1. Health and demographics in Russia: why economic growth won't help? Kirill Danishevskiy, MD, MPH, Ph.D. Lead consultant Open Health Institute President, Society of Evidence-based medicine Assistant professor, Moscow Medical Sechenov Academy 7908046@mail.ru7908046@mail.ru, tel. (+7-495) 7908046

3. Probability of a 20 year old living to age 60 years in 2003 Source : www.mortality.org, calculations by VM Shkolnikov, Max Planck Institute

4. Difference in CVD mortality by age

5. Difference in injury mortality by age

6. Alcohol as determinant of mortality Life expectancy, males Life expectancy, females Ethanol, liters per person per year consumed years liters

7. Alcohol poisonings and life expectancy at birth Russia (M+F) 1965-2006 R= - 0.94 Source : VM Shkolnikov

8. Strong liquor consumption in liters of pure ethanol

9. 9 Proportion of male smokers is not declining Rural Urban Moscow/SPB Source: Perlman et al Tob.Control 16 (5):299-305, 2007 Data: RLMS

10. 10 Proportion of female smokers is on raise Rural Urban Moscow/SPB Data: RLMS Source: Perlman et al Tob.Control 16 (5):299-305, 2007

11. % of deaths aged 35-69 years attributable to smoking in 2000 MenWomen Belarus33%0% Russia33%3% Ukraine32%3% Central Asia (8)23%4% Estonia31%3% Latvia30%2% Lithuania29%0% United Kingdom25%21% Germany29%11% Source : http://www.deathsfromsmoking.net/

12. Time to act Legal drugs are the main issue Smoking – 400k deaths, alcohol 500k deaths per annum Interventions are clear on tobacco Need for coherent policy on alcohol, similar to FCTC Need to overcome personal biases and give a coherent message – go against the industry!!!