George Bakhturidze

Attitudes towards smoking restrictions and tobacco advertisement bans in Georgia

Objectives This study aims to provide data on a public level of support for restricting smoking in public places and banning tobacco advertisements. Design A nationally representative multistage sampling design, with sampling strata defined by region (sampling quotas proportional to size) and substrata defined by urban/rural and mountainous/lowland settlement, within which census enumeration districts were randomly sampled, within which households were randomly sampled, within which a randomly selected respondent was interviewed. Setting The country of Georgia, population 4.7 million, located in the Caucasus region of Eurasia. Participants One household member aged between 13 and 70 was selected as interviewee. In households with more than one age-eligible person, selection was carried out at random. Of 1588 persons selected, 14 refused to participate and interviews were conducted with 915 women and 659 men. Outcome measures Respondents were interviewed about their level of agreement with eight possible smoking restrictions/bans, used to calculate a single dichotomous (agree/do not agree) opinion indicator. The level of agreement with restrictions was analysed in bivariate and multivariate analyses by age, gender, education, income and tobacco use status. Results Overall, 84.9% of respondents indicated support for smoking restrictions and tobacco advertisement bans. In all demographic segments, including tobacco users, the majority of respondents indicated agreement with restrictions, ranging from a low of 51% in the 13–25 age group to a high of 98% in the 56–70 age group. Logistic regression with all demographic variables entered showed that agreement with restrictions was higher with age, and was significantly higher among never smokers as compared to daily smokers. Conclusions Georgian public opinion is normatively supportive of more stringent tobacco-control measures in the form of smoking restrictions and tobacco advertisement bans.

Promoting health in Georgia.

This paper discusses the public health situation in Georgia. In 1991 Georgia became an independent republic following the collapse of the Soviet Union. The armed conflict with Russia in 2008 and political unrest in recent years has presented the Georgian population and politicians with a demanding situation. As part of the WHO European Region, the Commonwealth of Independent States (CIS) including Georgia is on the unfortunate side of a European health divide, with low male life expectancy and high under-five mortality. There is also a high degree of economic inequality in the population. We first look at the main players and the current strategies in public health work. Next we discuss this on the background of health promotion principles and recent international developments in knowledge and policy recommendations in the field of health promotion. Finally we point to some of the major public health challenges that Georgia faces. We conclude that the Georgian focus on reducing risk behaviours and improving access to quality health care is worthy of praise, but that this is not sufficient to solve the current public health challenges. Strategies for working across sectors with social determinants of health should be built into Georgian health thinking and policies. A health promotion work force should be developed. International developments such as the Commission on Social Determinants of Health (CSDH) report, the ‘Health 2020’ framework and the HP Core Competencies project all provide useful input to future development of healthy public policies in Georgia.