Prevalence and Predictors of Adolescent Tobacco Use in the Russian Federation: Insights From a Nationwide Survey

Tobacco use is a leading cause of preventable disease and death worldwide. In Russia, despite tobacco-control measures, adolescent tobacco use remains a significant public health concern.

This study aimed to assess the prevalence and predictors of tobacco use among adolescents aged 13-15 years in the Russian Federation using data from the Global Youth Tobacco Survey (GYTS).

The present study was a cross-sectional study based on secondary analysis of data from the 2021 Russian Federation GYTS. Descriptive statistics, bivariate analysis, and multivariable logistic regression were used to evaluate sociodemographic and attitudinal factors associated with adolescent tobacco use.

The findings showed that the prevalence of adolescent tobacco use was 16.3% among 13-year-olds, to 21.4% among 14-year-olds, and 29.6% among 15-year-olds (p < 0.001). Male adolescents had a higher prevalence of tobacco use than females (22.7% vs. 20.8%, p = 0.009). Tobacco use prevalence also increased by school level, reaching 29.0% among ninth-grade students, compared with 17.2% and 20.7% among seventh- and eighth-grade students, respectively (p < 0.001). Weekly spending was strongly associated with tobacco use, with prevalence rising to 36.0% among adolescents spending 1000 rubles or more per week. In multivariable analysis, adolescents spending 1000 rubles or more per week had over twice the odds of tobacco use (adjusted odds ratio [OR]: 2.03; 95% confidence interval [CI]: 1.75-2.46; p < 0.001). Positive tobacco use expectancies were also strongly associated with tobacco use, with adjusted ORs reaching 10.79 among adolescents who agreed that they might enjoy tobacco use.

The findings of this study highlight that adolescent tobacco use in Russia continues to be a significant public health issue, characterized by an increasing prevalence with age, an emergence of a relatively small sex difference in prevalence, and strong associations with socioeconomic factors and positive tobacco use expectancies.