Russia

By Kirill Danishevski
Open Health Institute, Head of Anti-tobacco Advocacy Coalition Project, Moscow, Russia

Russia is a prime target for the transnational tobacco industry (TTI). It already has one of the highest burdens of tobacco-related disease in the world, with over 60% of men smoking ⁽¹⁾ and almost half of male deaths caused by smoking.⁽²⁾ Smoking rates have been rising among men and women since the political transition in 1991. Investment of US$1.7 billion by the TTI up to 2000 was associated with a substantial increase in tobacco consumption. The latest data show that between 1992 and 2003 smoking rates increased by 8% among men and more than doubled among women .⁽³⁾

Young women have been most affected, reflecting targeted marketing by the tobacco industry. It is particularly unfortunate therefore that Russia is one of the few countries that did not accede to the Framework Convention on Tobacco Control (FCTC). Since the TTI invested heavily in the early 1990s,⁽⁴⁾ it has held enormous influence over tobacco control policy in Russia, assisted by the high degree of corruption and ignorance about tobacco. Industry documents also indicate that the TTI sees Russia as an important ally in its fight against the FCTC. ⁽⁵⁾

Russia’s national legislation is weak. The law limiting tobacco smoking states that smoking is not allowed in public places unless they are designated, without regulating what places can be designated and who should be enforcing. This means that in fact smoking is allowed nearly everywhere. The taxation code sets excise taxes at the level of US$0.1-0.3 for most cigarette brands, meaning that their price seldom exceeds US$1. Although advertisements are banned on television, they are widespread in magazines. Product placement seems also to be widely used.

The population is poorly informed about the hazards of tobacco, and the majority of medical personnel are smokers. NGOs are inactive in this field, with many actually supporting the “smoking is a free choice” idea. This is largely due to ignorance, rather than vested interests. The FCTC is unknown and not discussed by the public or officials. Several years ago modest support for anti-tobacco activities was provided by the Canadian Development Agency (CIDA) and then the Soros foundation (Open Society Institute). In 2007 the Bloomberg Initiative made funds available for tobacco control. The Ministry of Health and Social Development has so far failed to recognise smoking as part of its remit. Many of the executive government bodies openly or implicitly collaborate with tobacco industry.

On 31 August 2006 the “Russian Coalition for joining FCTC” was established, uniting activist organisations that are independent of the tobacco industry. The establishment of the Coalition immediately caused alarm in industry circles. It led to the establishment of an industry-run “Committee on the problem of tobacco” under the auspices of the Ministry of Health. It also led to a high-profile roundtable discussion in the Public Chamber. It was entitled “Problems with acceding to the FCTC”. The tobacco industry pushed for misleading and ineffective interventions, and anti-tobacco activists were deprived of the right to speak.

Such actions illustrate the ease and audacity with which the TTI dictates policy in Russia. However a recognition is gradually emerging that the health effects of tobacco use have consequences for future economic growth in Russia. This was set out recently in a World Bank publication “Dying too young”. The implications for national security of depopulation of strategic areas are also being recognised.

The Open Health Institute/Russian FCTC Coalition has received a 24-month grant from the Bloomberg Initiative to Reduce Tobacco use. The grant is for developing sustainable Russian structures to promote ratification of FCTC and advocate for stronger tobacco control legislation and compliance.

References
⁽¹⁾ Gilmore A, Pomerleau J, McKee M. Rose R, Haerpfer C et al. Prevalence of smoking in eight countries of the former Soviet Union. Results from the Living Conditions, Lifestyles and Health Study. Am J Public Health 2004; 94: 2177-84.
⁽²⁾ Peto R., Lopez A., Boreham J., Thun M. Mortality from smoking in developed countries 1950-2000 (2nd edition). http://www.deathsfromsmoking.net/countries.html
⁽³⁾ Perlman F, Bobak M, Gilmore A, McKee M. Trends in the prevalence of smoking in Russia during the transition to a market economy. (submitted) Tobacco Control.
⁽⁴⁾ Gilmore A, McKee M. Tobacco and transition: an overview of industry investments, impact and influence in the former Soviet Union. Tobacco Control 2004;13: 136-142.
⁽⁵⁾ Demin A. Work in progres