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War Causes Ukrainians to Smoke More

April 2023
Since the beginning of 2021 the number of never smoking Ukrainians has dropped by 4.7% and now stands at 68.8%. Two years ago, this indicator was 73.5%. This is evidenced by a comparative analysis of the findings of surveys conducted by KIIS in early 2021 and at the end of 2022.

The increase in the number of smokers is significant, given that smoking prevalence before the war was 26.5%.

In particular, the number of “daily” smokers increased by 2.3%, and the number of smokers who consume tobacco less than every day increased by 2.4%.

The most obvious reason for the increase in smoking rate is the war. In fact, it has set the country several years back in its tobacco control efforts. This was emphasised by Natalia Toropova, head of the Healthy Initiatives NGO when presenting the survey findings: “The overall trend is disappointing. Ukrainians have taken to smoking at a higher rate. This was predictable, as it is a human reaction to war-related stress, and a complete change of life priorities. But where does this bring us? Smoking remains a major cause of deaths and disabilities that could be prevented.”

The proportion of respondents who had been smokers before the war and have started smoking even more is 30.3%, those whose smoking remains at the same level is 44.4%, those who are smoking less is 17.8%, while those who have quit smoking altogether is 6.4%.

When asked about their smoking status, 5,5% of pre-war non-smokers reported having started smoking since the outbreak of the war and still doing so, while 0.6% of them started smoking but gave up later.

The vast majority (78.8%) of those whose smoking rate has increased use combustible cigarettes, which are associated with the highest health risks.

Despite the increasing number of smokers, smoking cessation programs remain a low priority for Ukraine’s healthcare system. According to a KIIS survey, 31% of smokers were self-reliant when trying to quit, and only 0.9% relied on counselling at healthcare facilities.

The effectiveness of independent tobacco cessation attempts is low. According to the Smokfree Action Coalition (SFAC), smokers make on average 30 or more attempts before finally quitting. Smokers who receive support when quitting can succeed after not mora than three attempts.

In times of war, people seek solutions to mitigate stress. Speaking about the most vulnerable groups facing the fastest growing smoking rates, Dr Yuriy Stratovych names the military, people living under occupation, residents of areas affected by intense shelling, displaced people and refugees. He also dispels the myth that smoking helps to cope with stress. “People who smoke are addicts and require extensive professional assistance”, the doctor says.

“Smoking during the war is a part of everyday communication. And in trenches, we either shoot or smoke. There is nowhere to charge electronic devices, and no psychologists nearby, only the forest, trenches and bullets whizzing by”, says Andriy Kulchytsky, Chairman of the Board of the Battalion 207. He used to be a long-time smoker, quit before the war, but resumed smoking following the Russian invasion.

Smoking is just one of the indicators reflecting the reaction of society and its psychological state. Although the topic of smoking may seem “irrelevant” in times of war, it has a major medium- and long-term impact on public health, the economy, healthcare system and demographics. However, mere appeals to quit a harmful habit do not yield the desired effect. Scaremongering about future health effects have very little effect during an open armed conflict, either. Smokers need professional help to improve their mental health and address their smoking addiction.

Healthy Initiatives is a think tank that implements research projects in Ukraine, Georgia, Kazakhstan and other countries (a total of 8 countries across Europe and Asia) focusing on economics and public health.

In 2021-2022, the organisation, in cooperation with Yale University (USA), launched an experimental study of human behaviour among those wishing to give up harmful habits. The study was conducted in Kyiv and New Haven but was put on hold following Russia’s attack on Ukraine, in part because some of the Ukrainian participants who had quit smoking eventually resumed tobacco use. Thus, an objective assessment of the duration of their cessation was impossible.

Furthermore, Healthy Initiatives, in collaboration with Cornell University (USA) is conducting research in three countries simulating 120+ scenarios of demographic and morbidity trends in Ukraine based on different regulatory policies.

This survey was funded with a grant from the Foundation for a Smoke-Free World, Inc. (“FSFW”), a US nonprofit 501(c)(3), independent global organization.
This survey is, under the terms of the grant agreement with FSFW, editorially independent of FSFW. The contents, selection and presentation of facts, as well as any opinions expressed herein, are the sole responsibility of the authors and under no circumstances should they be regarded as reflecting the positions of FSFW.
For more information about the Foundation for a Smoke-Free World, please visit its website (www.smokefreeworld.org).
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