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Mortality and economic burden of Krasnoyarsk region, Russia, caused by regular tobacco usage

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      This study assesses mortality and economic burden due to the regular tobacco usage among the population of the Krasnoyarsk region of the Russian Federation. This territory was chosen for the analysis because of two factors: high smoking prevalence in the Krasnoyarsk region (46% among the adult population) and premature mortality of the working-age population, which leads to a significant burden to the federal budget of the Russian Federation.

      Data sources

      In our work, three main causes of smoking-related deaths were considered: cardiovascular disease, lung cancer, and COPD. The working-age population was investigated (20–72 years old). The databases of mortality and population size of the territorial body of state statistics of the Krasnoyarsk region (data for 2013) were used as the information sources.


      Joint application of population-attributable risk and disability-adjusted life years method allowed us to estimate medico-demographic and economic burden due to the tobacco-attributable premature mortality in the investigated population.


      We found that tobacco use-related economic burden is at least equal to 2% of the gross regional product of the Krasnoyarsk region in 2013.


      An assessment of economic tobacco use-related burden is important for determining the volume of necessary funding for development of smoking prevention programs, proper estimation of tobacco companies’ taxation, and other measures for controlling tobacco use. Smoking cessation is a priority for prevention of the tobacco-related diseases and reduction of their burden on local economy.

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      Most cited references 29

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      Estimates of global mortality attributable to smoking in 2000.

      Smoking is a risk factor for several diseases and has been increasing in many developing countries. Our aim was to estimate global and regional mortality in 2000 caused by smoking, including an analysis of uncertainty. Following the methods of Peto and colleagues, we used lung-cancer mortality as an indirect marker for accumulated smoking risk. Never-smoker lung-cancer mortality was estimated based on the household use of coal with poor ventilation. Relative risks were taken from the American Cancer Society Cancer Prevention Study, phase II, and the retrospective proportional mortality analysis of Liu and colleagues in China. Relative risks were corrected for confounding and extrapolation to other regions. We estimated that in 2000, 4.83 (uncertainty range 3.94-5.93) million premature deaths in the world were attributable to smoking; 2.41 (1.80-3.15) million in developing countries and 2.43 (2.13-2.78) million in industrialised countries. 3.84 million of these deaths were in men. The leading causes of death from smoking were cardiovascular diseases (1.69 million deaths), chronic obstructive pulmonary disease (0.97 million deaths), and lung cancer (0.85 million deaths). Smoking was an important cause of global mortality in 2000. In view of the expected demographic and epidemiological transitions and current smoking patterns in the developing world, the health loss due to smoking will grow even larger unless effective interventions and policies that reduce smoking among men and prevent increases among women in developing countries are implemented.
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        Smoking-attributable mortality, years of potential life lost, and productivity losses--United States, 2000-2004.

        Cigarette smoking and exposure to tobacco smoke are associated with premature death from chronic diseases, economic losses to society, and a substantial burden on the United States health-care system. Smoking is the primary causal factor for at least 30% of all cancer deaths, for nearly 80% of deaths from chronic obstructive pulmonary disease, and for early cardiovascular disease and deaths. In 2005, to assess the economic and public health burden from smoking, CDC published results of an analysis of smoking-attributable mortality (SAM), years of potential life lost (YPLL), and productivity losses in the United States from smoking during 1997-2001. The analysis was based on data from CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) system, which estimates SAM, YPLL, and productivity losses based on data from the National Health Interview Survey and death certificate data from the National Center for Health Statistics. This report presents an update of that analysis for 2000-2004, the most recent years for which source data are available. The updated analysis indicated that, during 2000-2004, cigarette smoking and exposure to tobacco smoke resulted in at least 443,000 premature deaths, approximately 5.1 million YPLL, and $96.8 billion in productivity losses annually in the United States. Comprehensive, national tobacco-control recommendations have been provided to the public health community with the goal of reducing smoking so substantially that it is no longer a significant public health problem in the United States.
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          WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package


            Author and article information

            [1 ]Department of Health Care Management, Krasnoyarsk State Medical University, Krasnoyarsk, Russia
            [2 ]Department of Public Health and Health Care, Krasnoyarsk State Medical University, Krasnoyarsk, Russia
            Author notes
            Correspondence: Irina L Arshukova, Department of Public Health and Health Care, Krasnoyarsk State Medical University, Partizan Zheleznyak Street 1, Krasnoyarsk 660022, Russia, Tel +7 903 920 0082, Email iarshukova@
            Int J Chron Obstruct Pulmon Dis
            Int J Chron Obstruct Pulmon Dis
            International Journal of COPD
            International Journal of Chronic Obstructive Pulmonary Disease
            Dove Medical Press
            22 February 2016
            : 11
            : 351-355
            26955267 4769005 10.2147/COPD.S97287 copd-11-351
            © 2016 Artyukhov et al. This work is published and licensed by Dove Medical Press Limited

            This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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