US, Russia Work Together on Anti-Smoking Guidelines

WASHINGTON, May 7 (By Maria Young for RIA Novosti) – As Moscow gets ready to start implementing a nationwide ban on smoking in public places, an international public health partnership between the US and Russia has produced a comprehensive set of smoking cessation principles to be introduced next week to health professionals and government officials across Russia.

“The guidelines will be presented on May 14 in Moscow, and will be made available to all interested parties, including officials, specialists, NGOs, mass media and the public,” said Andrey Demin, president of the Russian Public Health Association and a physician at the Medical and Rehabilitation Center Under the Ministry of Health of the Russian Federation, in comments to RIA Novosti.

“This is the first comprehensive, evidence-based document which will help 50-plus million tobacco users in Russia and also those in Russian-speaking countries,” he added.

The guidelines are a product of the US-Russia Civil Society Partnership Program (CSPP), which launched in 2009 as then-Russian President Dmitry Medvedev and newly-elected US President Barack Obama met to reset US-Russian relations. The program identified 11 areas in which organizers felt both countries could benefit from cooperative efforts, including public health.

Developed by health experts and scientists in both countries, and based on the European model for smoking cessation, the document calls for any smoker who sees a healthcare provider in Russia to be counseled to stop smoking and get the opportunity for a treatment program tailored to their needs.

The anti-tobacco focus of the civil society partnership has worked because experts in both the US and Russia have faced the same challenges with the tobacco industry and its efforts to undercut anti-tobacco policies, said Donald Ziegler, an associate clinical professor in public health at the University of Illinois at Chicago and a retired director of prevention and lifestyles with the American Medical Association.

“Tobacco industries just swarmed Russia and the former Soviet Union after 1991, particularly from Japan, the US and Britain,” and led to a sharp increase in smoking and smoking-related deaths across the region, Ziegler told RIA Novosti.

An estimated 39 percent of Russia’s adult population smokes, and smoking-related illnesses claim approximately 400,000 deaths there each year, according to the World Health Organization (WHO).

Last month Medvedev said he thought the new legislation banning public smoking in Russia could save up to 200,000 lives annually.

Dozens of states and cities in the United States have enacted laws prohibiting smoking in public places and the percentage of adults in the US who smoke has dropped from 25 percent in 1993 to 19 percent in 2010, according to the US Centers for Disease Control (CDC), a federal public health and safety agency.

Ziegler is part of the group that developed the anti-smoking guidelines and will present them in Moscow, Lipetsk, St. Petersburg, Petrozavodsk, Kazan and Yelets beginning next week.

“The new smoking law in Russia goes into effect starting June 1 so… people won’t be able to smoke at work, in bars, in hospitals, and they have some of the highest levels of smoking in the world. It’s really going to be challenging,” he said.

The guidelines allow Russia to fulfill part of its obligation under a World Health Organization international tobacco control treaty, which requires guidelines for the treatment of tobacco dependence.

Both the United States and Russia have signed the treaty, but while Russia has ratified the treaty, the US has not, in large part because of the political power of the tobacco industry in America, a number of experts told RIA Novosti.

Between the treaty, the smoking ban and the new guidelines on treatment, Russian President Vladimir Putin appears poised to surpass the United States in its anti-tobacco efforts and further position Russia as a world leader on what has become a global health concern, they said.

“The smoking ban that’s going into effect is really a model for other countries. Putin has stepped up and taken a real lead in tobacco control,” said Thomas Glynn, director of cancer science and trends, at the American Cancer Society.

“Tobacco control is one area in which Russia is out ahead of the US,” said Judyth Twigg, co-chair of the CSPP public health working group and a professor of political science at Virginia Commonwealth University.

Twigg said the CSPP represents a new approach to US-Russian relations that recognizes Russia as an emerging power on the world stage.

“In the entire post-Soviet period we can look back and see that the US did behave badly in ways, coming in with advice about how Russia ought to restructure its society… but it no longer wants to be in a position of getting outside help. Russia doesn’t want to be seen as Africa, or other developing, third world countries,” Twigg told RIA Novosti.

The partnership between the two countries highlighted several smoking cessation tools including drugs that have performed well in clinical trials in Russia but that haven’t received much attention yet in the United States, she added.

“Tobacco use is a global epidemic. All countries including Russia, the US and the European Union need to deal with tobacco use cessation,” said Demin.

The hope now, he said, is that the Russian Ministry of Health will adopt the new smoking cessation guidelines, a move that would open the door for the Russian Federation to pay doctors to comply, and increase the likelihood that patients would get the counseling and treatment they need.


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