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

Study objective-The aims of this study were to assess and validate self rep orted smoking prevalence and to assess smoking cessation related process va riables in the Republic of Karelia, Russia and in North Karelia, Finland. Design-Comparative population surveys of random population samples from bot h areas in spring 1992. The study included a self administered questionnair e, physical measurements and laboratory tests. The validity of self reporte d smoking prevalence was assessed by serum cotinine analyses. Setting-The district of Pitkaranta in the Republic of Karelia, Russia and p rovince of North Karelia, Finland. Participants-The study population uas a 25 to 64 year old population in both areas. A stratified random sample of 1 000 people in Pitkaranta and 2000 people in North Karelia was drawn from th e population registers. In Pitkaranta 380 men and 455 women, and in North K arelia 673 men and 803 women, participated in the survey. Results-The self reported prevalence rates of daily smoking in Pitkaranta w ere 65% among men and 10% among women. In North Karelia the respective rate s were 29% and 13%. Women in Pitkaranta greatly underreported their smoking status, which was assessed by comparing the self reported data to the seru m cotinine measurements.. The smoking prevalence among women in Pitkaranta would rise from 10% to 21% if all participants with high cotinine values wo uld be regarded as smokers. Compared with smokers in North Karelia, a highe r percentage of smokers in Pitkaranta expressed their wish to quit and beli eved that they would succeed. However, on average they had fewer previous s moking cessation attempts than smokers in North Karelia. in addition, the h ealth personnel in North Karelia were more active in advising smokers to qu ilt. Conclusions-High smoking prevalence among men in Pitkaranta obviously contr ibutes much to the high premature death rate in the Republic of Karelia. Th ere is considerable underreporting of smoking in Pitkaranta, especially amo ng 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 Fates of ex smokers, together with less smoking ces sation counselling from health personnel, need to be considered in tailorin g antismoking interventions in the area.