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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1999 Sep;53(9):528–534. doi: 10.1136/jech.53.9.528

Comparing smoking and smoking cessation process in the Republic of Karelia, Russia and North Karelia, Finland

T Laatikainen, E Vartiainen, P Puska
PMCID: PMC1756967  PMID: 10562876

Abstract

STUDY OBJECTIVE: The aims of this study were to assess and validate self reported smoking prevalence and to assess smoking cessation related process variables in the Republic of Karelia, Russia and in North Karelia, Finland. DESIGN: Comparative population surveys of random population samples from both areas in spring 1992. The study included a self administered questionnaire, physical measurements and laboratory tests. The validity of self reported smoking prevalence was assessed by serum cotinine analyses. SETTING: The district of Pitkaranta in the Republic of Karelia, Russia and province of North Karelia, Finland. PARTICIPANTS: The study population was a 25 to 64 year old population in both areas. A stratified random sample of 1000 people in Pitkaranta and 2000 people in North Karelia was drawn from the population registers. In Pitkaranta 380 men and 455 women, and in North Karelia 673 men and 803 women, participated in the survey. RESULTS: The self reported prevalence rates of daily smoking in Pitkaranta were 65% among men and 10% among women. In North Karelia the respective rates were 29% and 13%. Women in Pitkaranta greatly underreported their smoking status, which was assessed by comparing the self reported data to the serum cotinine measurements. The smoking prevalence among women in Pitkaranta would rise from 10% to 21% if all participants with high cotinine values would be regarded as smokers. Compared with smokers in North Karelia, a higher percentage of smokers in Pitkaranta expressed their wish to quit and believed that they would succeed. However, on average they had fewer previous smoking cessation attempts than smokers in North Karelia. In addition, the health personnel in North Karelia were more active in advising smokers to quit. CONCLUSIONS: High smoking prevalence among men in Pitkaranta obviously contributes much to the high premature death rate in the Republic of Karelia. There is considerable underreporting of smoking in Pitkaranta, especially among women, which is probably attributable to the cultural unacceptability of female smoking in Russia. The common wish to quit, few previous cessation attempts and much lower rates of ex smokers, together with less smoking cessation counselling from health personnel, need to be considered in tailoring antismoking interventions in the area.

 

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Selected References

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  1. Clark M. A., Kviz F. J., Crittenden K. S., Warnecke R. B. Psychosocial factors and smoking cessation behaviors among smokers who have and have not ever tried to quit. Health Educ Res. 1998 Mar;13(1):145–153. doi: 10.1093/her/13.1.145. [DOI] [PubMed] [Google Scholar]
  2. Cohen S., Lichtenstein E., Prochaska J. O., Rossi J. S., Gritz E. R., Carr C. R., Orleans C. T., Schoenbach V. J., Biener L., Abrams D. Debunking myths about self-quitting. Evidence from 10 prospective studies of persons who attempt to quit smoking by themselves. Am Psychol. 1989 Nov;44(11):1355–1365. doi: 10.1037//0003-066x.44.11.1355. [DOI] [PubMed] [Google Scholar]
  3. Cummings S. R., Rubin S. M., Oster G. The cost-effectiveness of counseling smokers to quit. JAMA. 1989 Jan 6;261(1):75–79. [PubMed] [Google Scholar]
  4. DiClemente C. C., Prochaska J. O., Fairhurst S. K., Velicer W. F., Velasquez M. M., Rossi J. S. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991 Apr;59(2):295–304. doi: 10.1037//0022-006x.59.2.295. [DOI] [PubMed] [Google Scholar]
  5. Dobson A. J., Kuulasmaa K., Moltchanov V., Evans A., Fortmann S. P., Jamrozik K., Sans S., Tuomilehto J. Changes in cigarette smoking among adults in 35 populations in the mid-1980s. WHO MONICA Project. Tob Control. 1998 Spring;7(1):14–21. doi: 10.1136/tc.7.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Doll R., Peto R., Wheatley K., Gray R., Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994 Oct 8;309(6959):901–911. doi: 10.1136/bmj.309.6959.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dreyer L., Winther J. F., Pukkala E., Andersen A. Avoidable cancers in the Nordic countries. Tobacco smoking. APMIS Suppl. 1997;76:9–47. [PubMed] [Google Scholar]
  8. Emmons K. M., Abrams D. B., Marshall R., Marcus B. H., Kane M., Novotny T. E., Etzel R. A. An evaluation of the relationship between self-report and biochemical measures of environmental tobacco smoke exposure. Prev Med. 1994 Jan;23(1):35–39. doi: 10.1006/pmed.1994.1005. [DOI] [PubMed] [Google Scholar]
  9. Geographical variation in the major risk factors of coronary heart disease in men and women aged 35-64 years. The WHO MONICA Project. World Health Stat Q. 1988;41(3-4):115–140. [PubMed] [Google Scholar]
  10. Hymowitz N., Sexton M., Ockene J., Grandits G. Baseline factors associated with smoking cessation and relapse. MRFIT Research Group. Prev Med. 1991 Sep;20(5):590–601. doi: 10.1016/0091-7435(91)90057-b. [DOI] [PubMed] [Google Scholar]
  11. Jarvis M. J., Tunstall-Pedoe H., Feyerabend C., Vesey C., Saloojee Y. Comparison of tests used to distinguish smokers from nonsmokers. Am J Public Health. 1987 Nov;77(11):1435–1438. doi: 10.2105/ajph.77.11.1435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kemmeren J. M., van Poppel G., Verhoef P., Jarvis M. J. Plasma cotinine: stability in smokers and validation of self-reported smoke exposure in nonsmokers. Environ Res. 1994 Aug;66(2):235–243. doi: 10.1006/enrs.1994.1059. [DOI] [PubMed] [Google Scholar]
  13. Korhonen T., Uutela A., Korhonen H. J., Urjanheimo E. L., Puska P. Smoking cessation advice from health professionals: process evaluation of a community-based program. Patient Educ Couns. 1999 Jan;36(1):13–21. doi: 10.1016/s0738-3991(98)00070-6. [DOI] [PubMed] [Google Scholar]
  14. Kviz F. J., Clark M. A., Prohaska T. R., Slezak J. A., Crittenden K. S., Freels S., Campbell R. T. Attitudes and practices for smoking cessation counseling by provider type and patient age. Prev Med. 1995 Mar;24(2):201–212. doi: 10.1006/pmed.1995.1034. [DOI] [PubMed] [Google Scholar]
  15. Leon D. A., Chenet L., Shkolnikov V. M., Zakharov S., Shapiro J., Rakhmanova G., Vassin S., McKee M. Huge variation in Russian mortality rates 1984-94: artefact, alcohol, or what? Lancet. 1997 Aug 9;350(9075):383–388. doi: 10.1016/S0140-6736(97)03360-6. [DOI] [PubMed] [Google Scholar]
  16. McKee M., Bobak M., Rose R., Shkolnikov V., Chenet L., Leon D. Patterns of smoking in Russia. Tob Control. 1998 Spring;7(1):22–26. doi: 10.1136/tc.7.1.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Murray R. P., Connett J. E., Lauger G. G., Voelker H. T. Error in smoking measures: effects of intervention on relations of cotinine and carbon monoxide to self-reported smoking. The Lung Health Study Research Group. Am J Public Health. 1993 Sep;83(9):1251–1257. doi: 10.2105/ajph.83.9.1251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Nikitin Y. P., Shalaurova I. Y., Serova N. V. The validation of serum thiocyanate smoking data in a population survey. Rev Epidemiol Sante Publique. 1990;38(5-6):469–472. [PubMed] [Google Scholar]
  19. Parish S., Collins R., Peto R., Youngman L., Barton J., Jayne K., Clarke R., Appleby P., Lyon V., Cederholm-Williams S. Cigarette smoking, tar yields, and non-fatal myocardial infarction: 14,000 cases and 32,000 controls in the United Kingdom. The International Studies of Infarct Survival (ISIS) Collaborators. BMJ. 1995 Aug 19;311(7003):471–477. doi: 10.1136/bmj.311.7003.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Patrick D. L., Cheadle A., Thompson D. C., Diehr P., Koepsell T., Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994 Jul;84(7):1086–1093. doi: 10.2105/ajph.84.7.1086. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Peto R., Lopez A. D., Boreham J., Thun M., Heath C., Jr Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet. 1992 May 23;339(8804):1268–1278. doi: 10.1016/0140-6736(92)91600-d. [DOI] [PubMed] [Google Scholar]
  22. Pierce J. P., Dwyer T., DiGiusto E., Carpenter T., Hannam C., Amin A., Yong C., Sarfaty G., Shaw J., Burke N. Cotinine validation of self-reported smoking in commercially run community surveys. J Chronic Dis. 1987;40(7):689–695. doi: 10.1016/0021-9681(87)90105-6. [DOI] [PubMed] [Google Scholar]
  23. Pierce J. P. International comparisons of trends in cigarette smoking prevalence. Am J Public Health. 1989 Feb;79(2):152–157. doi: 10.2105/ajph.79.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Puska P., Matilainen T., Jousilahti P., Korhonen H., Vartiainen E., Pokusajeva S., Moisejeva N., Uhanov M., Kallio I., Artemjev A. Cardiovascular risk factors in the Republic of Karelia, Russia, and in North Karelia, Finland. Int J Epidemiol. 1993 Dec;22(6):1048–1055. doi: 10.1093/ije/22.6.1048. [DOI] [PubMed] [Google Scholar]
  25. Sans S., Kesteloot H., Kromhout D. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J. 1997 Dec;18(12):1231–1248. [PubMed] [Google Scholar]
  26. Senore C., Battista R. N., Shapiro S. H., Segnan N., Ponti A., Rosso S., Aimar D. Predictors of smoking cessation following physicians' counseling. Prev Med. 1998 May-Jun;27(3):412–421. doi: 10.1006/pmed.1998.0286. [DOI] [PubMed] [Google Scholar]
  27. Sillett R. W., Wilson M. B., Malcolm R. E., Ball K. P. Deception among smokers. Br Med J. 1978 Oct 28;2(6146):1185–1186. doi: 10.1136/bmj.2.6146.1185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Slattery M. L., Hunt S. C., French T. K., Ford M. H., Williams R. R. Validity of cigarette smoking habits in three epidemiologic studies in Utah. Prev Med. 1989 Jan;18(1):11–19. doi: 10.1016/0091-7435(89)90050-9. [DOI] [PubMed] [Google Scholar]
  29. Strecher V. J., DeVellis B. M., Becker M. H., Rosenstock I. M. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986 Spring;13(1):73–92. doi: 10.1177/109019818601300108. [DOI] [PubMed] [Google Scholar]
  30. Suadicani P., Hein H. O., Gyntelberg F. Serum validated tobacco use and social inequalities in risk of ischaemic heart disease. Int J Epidemiol. 1994 Apr;23(2):293–300. doi: 10.1093/ije/23.2.293. [DOI] [PubMed] [Google Scholar]
  31. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators. J Clin Epidemiol. 1988;41(2):105–114. doi: 10.1016/0895-4356(88)90084-4. [DOI] [PubMed] [Google Scholar]
  32. Virganskaya I. M., Dmitriev V. I. Some problems of medicodemographic development in the former USSR. World Health Stat Q. 1992;45(1):4–14. [PubMed] [Google Scholar]
  33. Woodward M., Tunstall-Pedoe H. An iterative technique for identifying smoking deceivers with application to the Scottish Heart Health Study. Prev Med. 1992 Jan;21(1):88–97. doi: 10.1016/0091-7435(92)90008-6. [DOI] [PubMed] [Google Scholar]
  34. Zaridze D. G., Dvoirin V. V., Kobljakov V. A., Pisklov V. P. Smoking patterns in the USSR. IARC Sci Publ. 1986;(74):75–86. [PubMed] [Google Scholar]
  35. Zimmerman R. S., Connor C. Health promotion in context: the effects of significant others on health behavior change. Health Educ Q. 1989 Spring;16(1):57–75. doi: 10.1177/109019818901600108. [DOI] [PubMed] [Google Scholar]
  36. de Vries H., Backbier E. Self-efficacy as an important determinant of quitting among pregnant women who smoke: the phi-pattern. Prev Med. 1994 Mar;23(2):167–174. doi: 10.1006/pmed.1994.1023. [DOI] [PubMed] [Google Scholar]

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