MOSCOW—More than 300,000 Russians die each year from tobacco-related diseases, yet the Russian government does little to discourage smoking and the country remains one of the world's leading consumers of cigarettes.
Russian President Vladimir Putin last week warned that the country's demographic future is grim, with an annual population decline of 700,000 and a birthrate so low that by 2050, the country may only have 110 million residents, down from the current 143 million.
But while Putin called for young people to have more children, he mentioned smoking only once, when he talked about the "huge number of young people" with chronic diseases and addictions to alcohol, smoking and narcotics.
The bottom line, public health advocates say, is that Russia—with its lax regulations and low taxes on cigarettes—is missing a big opportunity to stem the country's leading preventable cause of death.
"It looks like the Russian government is not interested in regulation or money," said Andrei Dyomin, a Moscow Medical Academy professor and president of the Russian Public Health Association.
Cigarettes in Russia are plentiful and still amazingly cheap. One domestic brand costs 15 cents for a 20-cigarette pack. They are also easy to buy, even for minors. "I was seldom refused," said Yana Saftyf, 18, who spent years making underage purchases after she started smoking at age 14.
The national consequences of such individual choices are clear. Putin in his May 10 state of the nation address called the demographic crisis the nation's "most acute problem" and proposed financial incentives to encourage young couples to have more children.
There's no clear answer to why the government isn't pressing more to stop smoking as another way of addressing the demographic decline.
More than 40 percent of Russia's high school graduates already are smokers, according to Russian health experts. In some regions, that number surpasses 50 percent. The World Health Organization—which declared May 31 World No Tobacco Day—says 61 percent of Russian men and 36 percent of all Russian adults smoke, among the highest rates in the world.
The Russian anti-smoking movement has made progress, but nowhere near as much as its counterpart in the United States, where only 21 percent of adults smoke.
In Russia, tobacco ads on television and radio were banned just five years ago. A law that goes into effect in July is supposed to stop outdoor advertising of cigarettes. Smoking in many workplaces, government buildings and on public transportation is also prohibited, but smokers routinely flout the bans.
"All these laws are declared, but many without any penalties," said Dr. Vladimir Levshin, head of cancer prevention for the Russian Cancer Research Institute. "Most smoking restrictions are actually ignored."
Making matters worse, the nation is a leading illicit exporter of cigarettes, mainly from the Russian production of such multinational companies as Philip Morris and British American Tobacco.
Dyomin said Russia produces roughly 400 billion cigarettes a year, while only 300 billion are smoked. "That means 100 billion are smuggled abroad," Dyomin said. "That creates the possibility for corruption and all kinds of illegal things."
Smokers in European Union nations, where cigarette taxes are high, are the main customers for cut-rate Russian smokes.
With Russia facing so many health crises—AIDS, drug abuse, alcoholism and tuberculosis—anti-tobacco activists can't get the government's attention.
Dyomin said government anti-smoking campaigns are co-opted by the tobacco industry, a charge that one industry representative denied.
Maria Bezhanova, media manager for British American Tobacco in Russia, said tobacco companies sponsor anti-smoking programs in schools and are "one of the most socially responsible" industries. "We do everything to prevent" retail sales to minors and to teach about the health risks, Bezhanova said, but law enforcement must do its job. "It's a problem of control," she said.
Bezhanova concedes that the anti-smoking campaign has done little to push smoking up the list of health dangers Russians worry about.
"Only 1 percent of people take smoking as the biggest problem," Bezhanova said. "The rest is about money and unemployment and other subjects. There is danger of smoking, but it doesn't look like people take it seriously."
Government officials have historical reasons to go slow in curbing tobacco. A cigarette shortage in 1990, as the Soviet Union was collapsing, sparked rationing, long lines at kiosks and protests. Any frontal assault on smoking would likely produce a popular backlash, Dyomin said, and "it looks like the government doesn't want to irritate people."
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(Bonner reports for The St. Paul Pioneer Press.)
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(c) 2006, Knight Ridder/Tribune Information Services.
PHOTOS (from KRT Photo Service, 202-383-6099): RUSSIA-SMOKING
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