trends by gender, education and area of residence. We also compared the mean reported age of first smoking in current smokers between 10-year birth cohorts.

Results Between 1992 and 2003, smoking prevalence doubled amongst women from 6.9% (95% CI: 6.3-7.6%) to 14.8% (13.9-15.7%), and increased slightly in men from 57.4% (56.0-58.8%) to 62.6% (61.1-64.1%). In both sexes the rise was significantly greater in the least educated, markedly so in women (a doubling in the least educated versus a 1.5-fold rise in the most educated). In women the rise was significantly steeper in rural residents (3-fold versus 1.5-fold in urban areas). The mean age of first smoking was significantly lower in women born after 1960, but in men it was stable between cohorts.

Conclusions For the first time we have shown unequivocally that female smoking increased markedly during the transition in Russia, particularly in less educated and rural women. The already high prevalence of male smoking has continued to rise. Changes are likely to reflect tobacco industry activity. Improved tobacco control is therefore urgently needed.