World No Tobacco Day 2023: Ukraine survey results highlight challenges

On World No Tobacco Day (WNTD), Ukraine's commitment to tobacco control remains steadfast amidst the ongoing conflict. The Centre for Public Health of the Ministry of Health (MoH) of Ukraine, together with WHO, emphasizes the significance of this day which serves as a global platform to raise awareness about the hazards of tobacco use and promote cessation efforts. Ukraine implemented comprehensive legislative measures to regulate both traditional and novel tobacco and nicotine products in January 2022, prior to the full-scale invasion by the Russian Federation.

To evaluate the impact of these regulations and understand changes in tobacco usage during the war, WHO, in collaboration with the MoH and the Kyiv International Institute of Sociology, conducted a national survey on tobacco use among adults (those aged over 18) in April 2023. The insights gained from this survey reveal the importance of comprehensive regulations for heated tobacco products (HTPs) and e-cigarettes. Banning their use indoors and prohibiting the availability of flavoured products have emerged as crucial factors in preventing their uptake.

Flavours and aggressive marketing

The survey highlighted the demand for smoking cessation services and the vital role of primary health care workers in assisting tobacco users to quit. WHO, in partnership with the MoH and Centre for Public Health, presented the survey results, reaffirming the importance of evidence-based interventions.

Dr Jarno Habicht, WHO Representative in Ukraine, commended Ukraine's proactive efforts in controlling tobacco prior to the war. He emphasized that the new regulations, once fully implemented, will contribute to reducing smoking rates and saving lives. Dr Habicht also warned against the misleading claims that novel tobacco products serve as smoking cessation aids and underscored the need for their strict regulation.

Tetyana Skapa, Head of the Department of Noncommunicable Disease Prevention and Drug Trafficking at the Centre for Public Health, said the research showed that a significant number of consumers of tobacco and nicotine products are addicted to products with aromatic additives. "Among the consumers of these products, there is a significant share of women and young people; it is obvious that flavours and aggressive marketing of these dangerous products contribute to this. We know that during emergencies, the burden of tobacco use can increase. Therefore, it is important for us to know the current situation and to understand what measures need to be taken."

Implementing legislation

From 11 July 2023, according to the new legislation, cigarettes, and liquids for e-cigarettes, with aromatic additives will be prohibited from sale in Ukraine. Iryna Soroka, Deputy Head of the Department for the Prevention of Noncommunicable Diseases at the Centre for Public Health, says that only a systematic approach will further reduce tobacco use in the country.

"The results of the survey show, in particular, that people's willingness to quit smoking is noticeably high," she comments. "The Centre for Public Health helps to raise awareness among family doctors about motivational counselling for help to quit smoking. Another obvious problem is that there are gaps in implementing legislation. The Centre has developed a website where anyone who wants to can file a complaint about the violation of their right to a smoke-free environment."

Survey highlights

Smoking prevalence and the use of novel tobacco products among the adult population showed no substantial changes, with some minor indications of lower rates.

Approximately 27.4% of respondents (44.0% men and 13.7% women) were current users of tobacco and nicotine products. Among them, 23% were daily users (37.5% men and 11.1% women).

Of respondents, 22.2% were current cigarette smokers (37.8% men and 9.3% women), while daily smokers constituted 19.5% (33.3% men and 8.1% women). Cigarettes remained the most used tobacco product (83% of tobacco product users).

The prevalence of novel tobacco and nicotine product use was as follows: e-cigarettes 3.3%, HTPs 3.0% and hookah 2.6%.

HTP users cited the ability to use these products in places where traditional smoking was banned as the primary reason for use (54.3%).

E-cigarette users mentioned attractive flavours (50.0%) and social norms as the main influencers of the uptake of such products (42.3%).

Passive smoking persisted, with 28.8% of respondents reporting exposure to tobacco smoke at home and 21.7% indoors at their workplaces.

Smoking cessation efforts indicated that 63.1% of smokers plan to quit, with 16.4% expressing the need for professional help.

Towards a smoke-free future

The MoH expressed its appreciation for the public's commitment to tobacco control, particularly during the current crisis. The survey's findings will support efforts to address tobacco use risk factors and guide decision-making processes. Efforts are underway to enforce tobacco control measures, including inspections to tackle indoor smoking, especially hookah use in cafes, bars and restaurants.

On WNTD, Ukraine and WHO urge individuals, communities and policy-makers to continue working together to protect public health and combat tobacco use. By prioritizing evidence-based interventions and fostering a supportive environment, we can create a smoke-free future for all.

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