PREVENTIVE MEDICINE.

The prevalence of Smoking in men, Russia is leading among the developed countries of the world. Conducting effective legislative and administrative-legal, educational, and therapeutic interventions will reduce the prevalence of Smoking in the country. Key words: tobacco Smoking, malignancies, chronic obstructive pulmonary disease, cardiovascular disease, treatment of nicotine addiction. In Russia 43.9 million (39.1%) adults (aged 15 year or more), including 30.6 million (60.2%) males and 13.3 million (21.7%) females are smokers. The latter holds the lead in the spread of male smoking among economically developed countries. Effective legislative and administrative-legal, educational and therapeutic efforts will permit the spread of tobacco smoking to be reduced in the country. Key words: tobacco smoking, malignancies, chronic obstructive pulmonary disease, cardiovascular diseases, treatment for nicotine dependence. Currently, globally, tobacco kills 1 in 10 adults. If not implemented effective measures against Smoking, then by 2030 it will kill 1 in 6 people, i.e. this will cause more than 10 million deaths per year. It is expected that 7 out of 10 of these deaths will occur in low and middle economic development, including the Russian Federation [1, 2]. The high mortality rate from tobacco is that nicotine and other substances contained in tobacco smoke, increase the risk of development of diseases of almost all organs and systems of the person. In the process of combustion of cigarettes and other Smoking tobacco produces smoke that contains more than 4,000 substances . Composition of tobacco smoke have not been studied, however, identified at the present time the substances are highly toxic, irritating, toxic and carcinogenic substances (table. 1). For example, vapors of benzene (the maximum allowable concentration (Mac) of 5 mg/m 3), even in small quantities with repeated exposure disrupt the function of blood-forming organs, large quantities act on the Central nervous system; formaldehyde (MPC 0,005 mg/m 3 ) is toxic, it irritates the mucous membranes of the respiratory tract, eyes; hydrocyanic acid (MPC 0.3 mg/m 3 ) is a strong poison that binds hemoglobin, paralyzes the respiratory centers and cause suffocation; aniline (MPC 0,1 mg/m 3 ) is a toxic substance; a pair of cadmium (MPC 0,1 mg/m 3 ) paralyze the nervous system. A special place among substances of tobacco smoke is carbon monoxide, the main effect of which is to block the hemoglobin, which leads to the development of tissue hypoxia. Carcinogens in tobacco smoke (benzene, Benzen, 1,3-butadiene, nitroso – nornicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1 – buta non) is more than 10 times increase the risk of developing cancer as active and passive smokers [4]. Nicotine, for which tobacco products are consumed only in small quantities positively stimulates the Central nervous system, but to nicotine quickly develops dependence and tolerance that compels the smoker to increase the frequency of Smoking cigarettes, which means to consume more harmful substances contained in tobacco smoke. Pharmacological action of nicotine is varied [5]. It relates to the release of adrenaline from the adrenal glands, norepinephrine in the hypothalamus, dopamine in the mesolimbic system, increasing catecholamine levels in the blood, affecting blood pressure, heart rate and blood clotting factors, variable increase in the secretion of acidic gastric juice, leading to the development of stomach ulcers, etc. Smokers have lower body weight than non-smokers, which is associated with a decrease calorie consumption and increase the speed of metabolic processes and an increase in secretion of catecholamines and adrenal hormones. Thus, once in the arterial blood of man and then acting all organs, substances contained in cigarette smoke lead to development of diseases of almost all organs and systems (see figure). The Russian Federation is among the countries with very high prevalence of tobacco use. Many epidemiological studies conducted in different regions of Russia in the period from 2000 to 2005 has presented a very high prevalence of Smoking among the adult population.

POLICIES AND STRATEGIES of TOBACCO CONTROL table 1. Substances contained in tobacco smoke gas phase Components Number of in the main thread (ág/cigarette) Nicotine 1000 2500 carbon Monoxide 10000 23000 12 48 Benzene Toluene Formaldehyde 160 70 100 Acrolein 60 100 50 130 Ammonium Hydrocyanic acid 400 500 nitrogen Oxides Acetone 100 600 100 250 16 40 Pyridine Phenol Aniline 60 140 Benzpiren 0,36 0,02 0,04 0,07 0,02 Benzanthracene N-nitrosonornicotine 0,2 3 4-(methylnitrosamino)-1-(3-0,1 1 pyridyl)-1-butanone Cadmium Nickel 0,02 0,1 0,08 0,06 Zinc a fragment of the poster world health organization the body of the smoker , 2003 The prevalence of Smoking in men ranged from 56.4 per (Tver) to 81.5% (Chelyabinsk), women 13.6 (Ekaterinburg) to 36.7% (Chelyabinsk) [4]. In 2009 in Russia on a representative sample of a Global poll of adult population about tobacco consumption [6] studied the prevalence of tobacco use among the adult (15 years and older) population. Overall, 39.1 per cent (43.9 per million people) of the adult Russian population was regular smokers of tobacco. Among them men of 60.2% (30.6 million), women, 21.7 percent (13.3 million). The prevalence of tobacco use was different in different age groups. In males, the greatest prevalence of tobacco use has been identified in the age group 25 to 44 years of 68.3%. In the age group of 19 to 24 years of 62.1%. Among women, the greatest prevalence of tobacco use was identified in the age group from 19 years to 24 years, 37.9 percent, and in the age group 25 to 44 years 31.3 per cent, i.e. more than 30% of women of reproductive age were active tobacco users. Among women with higher education (26.6 percent), Smoking significantly more than women with average (19.7 per cent) and elementary (2.7 per cent) education. Men also high prevalence of tobacco use has been found in persons with the average (43,1%) and higher education (38.1 per cent) compared with primary (18%) education. The study revealed a very high intensity of Smoking. The average number of cigarettes smoked per day among adults was 16.9 (18,4 men, women, and 12.6). As a result of high intensity of Smoking as in Smoking men (63,6%) and Smoking women (45.9 per cent) showed signs of a high degree of nicotine addiction. High prevalence and intensity of tobacco consumption leads to high morbidity and mortality associated with tobacco. Tobacco Smoking causes cancer of the lung, larynx, kidney, bladder, stomach, colon, mouth and esophagus as well as leukemia, chronic bronchitis, chronic obstructive pulmonary disease, coronary heart disease, stroke, miscarriage (miscarriage), premature birth, birth defects, infertility and other diseases [7, 8]. Tobacco kills up to half of its users. By the end of this century, tobacco can claim the lives of 1 billion people. According to experts [4, 9], from diseases associated with tobacco, die each year about 400,000 Russians. However, currently, Smoking is one of the leading preventable causes of death. Tobacco use is often and mistakenly perceived as solely a personal choice. However, as practice shows, a number of strategies to reduce tobacco consumption in society. In the mid-twentieth century, the prevalence of tobacco consumption was very high in almost all countries of the world and corresponded to the modern Russian level .

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