Decreasing the prevalence of smoking among Finnish physicians

A postal survey of smoking habits was conducted in a populationof Finnish physicians between October and December 1990. Amongthe 1,623 surveyed (1,231 responses, a 75.8% response rate)the prevalence of daily smoking among male physicians was 10%while in females it was 6%. Another 15% (6% of females) smokedoccasionally. Smoking was more prevalent among elderly physicians.Daily smoking among physicians has decreased since 1969, whenthe daily smoking prevalence was 24% among male respondentsand 17% among females. In addition, according to the survey,Finnish physicians often advice their patients to stop smokingif they have a disease, disorder or complaint for which theprognosis has already been reported to be associated with smoking.     

Changes and determinants in cigarette smoking prevalence in southwestern France, 1985-1997

OBJECTIVE AND METHODS: Smoking trends were assessed in southwestern France for the period 1985-1997 using data from the MONICA population surveys conducted in the Toulouse region. RESULTS: Smoking prevalence decreased in men and remained stable in women, with the exception of age group 35-44 years (stabilization in men, increase in women). In both genders, prevalence of ex-smokers increased. Higher educational level was negatively associated with smoking in men and positively associated in women; in both genders, older age was negatively associated with smoking. CONCLUSIONS: In southwestern France, the decrease or stabilization in smoking prevalence is due to an increase in ex-smokers rather than in never smokers.     

Dilemmas in sickness certification among Swedish physicians

Despite a growing concern for matters related to sick-leaveand its economical and human consequences, little Is still knownof the practice of sickness certification. To remedy this, astudy based on the critical incident technique was designedto explore dilemmas experienced by physicians when issuing sicknesscertificates. A questionnaire was distributed to 170 generalpractitioners (GPs), private physicians and psychiatrists inthe Swedish county of Ostergotland asking about sickness certificationdilemmas, the consequences of the dilemma and how the situationwas resolved. Through a semi-qualitative analysis, 2 main typesof dilemma were identified. Insurance-associated dilemmas werethe most frequent and concerned the grading of work incapacity,the duration of a sick-leave period and the difficulties ininterpreting the sickness insurance legislation. The focus onbiomedical diagnosis in the sickness certificate was found tocomplicate the certification routines, since working capacitymay be reduced even though a diagnosis has not been confirmed.The primary medical dilemmas consisted of difficulties relatedto encountered obstacles In the clinical management, e.g. insubjective medical history, diagnosis or patient compliance.It is concluded that the physicians' role in the insurance systemmakes it necessary to give the medical diagnosis a social interpretation.The development of standards for grading of work incapacityis needed as well as routines for closer cooperation betweenthe different actors in the sickness insurance system.     

Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994-2002

BACKGROUND: While the graded relationship between socio-economic status (SES) and risk behaviour in adulthood has been the subject of intense research, far less is known about socio-economic differences in health-related behaviour among adolescents. The purpose of the present study is to examine socio-economic differences in adolescent tobacco use in Germany as well as changes in the relationship between 1994 and 2002. METHODS: Data were obtained from the 'Health Behaviour in School-aged Children' study conducted in the largest federal state of Germany, Northrhine-Westfalia, in 1994, 1998 and 2002. The analysis is based on 11.401 11- to 15-year old students. Socio-economic differences in regular smoking were studied in relation to both parental SES (family affluence) and students own SES (school type). Trends from 1994 to 2002 were analysed for each category of family affluence and school type separately. RESULTS: Family affluence only had a weak effect on regular smoking while for type of school a strong social gradient for smoking was found for both the genders. Trend analyses within the different family affluence and school-type categories showed that smoking has generally increased in all socio-economic groups. The level of socio-economic differences remained virtually unchanged in girls and boys in the past 10 years in Germany. CONCLUSIONS: The same relationships of family affluence and school type with smoking have persisted for almost a decade in Germany. Students own SES affects adolescent smoking substantially. Prevention programmes should focus on the school setting in order to tackle current as well as future health inequalities.     

Trends in cigarette smoking habits in The Netherlands in relation to age, gender and educational level 1987-1991

The objective of the study was to obtain information on recenttrends in smoking habits in socioeconomic subgroups (gender,age and educational level) in The Netherlands. The data wereanalysed from the Monitoring Project on Cardiovascular DiseaseRisk Factors yearly cross-sectional surveys that were performedbetween 1987 and 1991. Each year a random sample of men andwomen aged 20–59 years in three towns in The Netherlandswas invited to participate in the study. The overall responserate was 50% for men and 57% for women. A total of over 36,000subjects participated in the study. The age-standardized prevalenceof current, former and never smoking was the outcome measure.Data on smoking habits were collected by means of a self-administeredquestionnaire. The age-standardized smoking prevalence between1987 and 1991 fell from 41.4 to 38.9% in men (–0.5 percentagepoints per year and 95% Cl: –1.0 to –0.02) and from42.0 to 38.2% in women (–0.8 percentage points per yearand 95% Cl: –1.3 to –0.3). The prevalence of currentsmoking decreased in men with low education and in women withlow and intermediate/high education. In the 1961–1970birth cohort of men with intermediate/high education a relativelylarge increase of 2.8 percentage points (95% Cl: 1.0–4.5)per year was observed. The decrease In smoking prevalence observedbetween 1987 and 1991 was small compared to the period before1987. Differences in the magnitude and direction of trends wereobserved between birth cohorts and educational levels. The resultsof the study emphasize the need for an approach that is targetedtoward specific sociodemographic subgroups.     

Smoking attributable mortality in the community of Madrid: 1992-1998

Background: The proportion of smokers and the number of cigarettesconsumed per person-year in Madrid is above the European average.To evaluate the impact of smoking in public health smoking attributablemortality was estimated for 1998 and for changes since 1992.Methods: The number of smoking attributable deaths and yearsof potential life lost attributable to cigarette smoking for1992 and 1998 by gender and age group were estimated, basedon the population attributable fraction. The relative risksof the Cancer Prevention Study II were used. To compare thetwo periods of study, a Poisson regression analysis adjustedby age was applied. Results: In 1998, 15.9% of total mortalityin the population older than 34 years was attributable to smoking.Lung cancer and chronic obstructive pulmonary disease are themain causes of death in both genders. In the period studied,1992–1998, the adjusted rates diminished in men in bothage groups, while in women they increased in the age group 35to 64 years. The mortality from lung cancer remained stablein men, increasing in women by 12%. The years of potential lifelost decreased by 14% in men and increased by 42% in women.Conclusions: One in four deaths in men and one in 36 deathsin women are attributed to cigarette smoking. The smoking attributablemortality in males has tended to stabilize, while in women prematuremortality is increasing. Key points

• Smoking attributable mortality was estimated for 1998 and forchanges since 1992 to evaluate the impact of smoking in thepopulation older than 34 years.

MAIN RESULTS

• In the period studied, 1992–1998, the adjusted mortalityrates attributable to smoking diminished in men, while in womenthey increased in the age group 35 to 64 years.
• The main causesof Smoking attributable mortality are Lung cancerand chronicobstructive pulmonary disease in both genders. Themortalityfrom lung cancer remained stable in men, increasingin womenby 12%.

IMPLICATIONS FOR PUBLIC HEALTH

• In the Community of Madrid, health promotion programmes to reducecigarette smoking need to be intensified, specially in women

     

Determinants of smoking status: cross-sectional data on smoking initiation and cessation

BACKGROUND: Cigarette smoking is known to increase the risk of chronic disease. Improved understanding of factors that contribute to smoking initiation and cessation may help to underpin strategies that lead to smoking behavior change. METHODS: Cross-sectional data obtained from 11,967 men and women, aged 20-65 years, were used to study associations with smoking initiation and smoking cessation within the general population. Information on smoking habits, socio-demographic factors and psychosocial factors were collected through self-administered questionnaires. Multiple logistic regression analyses were undertaken by gender. RESULTS: Adverse childhood experiences and personality characteristics (including extraversion, neuroticism and hostility) were found to be related to smoking initiation. Age, marital status and tobacco-related factors were consistently associated with smoking cessation. Older people, married persons and those who smoked more cigarettes per day had a higher likelihood of quitting, both for men and women. CONCLUSIONS: Smoking initiation was found to be associated with adverse childhood events and with measures of personality whereas smoking cessation was associated predominantly with socio-demographic and tobacco use-related factors.     

Workplace smoking policies in Taiwan and their association with employees' smoking behaviours

BACKGROUND: The implementation of worksite smoking policies has shown significant effects on reducing employees' smoking consumption and protecting non-smoking workers. However, there are no data about workplace smoking policies in Taiwan. The purpose of this study was to document the status of worksite smoking policies in Taiwan and its potential impact on employees' smoking behaviours. METHODS: A two-stage investigation was conducted. The first stage was to examine the current status of workplace smoking policies and the second was to evaluate the relationship between workplace smoking policies and employees' smoking behaviours. After two follow-ups in each stage, 264 companies and 1141 employees returned their questionnaires. RESULTS: Workplace smoking policies were associated with types of businesses and size of workplaces. Only approximately half of manufacturing and service companies have implemented a prohibitive smoking policy. Large facilities (>750 employees) were more likely to implement a prohibitive policy (57%). Employees in workplaces with a prohibitive policy had lower prevalence of smoking and cigarette consumption, and less exposure to passive smoking. Although most smokers agreed with banning smoking in their work environment, no difference in interest in participating in cessation programs was found. CONCLUSIONS: Significant associations were found between workplace smoking policies and employees' smoking behaviours. Results of the study provide basic information for designing more refined smoking policies in the workplace in Taiwan.     

Injury mortality in the European Union 1984-1993: An overview

Background: Approximately 190,000 European Union (EU) citizensdie annually as a result of an injury. In response, the EuropeanCommission identified accidents and injuries as a priority areafor action in the field of public health in 1993. In 1984, theWorld Health Organization (WHO) Health for All targets wereset in Europe to reduce unintentional injuries by 25% and reversethe rising trends in suicide by the year 2000. The aim of thisstudy was to examine the trends in mortality due to externallycaused physical injuries between 1984 and 1993 in the 15 countrieswhich are currently members of the EU. Methods: Injury mortalitydata for all countries were obtained from the WHO and nationalgovernment agencies. Age-standardized mortality rates were calculatedfor both unintentional and intentional injuries and examinedover time. Results: Downward trends in age-standardized injurymortality due to unintentional injuries were identified in mostcountries. Marked variations were observed between countries,with low rates in the UK, The Netherlands and Sweden and highrates in Finland, Portugal and France. Age-standardized suiciderates decreased In most countries over the study period, withmarked variations between countries. In general, countries innorthern Europe experienced higher suicide rates than countriesin southern Europe. Mortality rates due to homicide and otherviolent causes were low and relatively stable over the studyperiod. Conclusions: Most countries appear to be on track tomeet the WHO targets for unintentional injury mortality andsuicide mortality. However, disparities between countries remain,for reasons that are unclear. While mortality data were valuablein describing the epidemiology of fatal injury in Europe, agreementon standardized practices of data collection, coding and analysiswould improve the comparability of data between countries.     

Influence of social environment in smoking among adolescents in Turkey

BACKGROUND: The aim of this study was to examine the social determinants of smoking among adolescents attending school and/or work. METHODS: A survey was carried out on 6012 adolescents aged between 13 and 17 years in 15 cities, recruited from schools, vocational training centres and work places. A self-completed questionnaire was used for data collection. Single- and multi-level regression analyses were run to estimate models. RESULTS: Ever smoking and current smoking rates were 41.1% and 10.5% among girls, and 57.5% and 25.2% among boys. These rates were 47.0% and 13.3% among those who only attended school, 62.2% and 31.7% among those who attended school and worked simultaneously, and 67.5% and 43.0% among those who worked and did not attend school. In multi-level analysis, the major predictors of current smoking were close friends smoking [odds ratio (OR) 3.48; 95% confidence interval (CI) 1.93-6.27], no knowledge of harmful effects of short-term smoking (OR 2.15; 95% CI 1.74-2.67), vulnerability to peer pressure (OR 1.90; 95% CI 1.48-2.46), negative self-perception (OR 1.69; 95% CI 1.31-2.18) and male sex (OR 1.68; 95% CI 1.30-2.16). Mothers higher education was a predictor for girls' smoking, while mother's lower education was a predictor for boys' smoking. At the school level, smoking prevalence was a predictor of current smoking (OR 1.07; 95% CI 1.05-1.08). CONCLUSIONS: Smoking patterns were similar to Western countries in several aspects, while male prevalence rates were higher and the impact of gender-related predictors was significant. Our findings suggest that youth smoking prevention policies should address personal, familial and educational environmental level requirements, taking into consideration the gender differences in addition to international guidelines.     

School connectedness and daily smoking among boys and girls: the influence of parental smoking norms

BACKGROUND: The objective was to test whether an association between school connectedness and smoking exists among Danish school children, and if so, to examine whether parental smoking attitude and parental smoking behaviour influenced this association. METHODS: Data were collected by the Danish contribution to the cross-national study Health Behaviour in School-Aged Children (HBSC) 1998. Analyses were performed on questionnaire-based data from 1537 students at grade nine from a random sample of schools in Denmark. RESULTS: An independent inverse association was found between school connectedness and smoking among both boys and girls. Parents' attitude to their children's smoking significantly modified this association among boys. Among girls the modifying effect was less marked. Neither among boys nor girls did parental smoking behaviour significantly modify the association between school connectedness and smoking, although a modifying tendency was observed among girls. CONCLUSIONS: The smoking behaviour of Danish adolescents may be influenced by complicated interactions of varying sets of experienced smoking norms, and any research project or preventive programme focusing on the influence of school life on adolescent smoking behaviour needs to consider the family smoking norms. Additionally, the results stress the important role of gender by indicating that the smoking behaviour of girls may be more sensitive to restricting social influences than the smoking behaviour of boys.     

Changes in smoking prevalence and attitudes to smoking among Japanese physicians between 2000 and 2004

OBJECTIVES: To estimate smoking prevalence among Japanese physicians in 2004, clarify their attitudes towards smoking, and compare and examine the results of the 2004 survey with those of the 2000 survey. STUDY DESIGN: Cross-sectional study. METHODS: Among members of the Japan Medical Association, 3000 male and 1500 female physicians were selected at random, and mailed self-administered, anonymous questionnaires. The survey was conducted between February and July 2004. Data from 3633 respondents were analysed. RESULTS: Smoking prevalence among males in 2004 was 21.5% [95% confidence interval (CI) 19.9-23.1%], which was significantly lower than that found in 2000 (27.1%; 95%CI 25.4-28.8%). Smoking prevalence among females in 2004 was 5.4% (95%CI 4.1-6.7%), which was not significantly different from that in 2000 (6.8%; 95%CI 5.4-8.2%). For nicotine dependency, no significant differences were observed for male or female physicians between 2004 and 2000. The percentages of respondents who agreed that 'physicians should not smoke' and 'patients should not smoke' increased in both males and females. The proportion of physicians that actively encouraged smoking cessation also increased in 2004. CONCLUSIONS: There were some favourable changes in anti-smoking behaviour among Japanese physicians between 2000 and 2004. However, several problems still need to be resolved, and further anti-smoking measures are required.     

Postpartum return to smoking among usual smokers who quit during pregnancy

BACKGROUND: Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse. METHODS: Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. Smoking status was recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social characteristics and preventive behaviour were compared for regular smokers who had quit smoking during pregnancy and those who had not, and among quitters, who had resumed smoking postpartum and those who had not. RESULTS: In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking relapse was the partner's smoking behaviour. CONCLUSION: Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they are smokers.     

Factors associated with stages of cigarette smoking among Turkish youth

BACKGROUND: This study examines prevalence and determinants of cigarette smoking among Turkish youth and transition among smoking stages. METHODS: Cross-sectional data from the Global Youth Tobacco Survey (GYTS) obtained from 15 197 youth were used to study factors associated with various stages of cigarette smoking among Turkish youth. RESULTS: Males and high-school students have higher odds of being susceptible to smoking compared with other non-smokers and higher odds of becoming established smokers. Exposure to parent, teacher, and peer smoking, anti-tobacco curricula, cigarette promotions, and perceived ease of access to cigarettes are all significant predictors of being susceptible to smoking and established smoking. Turkish youth who attribute positive traits to smokers are more likely to be susceptible to smoking and to become established smokers. Parental advice and media exposure to anti-tobacco messages were not significantly associated with becoming an established smoker. CONCLUSION: The results reveal the importance of early prevention programmes, which should begin before high school, and targeting efforts towards male students and all students who are not yet smokers but susceptible to smoking. Findings also suggest that prevention policies that challenge the cultural perceptions of smokers among Turkish youth are needed.     

Smoking by French general practitioners: behaviour, attitudes and practice

INTRODUCTION: This paper examines smoking prevalence, sociodemographic factors and the medical practice of French general practitioners. METHOD: Data from the 1998 cross-sectional national survey of 2,073 GPs. The questionnaire was administered by telephone. A response rate of 67% was attained. Instrumentation included questions about medical practice, sociodemographic characteristics, and health behaviour. Bivariate and multiple logistic regression (MLR) analyses were conducted. RESULTS: Almost one-third (32.1%) of physicians were current smokers. A significantly higher proportion of male (33.9%) were smokers compared to women (25.4%, p<0.001) and men were more likely to be former smokers (49.1% versus 31.7%). Two-thirds of physicians reported recommending nicotine replacement therapy to their patients. MLR shown that former smokers were more likely (OR = 1.51, 95% CI, 1.24-1.83) to indicate that their help in getting patients to quit was not effective compared to smokers. Also, physicians who were 'dissatisfied' with the profession were more likely (OR = 0.75, 95% CI, 0.60-0.92) to report their help as not effective than those who were 'satisfied'. CONCLUSION: These data support the need for greater professional participation in reducing smoking among general practitioners in France and greater education concerning the vital role of physicians in promoting cessation among the general population. KEY POINTS: This study examines smoking habits among French GP's, intervention practices, and opinions about their ability to help patients quit smoking. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women.     

Effects of a population-based smoking cessation programme on smoking in pregnancy.

A controlled study was conducted to evaluate the effects of a low-intensity population-based smoking cessation programme in maternity care clinics. Quitting smoking during pregnancy was assessed by a self-administered questionnaire and verified by hair nicotine concentration. In the intervention area, 58/306 women (19.0%) reported quitting smoking during pregnancy whereas in the reference area the numbers were 22/152 (14.5%) (difference = 4.5%, 95% confidence interval: -2.6%-11.6%). The intervention group indicated that they received more information on adverse effects of smoking, studied the material more actively, and felt that material from maternity care influenced their smoking behaviour more than the reference group.     

Attitudes towards smoking policies and tobacco control measures in relation to smoking status and smoking behaviour

BACKGROUND: To examine support for various smoking policies and tobacco control measures among lifetime smokers in a country with weak anti-smoking legislation and an underdeveloped anti-smoking climate. METHODS: Current (n = 624) and former smokers (n = 131) from a general population survey filled in the 30-item Smoking Policy Index (SPI). Structural equation modelling was used to confirm the SPI factorial structure and to test whether smoking status and smoking behaviour variables were related to the six dimensions of the SPI. RESULTS: The dimension with the highest support was penalties for sales to minors. Sanctions against smokers had the lowest support. Current smokers compared with former smokers showed lower support on the taxes/fees, public education, and environmental restrictions dimensions while controlling for gender, age, and social status. Within current smokers, unfavourable smoking behaviours were associated with lower support. CONCLUSION: Even in a country with poor tobacco control conditions, lifetime smokers including smokers with highly unfavourable smoking behaviours strongly support smoking policies and tobacco control measures concerning penalties and advertising/promotion. These measures should be used to promote anti-smoking legislation, and strict law enforcement of these measures is expected to be accepted by all smokers. For measures that are not supported by all lifetime smokers, interventions may be useful to increase acceptability. A limitation of the present study is the absence of never-smokers as a comparison group.     

Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999)

BACKGROUND: We wanted to examine how the acceptance of euthanasia among the general public in Western Europe has changed in the last decades, and we wanted to look for possible explanations. METHODS: We analysed data from the European Values Surveys, held in 1981, 1990, and 1999-2000 in 12 West European countries. In each country, representative samples of the general public were interviewed using the same structured questionnaire in all countries. Euthanasia was explained in the questionnaires as 'terminating the life of the incurably sick'. RESULTS: A total of 46 199 respondents participated in the surveys. A significant increase in acceptance of euthanasia could be observed in all countries except (West) Germany. While the average increase in euthanasia acceptance was 22%, the increase was particularly obvious in Belgium, Italy, Spain, and Sweden. Although changes in several characteristics of respondents, such as decrease in religious beliefs, rising belief in the right to self-determination, and (to a lesser extent) rise in levels of education, were associated with growing acceptance of euthanasia, they could only partly explain the increase of euthanasia acceptance over the years. CONCLUSIONS: An increase of euthanasia acceptance among the general public took place over the last two decades in almost all West European countries, possibly indicating a growing support for personal autonomy regarding medical end-of-life decisions. If this trend continues, it is likely to increase the public and political debate about the (legal) regulation of euthanasia under certain conditions of careful medical practice in several West European countries.     

Increase in cigarette smoking and decline of anti-smoking counselling among Chinese physicians: 1987-1996

Four hundred and ninety-three Chinese physicians were surveyedin 1996 on their cigarette smoking patterns, frequency and methodsof anti-smoking counselling in Wuhan, capital city of HubeiProvince, People's Republic of China. It was found that 61.3%of the male and 12.2% of the female physicians were currentcigarette smokers, an increase of 20.4% for males and 149.0%for females in comparison with findings among physicians inthe same city in 1987. Also, about one-third (30.2%) of thesmokers reported a daily consumption of 20 cigarettes or more,showing a 23% increase. In addition, two-thirds (68.6%) of thephysicians counselled their patients about cigarette smokingin the past year, representing a 25% decrease. In the 1987 sample,physicians' age and cigarette smoking status predicted the frequencyof their anti-smoking counselling. In the present sample, thesetwo variables are no longer associated with physicians' counsellingfrequency. Unchanged over the 9 years are the strong associationsbetween physicians' counselling frequency and whether they perceivedthemselves as the most influential people in helping patientsquit smoking, and whether they perceived their past counsellingexperiences as successful. In conclusion, the findings of thepresent study have provided valuable information on Chinesephysicians' cigarette smoking patterns and their anti-smokingcounselling practices. The dramatic increase in cigarette smokersamong Chinese physicians, especially female physicians, in thepast 9 years is alarming. The trend seems to be that more physiciansare cigarette smokers now than 9 years ago, and fewer care tocounsel their patients about cigarette smoking. These criticalchanges have raised new themes regarding future anti-smokingstrategies in China.     

Health behaviour in Estonia,Finland and Lithuania 1994-1998. Standardized comparison

BACKGROUND: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. METHODS: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. RESULTS: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. CONCLUSIONS: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.