title: Changes in smoking among adolescents in the Republic of Karelia, Russia and Eastern Finland from 1995 to 2013.
abstract: OBJECTIVE
  The aim of this study was to compare the prevalence of smoking, smoking experimentation and future intention to smoke in the Pitkäranta district, the Republic of Karelia, Russia and Eastern Finland in the years 1995 and 2013.
  
  
  METHODS
  Cross-sectional studies were carried out among 15-year-old ninth grade adolescents in all schools in the Pitkäranta region (1995: n=385, response rate 95%; 2013: 182, response rate 98%) and a sample of schools in Eastern Finland (1995: n=2098, response rate 91%; 2013: 635 response rate 95%).
  
  
  RESULTS
  The daily smoking prevalence among adolescents did not change either in Eastern Finland or in the Pitkäranta district from 1995 to 2013. However, smoking among Finnish adolescents was more common than among Russians (p<0.001) and boys, in general, smoke more commonly than girls (p<0.001). In Finland, early smoking experimentations declined by half among both genders but in Pitkäranta the girls' smoking experimentations tripled (relative risk 3.03, 95% confidence interval 1.76-5.20) from 1995 to 2013. The combined effect of country and gender was significant (p<0.001) for future intention to smoke. In Finland future intentions to smoke were very similar in boys and girls compared with obvious gender differences in Russia.
  
  
  CONCLUSIONS
  These results suggest that more attention should be paid for programmes that consider better gender and culture-specific issues in preventing initiation of smoking and promoting an anti-smoking climate in societies.
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Finland annamari.aura@uef.fi.
authors.forename: Annamari
authors.initials: A
authors.lastname: Aura
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland National Institute for Health and Welfare, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.affiliation: Statcon Oy, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Isoaho
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Bykachev
authors.affiliation: State Budgetary Health Care Institution of the Republic of Karelia, Russian Federation.
authors.forename: Galina
authors.initials: G
authors.lastname: Lazutkina
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Finland.
authors.forename: Kerttu
authors.initials: K
authors.lastname: Tossavainen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D033182:Intention; D008297:Male; D015995:Prevalence; D012426:Russia; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*
keywords: Adolescent; gender; health behaviour; school; smoking