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Speculation About Options for Teen Tobacco Use Cessation in the Russian Federation

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Speculation About Options for Teen Tobacco Use Cessation in the Russian Federation TOBACCO INDUCED DISEASES Vol. 3, No. 3:1-15 (2007) © PTID Society Speculation about Options for Teen Tobacco Use Cessation in the Russian Federation Steve Sussman, Ulya Gufranova, & Andrey Demin University of Southern California, Schenenov Moscow Medical Academy, and Russian Public Health Association ABSTRACT: This paper summarizes prevalence and consequences, recent policies, prevention and cessation efforts, recent developmental work (focus groups), and speculation about the current status of cigarette smoking in the Russian Federation. Unique aspects of modern Russian society are suggested as leading to relatively high prevalence internationally of smoking among Russian males. Similar factors may lead to deflated smoking cessation attempt and quit rates. We believe that the future of tobacco control in Russia is close, but that it will involve raising the prices of tobacco products, enforcing no tobacco use policies among minors, ratification of the Framework Convention on Tobacco Control (FCTC) and implementation of evidenced-based tobacco use prevention and cessation programs. “Today I intend to tell you about tobacco the world, particularly among men, due -- like a people’s whim and disaster.” in large part to smoking. Russia like I. M. Dogel, a Russian pharmacologist. other countries deserves a healthy posterity. The negative influence of “The veritable civilization index tobacco on health currently is one of the isn’t a reach level and towns dimensions, most thoroughly investigated health not harvest abundance, but a person’s problems. It is known today that there is look which was cultivated by country” a cause-and-effect relation between (R.U.Emerson, American poet and smoking and many diseases, particularly philosopher in 19th century). The look cardiovascular, pulmonary, and cancer- cultivated by a country hooked on related diseases. The recognition that nicotine is not admirable. Cigarette tobacco use is the leading behavioral smoking in Russia has led to relatively cause of death has led, directly or high work absences, decreased indirectly, to smoking prevalence being productivity, decreased longevity, high cut in half in several countries in the national medical costs, decreased world (MacKay, Eriksen, & Shafey, personal disposable income, and has 2006). Tobacco control efforts are contributed to a social fatalism that has relatively new in the Russian Federation. immobilized economic growth among Russia is the largest country the masses. People have to understand geographically with a very long and that their health is open to a type of proud history. However, currently the injury that is within their behavioral average life span is one of the lowest in control. “The secret of life prolongation 2 Sussman S, Gufranova U, Demin A is the ability to not shorten it” through a cardboard tube) is $.07 USD. (Feihttersleben, Australian doctor in the Thus, tobacco smoking is relatively 19th century). As Russian doctor and inexpensive. scientist E.M. Tareev said, “The State In 2000, in the Russian must demand from citizens that they Federation, the proportion of lung cancer don’t shorten their life from smoking. deaths attributed to smoking was 94% The community which leads a rational among males and 40% among females. and hard-edged fight with harmful habits The proportion of cardiovascular disease promotes a national recovery.” due to smoking was 27% among males In Russia, for people over 18 and 2.3% among females (e.g., Davis et years old, approximately 60% of adult al., 1994). The proportion of total deaths males smoke and 16% of adult females through all related causes due to smoke (MacKay, Eriksen, & Shafey, smoking was 26% among males, 3% 2006; Ross, 2004). Smoking among among females and 15% of total adult males in the Russian Federation is population deaths. There are 300,000 among the highest prevalence in the tobacco-related deaths in the Russian world (after Armenia, Cambodia, China, Federation per year. Average number of Kenya, and Turkey), whereas it is much years lost due to smoking is 19 among lower among adult females. On the other males and 16 among females (MacKay, hand, prevalence of smoking among Eriksen, & Shafey, 2006). The World young adult women may be as high as Health Organization states that tobacco 27% (Gilmore et al., 2004; Ross, 2004; and alcohol use are the leading risk WHO, 1999), and women in Russia may factors for premature deaths in the tend to grossly underestimate their Russian Federation smoking prevalence (Laatikainen, (http://www.who.dk/eprise/main/WHO/ Vartianen, & Puska, 1999). Russian Progs/CHHRUS/sum/20041126_2). families may spend an average of 15% One means to ascertain a trend of of their total household budget on decreased prevalence is through cigarettes (Ross, 2004). assessments of youth. Unfortunately, in Over 50% of cigarettes sold in some estimates, one third of Russian Russia are produced by transnational youth have tried a cigarette by 10 years companies (Demin, 2001; Ross, 2004). of age, particularly males (Prokhorov & These are located primarily outside of Alexandrov, 1992; Ross, 2004). The the Russian Federation, including Japan median age of smoking initiation is 11 Tobacco International, British American years. A total of 27.4% of 15 year old Tobacco, Liggett, Imperial, and Phillip males and 18.5% of 15 year old females Morris. Domestic companies include are current smokers (and smoke an Tabakprom and Yelets, the latter which average of 17 days each month, produces the popular local brand, Prima. approximately 6 cigarettes per day when Perhaps 20% of cigarettes on the market smoking; 9% of 11-15 year old boys and are sold illegally. The cost of a pack of 6% of same age girls are daily smokers; imported and domestic cigarettes is Ross, 2004). Up to 27% of high school approximate $1 and $0.62 USD, youth are daily smokers depending on respectively, and cost of a Belomorkanal region sample and average age (e.g., The papirosi (an inexpensive local-type Global Youth Tobacco Survey cigarette, 5th grade tobacco smoked Collaborative Group, 2002; Kemppainen Speculation about Options for Teen Tobacco Use Cessation in the Russian Federation 3 et al., 2002; Ross, 2004). Only 4% use a The data suggest operation of a tobacco product other than cigarettes. rather lax enforcement of youth smoking Pessimistically, over half of nonsmoking policy. While youth under 18 years of high school youth report contemplation age are prohibited from purchasing of smoking in the future and 45.8% of tobacco, and store clerks that sell to Russian teens are regularly exposed to minors may be subject to an passive smoking at home (Kemppainen administrative hearing and sanctions et al., 2002;.MacKay, Ericksen, & according to the current Federal Law on Shafey, 2006; Ross, 2004). These data Tobacco (passed in 2001; see Appendix indicate that addiction to nicotine occurs 1), no penalties for selling tobacco to at a young age, that prevalence of youth are evident. In fact, 63% of smoking among youth is high. Perhaps, Moscow school students purchased information can be learned about the tobacco from street vendors in 1999; context of teen smoking that would little decrease is noted since then assist in smoking cessation efforts. (Demin, 2001; Ross, 2004). A total of 17% of high school age youth report Contexts of Smoking among Youth: having been offered free cigarettes by Reflection of Policy Enforcement cigarette company representatives, and Regarding locations of smoking, 50% are well aware of tobacco approximately 44% smoke in public advertising (Ross, 2004). Parents might spaces (e.g., on the street, in parts, near be prosecuted for knowingly permitting stores), 14% smoke at social events, 7% their youths to purchase cigarettes but smoke while at the high school, and 6% this policy would be difficult to enforce smoke at home (Ross, 2004). A total of because proof would be difficult to 63% purchase cigarettes in a store or obtain. Smoking is restricted but not from a street vendor, 7% buy cigarettes totally banned in several public locations from vending machines, 5% receive (workplaces, covered sports facilities, cigarettes as gifts from older persons, public transport, air flights, cultural and and 17% borrow cigarettes from a peer. educational institutions and government Youth pay about $0.60 U.S. (50 rubles) buildings). Size of warning labels on per pack of cigarettes (Ross, 2004). packages is small (about 4% of the Thus, high school youth spend pack). Over 80% of Russia’s youth are approximately $60 U.S.D. per month on aware of the change in laws and 90% cigarettes. If this amount spent is accept the law (see Appendix 1). accurate (and another family member However, there is a general attitude that smoked; e.g., the parent), 15% of an the law can’t be enforced. average family’s income is spent on the Tobacco industry taxes only youth’s and other person’s cigarettes accounts for around 2% of the federal (based on a sample of 99 schools in budget, which is relatively small (Ross, Moscow in 1999; Ross, 2004). The most 2004). In 2000, the excise tax on popular single brand of cigarettes cigarettes was only approximately 7% of smoked among youth is Golden Jawa the retail price (Ross, 2004); the current (20%), followed by L&M (14%), and total tax on cigarettes may be 32% of the Marlboro (12%). However, most youth total cost which is among the lowest in do not have a strong brand preference the world (MacKay, Eriksen, & Shafey, (Ross, 2004). 2006). There would seem reason 4 Sussman S, Gufranova U, Demin A considering the toll on productivity to Replacement Therapy (NRY) is attempt large tax increases and available over the counter but there is no widespread anti-tobacco programming government coverage of cost. There are though this has not happened. There are no interventions to protect non-smokers. publicized ongoing lawsuits again the We might ask what types of tobacco industry in the Russian programming may impact youth Federation (MacKay, Eriksen, & Shafey, smoking and perhaps break the chain of 2006; Ross, 2004; with causing smoking prior to adulthood.
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