Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.
National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038.
BMC Public Health. 2020 Mar 23;20(1):378. doi: 10.1186/s12889-020-08464-4.
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.
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.
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.
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.
本研究旨在通过年龄、性别和教育程度来识别俄罗斯当前吸烟的长期趋势和模式，包括最近实施控烟政策的 2008 年在内，并估计任何流行率降低对死亡率的影响。我们基于前所未有的大量调查数据进行了深入分析。
我们研究了 1996-2016 年的俄罗斯纵向监测研究的 17 个轮次、1975-2017 年在俄罗斯进行的 11 项其他调查以及来自英国和美国的两项比较调查中吸烟的 pooled 微观数据。通过年龄和教育程度进行标准化，回归和荟萃分析用于估计男性、女性、年龄和教育模式中当前吸烟流行率的趋势。
从 20 世纪 70 年代中期到 21 世纪中期，男性吸烟率相对稳定在 60%左右，此后每个年龄段和教育组的吸烟率都有所下降。在女性中，吸烟趋势更为多样化。55 岁以上人群的吸烟率从非常低的水平（<5%）翻了一番以上。在较年轻的年龄组中，吸烟率在 2000 年代中期以前急剧上升，此后有所下降。趋势因教育程度而异，受教育程度最低的女性是长期上升的主要原因。我们估计，2008-16 年期间男性吸烟率的下降可能导致男性心血管疾病死亡人数的观察下降了 6.2%。
2008 年俄罗斯开始实施有效的控烟策略，与男性吸烟率的下降相一致，与过去几十年稳定的高吸烟率相比，无论年龄和教育程度如何，吸烟率都有所下降。在女性中，下降更为不均匀，年轻女性最近出现下降趋势，而中年女性的吸烟率有所上升，尤其是受教育程度最低的女性。在男性中，这些积极变化对 2005 年以来俄罗斯死亡率的下降做出了微小贡献。
