Affordability of cigarettes and consequences of tobacco epidemic in Russian regions

Abstract

The paper addresses the effects of the tobacco epidemic in Russian regions, including the impact of cigarettes affordability on mortality attributed to tobacco. As a characteristic of such consequences, the authors consider the standardized mortality rates from lung cancer in the Russian regions. Regression analysis of the factors of regional lung cancer mortality reveal a high level of losses in the northern and eastern regions as well as significant gender differences. It indirectly shows the incompleteness of female tobacco epidemic in Russia — men are more active in quitting smoking, especially those from high-income and highly educated groups of urban population. Decomposition of regional differences shows the dominant role of the territorial factor: 72% of differences among men and 55% among women are due to what of eight federal districts they belong. Gender wage gap is also an important factor for men (more equity corresponds to lower losses from tobacco epidemic). We explain this by greater tolerance towards male smoking in regions with higher levels of gender inequality. For women, other factors turned out to be significant: about 25% of differences are explained by the risk of secondhand smoke and another 13% — by poor environmental situation. Despite high price that Russia pays for the consequences of mass smoking, the affordability of cigarettes by international standards remains high. At the same time, econometric modeling shows no significant effect of prices on tobacco mortality: most likely, in Russia, the threshold value after which an increase in price significantly reduces the future losses from smoking has not yet been reached. The research is conducted with the financial support of the Russian Foundation for Basic Research (RFBR) under grant No. 19-29-07546 mk “The Impact of Human Capital on Current and Future Economic Growth in Russia”.