Smoking as a factor of reduced life expectancy in Russia

Abstract

Smoking is an important factor of preventable mortality in Russia. According to the author’s calculations, based on international estimates of the relative risks of mortality for smokers and Russian data on smoking prevalence, self-assessment of health and mortality by causes of death, in 2017 the life expectancy of smokers was 5.2-5.3 years lower than that of non-smokers, while healthy life expectancy was 2.6-3.2 years lower. Since 2005, smoking-related standardized mortality rates have been steadily declining, generally repeating the changes in mortality from all causes in Russia during this period. However, the aggregated data conceal significant gender differences – the main decrease in smoking-related mortality was observed among men. The smoking epidemic among men started earlier and is now at a more mature stage (decline) than among women (stagnation or even growth for some groups). From 2004 to 2017, the life expectancy of women smokers increased significantly more (by more than a year and a half) than for non-smokers, although for men such a trend is not observed. The decomposition of differences in life expectancy between smokers and non-smokers shows that the advantage in life expectancy of non-smoking women mainly decreased in the age range from 50 to 69 years, mainly as a result of changes in mortality from cardiovascular diseases. For men, a similar reduction of the advantage in life expectancy of non-smokers compared to smokers occurred at younger ages, from 40 to 64 years. At older ages, non-smokers compensate for their lag in the increase of life expectancy; however, since for women this trend is observed later and on a smaller scale, life expectancy of women smokers in the study period grows faster.