1. Tobacco control in the Russian Federation Nataliya Toropova WHO Moscow, 2011

2. FCTC & Tobacco Epidemic in the Russian Federation 2 | Russian Federation: scary statistics 43.9 million adult smokers 330.000 - 400.000 Russian citizens die annually of tobacco Smoking is the third death cause in Russia 80% of Russians are DAILY victims of passive smoking 60.7% of men, 25% of women are smokers – i.e. twice as much as it was in 1990 29% of 15-16 y.o. are regular smokers 17,1% - is the contribution of smoking to the mortality rate (unbalanced nutrition – 12,9%,obesity – 12,5%, alcohol – 11,9%)

3. FCTC & Tobacco Epidemic in the Russian Federation 3 | Current tobacco control legislation 94% of the market controlled by 4 transnational companies (BAT, JTI, PM, Imperial Tobacco) and 5% - by Donskoi tabak Partial ad ban in force: on TV, on street bill boards Overwhelming tobacco ads are present in metro, magazines (except for the 1 st and last pages), train stations Smoke free acting: at work places, on suburb transportation, on planes (up to 3 hour flight) Tobacco excise duty – 7 rubles from a pack (12 euro cents)

4. FCTC & Tobacco Epidemic in the Russian Federation 4 | Framework Convention on Tobacco Control The first global intergovernmental legal agreement in the sphere of public health which identifies clear measures to combat tobacco epidemic. Adopted in 2003 and went in force in 2005 Russia joined on June 3, 2008 The document was based on generalizing the practical experience and factual data

5. FCTC & Tobacco Epidemic in the Russian Federation 5 | WHO MPOWER Monitor tobacco consumption and prevention policy Protect people from smoking Offer help in quitting smoking Warn about the dangers related to tobacco Enforce bans on tobacco advertisement, sponsorship and promotion Raise taxes on tobacco products

6. FCTC & Tobacco Epidemic in the Russian Federation 6 | MPOWER: Monitor The proper monitoring is very important: –Tobacco consumption –Effectiveness of tobacco-control initiatives –Keeping track of tobacco industry’s actions: advertisement, promotion, advocacy.

7. FCTC & Tobacco Epidemic in the Russian Federation 7 | MPOWER: Protect There is no safe passive smoking Zones free from tobacco smoke save health of non-smokers and help smokers to quit Only by having 100% of smoke-free environment one can achieve the result Smoke-free laws are supported by public and do not decrease business income Smoke-free laws ensure save labor

8. FCTC & Tobacco Epidemic in the Russian Federation 8 | MPOWER: Offer Health protection system is responsible for tobacco dependence cure Telephone quit lines are very effective Receive a detailed information about the smoking motivation and determine a level of dependence as well as what kind of help is required Provide a specific advice as to how to quit Help a patient: come up with the action plan, provide information about medication and give directions to the regional health center.

9. FCTC & Tobacco Epidemic in the Russian Federation 9 | MPOWER: Warn Most people are not aware of the full spectrum of health hazards caused by tobacco consumption and passive smoking Anti-tobacco advertisement does change the image of smoking and the image of tobacco industry 2/3 want to quit as a result ¾ approve of health warnings More than a half of people asked changed their opinion Pack warnings are effective,especially pictorial ones occupying at least ½ of a pack Impact of pack warnings in Brazil

10. FCTC & Tobacco Epidemic in the Russian Federation 10 | Pictorial pack warnings

11. FCTC & Tobacco Epidemic in the Russian Federation 11 | MPOWER: Enforce Every year up to 10 billions dollars is spent on tobacco advertisement Advertisement increase sales, diseases and number of deaths Only total advertisement bans are effective Within 10 years the decrease of tobacco consumption will happen 9 times faster than without it Tobacco advertisements increase tobacco consumption Motivates youth to start smoking Involves new groups in smoking, for instance women Demotivates smokers to quit

12. FCTC & Tobacco Epidemic in the Russian Federation 12 | Who is the target audience?

13. FCTC & Tobacco Epidemic in the Russian Federation 13 | Moscow metro: 7 million people daily

14. FCTC & Tobacco Epidemic in the Russian Federation 14 |

15. FCTC & Tobacco Epidemic in the Russian Federation 15 | MPOWER : Raise The most effective measure in combating tobacco epidemic Especially effective for youth and people with low income Taxation has to be above the inflation rate Tax increase is a win-win situation: smoking consumption goes down and state revenues go up World Bank: increase of a price for a pack of cigarettes by 10% leads to a decrease in smoking consumption by 4%-8% Tax rates vs. consumption, South Africa

16. FCTC & Tobacco Epidemic in the Russian Federation 16 | Norway, 1990-1998 Higher taxes  Higher income

17. FCTC & Tobacco Epidemic in the Russian Federation 17 | Accomplishments Ratification of the Framework Convention of Tobacco Control (FCTC) Approval of the National Tobacco Control Concept Successful completion of Global Adults Tobacco Survey Creating of the multisectoral expert tobacco-control team Bringing the issue of tobacco control to a high level Professional expertise

18. FCTC & Tobacco Epidemic in the Russian Federation 18 | September 13, 2010: 60 th session of the WHO European Committee “Russia has ratified the WHO Framework Convention on Tobacco Control and this is truly a big, significant event. We will surely consider the regulations of this international treaty in our domestic legislation.”

19. FCTC & Tobacco Epidemic in the Russian Federation 19 | September 23: National Tobacco Control Concept 2010-2015 APPROVED Increasing tobacco tax up to the average level of the WHO European region (53 countries) Total ad ban on tobacco products and tobacco industry sponsorship Gradual but 100% smoke free: 1 st stage – 100% smoke free in hospitals, schools, universities, government institutions; 2 nd stage – closed environment in cafes, bars, restaurants 2011: draft legislation to be submitted to the State Duma (The Parliament of the Russian Federation)

20. FCTC & Tobacco Epidemic in the Russian Federation 20 | To be changed……...

21. Contact information Nataliya Toropova N.Toropova@who.org.ru Tel: +7 495 787 21 08