[Smoking: the main cause of high mortality rate among Russian population]

Mortality rates in Russia are very high as compared to those in other developed countries, particularly among men. A series of hypotheses associating heavy drinking and social and economic stresses of the transition period with drastic increases in mortality rates in Russia in the mid-1990s have been generated. However, the hypotheses are under analytical study on an individual level. A case control study was carried out to investigate the association of mortality due to smoking, alcoholic consumption, and a variety of socioeconomic indices. A total of 13,079 individuals who died in 1990-1999 were identified during a populational survey of 90,147 families in four Russian cities: Barnaul, Tomsk, Tyumen, and Vladivostok. Data on lifestyle habits, such as smoking, alcohol consumption, and some socioeconomic characteristics of the deceased were obtained from questionnaire surveys with proxy respondents (wives, husbands, etc.). Proportional mortality analyses were carried out. Controls were selected from those who died from non-smoking-related causes. A statistically significant association was established between smoking and the risk of death due to cancers of the lung, mouth, pharynx, larynx, esophagus, stomach, and urinary bladder. There was also a dose-response relationship of the numbers of cigarettes smoked to the risk of cancers at these sites. Smokers were found to be at a statistically significantly increased risk for coronary heart disease and stroke. There was a close and statistically significant association between smoking and chronic obstructive lung diseases, respiratory tuberculosis, and other respiratory infections. There was also a close dose-response relationship of the number of cigarettes consumed per day to the risk of respiratory tuberculosis and obstructive lung disease.