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Public Health

The Rīga Stradiņš University (RSU) Institute of Public Health has conducted a study with the aim of finding out professionals’ assessments and recommendations to reduce the use of smoked and smokeless tobacco and electronic cigarettes in Latvia: “Situation of Smoked and Smokeless Tobacco Products in Latvia and Recommendations to Promote Public Health”.

The comprehensive study on the situation of smoked and smokeless tobacco products by the RSU Institute of Public Health showed that the current prevalence of smoking (cigarettes, cigars, cigarillos, tobacco) in Latvia was 32% in 2020 (the EU average was 23%). The proportion of men smoking in Latvia is significantly higher than the EU average, while the proportion of women smoking is similar to the EU average. In 2020, the lifetime prevalence of heated tobacco consumption was 6% on average in the EU and 14% in Latvia, with much higher prevalence among young people. In both EU countries and Latvia, lifetime prevalence of e-cigarette use was higher among men (17% and 28% respectively) than among women (12% and 15%). Among 15–24-year olds, the prevalence of e-cigarette use in Latvia is significantly higher than the EU average.

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Overall, there has been no improvement in the epidemiological situation of smoking in Latvia, either for traditional tobacco products or for electronic smoking devices. Experts highlight the rapid increase in the use of electronic smoking devices in recent years. The State Revenue Service (SRS) product consumption data confirm the tobacco and nicotine epidemic in Latvia.

Smoking in Latvia is common among people with mental health issues and healthcare workers. The use of electronic smoking devices is more common among women and young people.

Half of the surveyed users of electronic cigarettes, chewing tobacco, and nicotine gum started using these products because they do not emit smoke or an odour (52%), a third because they considered them to be a less harmful alternative (34%), and 39% because they were trying to quit or reduce smoking conventional tobacco products.

The study also summarises good practice in primary prevention and smoking cessation in different population groups. Based on the results, the authors make recommendations for reducing smoking in Latvia.

Media campaigns, internet posts, and educating children and adolescents within the education system are considered ineffective interventions in Latvia. Environmental restrictions on smoking, smoking cessation support groups, and nicotine replacement therapy, on the other hand, are considered effective interventions in Latvia.

Researchers at the RSU Institute of Public Health have made recommendations to policy makers for a smoking cessation strategy for the next five years. For example, to develop smoking cessation policies in a comprehensive way, rather than just pushing through individual initiatives; to reduce the influence of the industry on smoking cessation policy-making in Latvia (by educating legislators about the principles and importance of evidence-based policies, etc.); to develop a medium-term policy planning document on smoking cessation; to develop monitoring of the short- and long-term consequences of smoking, monitoring factors influencing public attitudes; and to regularly evaluate the effectiveness of public policies, including media campaigns, and their impact on the illegal market.

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The presentation of the study’s results at Rīga Stradiņš University. From the left: Minister of Health Hosam Abu Meri, the study’s authors Anda Ķīvīte-Urtāne, Director of RSU Institute of Public Health, and senior lab assistant Ļubova Tihomirova

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From the left: RSU Vice-Rector for Academic Affairs Dins Šmits and Minister of Health Hosam Abu Meri during the presentation of the study

The researchers also consider it essential to develop independent (non-industry-funded) research in this area, including on the short- and long-term health effects of electronic smoking devices, and to support the emergence and capacity-building of an active non-governmental sector in the field of smoking prevention and control, for example by raising funds from excise duties. It is also recommended that the rights of non-smokers be strengthened in legislation, including the complete abolition of designated smoking areas, the regulation of nicotine gum, etc.

In addition to providing important information, this study demonstrates the research quality and capacity of the RSU Institute of Public Health, not only in public health research, but also in its ability to provide evidence-based health policies.