Tobacco, Alcohol and Diet as Mortality Risk Factors: the secondary analysis of the 25-year Cohort Study

Background: Individual lifestyle risk factors have been linked to increased mortality globally; however, there is limited data on these associations in Russia. A secondary analysis of the Russia Longitudinal Monitoring Survey (RLMS) data was conducted to close this gap. Methods: The secondary data have been obtained from a nationally-representative annual cohort survey conducted by the Higher School of Economics (HSE). In this original study, for the first time in Russia, we extracted RRs for researched risk factors. Of additional original value, we made a prospective-retrospective cohort based on a representative longitudinal survey and provided the deaths as outcomes for survival analysis. We included 56,559 respondents between 1994 and 2019 in the study. Self-reported questionnaires were used to collect data, and Cox proportional hazard models were used to compute the hazard ratios (HR). Results: In total, 4063 deaths were reported during the analyzing period. Overall, the risk of death was more than 2.2 times higher for males than for females (HR 1/4 2.29, 95% CI: 2.14; 2.44). Individuals who used tobacco had 3.52 times (95% CI: 3.27; 3.79) higher risk of death. People with alcohol use had a 2.08 (95% CI: 1.92; 2.25), and responders with poor nutrition had a 2.16 (95% CI: 1.79; 2.60) higher mortality risk. Conclusion: Poor lifestyle risk behaviors, including tobacco smoking, alcohol consumption, and poor nutrition, are associated with a significantly higher risk of death in the Russian population.