Implementation of tobacco and nicotine control health policy in the regions of the Russian Federation: results of the EPOHA-RF2 study

Aim. To study the implementation of legislative measures to protect public health from tobacco and nicotine products in 12 Russian regions and to develop a related assessment scale.

Material and methods. We used data from the EPOHA-RF-2 survey (2023), which included 12662 users of tobacco products and/or electronic nicotine delivery systems (ENDS) aged ≥15 years in 12 Russian subjects. The implementation of key tobacco control legislative measures was assessed. An integrated scale for assessing tobacco/nicotine control standards was developed using the Joossens L & Raw M method (2006).

Results. The results of implementing six cost-effective tobacco control measures, as assessed by the World Health Organization (WHO), are presented. Increasing taxes on tobacco products is not accompanied by a affordability decrease — with a 77% increase in gross regional product per capita from 2017 to 2022, the relative price of tobacco products at consumer power parity decreased by 17,5%. Compliance with the smoking/vaping ban in public places ranges from 30,8%/34% on train platforms to 85,5%/80,4% on buses. In the workplace, it is violated in >40% of cases. The proportion of those exposed to tobacco products/ ENDS advertising is higher among 15-19-year-olds compared to whole sample (42,9/31,2% vs, 20,6/16,9%; p<0,05); they are more likely to encounter promotion at the point of sale (45-50,4%). The proportion of those who received information about the dangers of tobacco products and ENDS varies from 47,4% on television to 11,6% on the radio (3976% less than in 2018). The proportion who perceived warnings on cigarette packs ranged from 79,9% of those who paid attention to 31,9% who quit smoking. Medical assistance with smoking cessation is insufficient, since physicians asked 60,9% of patients about smoking and 25,7% about ENDS. Advice was given in 38,7%, consultation — in 11,6%, while 5,7% of patients were referred to a specialized office. The data are presented for 12 Russian regions and form the basis of a new version of the integrated assessment scale for tobacco control law measures. The mean total score for the implementation of tobacco control measures across Russian regions, calculated using this score, was 72,7 out of a possible 100 (ranging from 65,6 to 90,3).

Conclusion. The data obtained is a basis for further study of the effectiveness of tobacco control measures. Compared to the 2018 studies, there is a weakening of legislative implementation in all areas of tobacco control policy.

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