Aim. To study the relationship of the density and proximity of tobacco products (TPs) and electronic nicotine delivery systems (ENDS) with increased levels of depression, anxiety and stress among the population in 3 constituent entities of the Russian Federation.Material and methods. The work used data from the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study in 3 Russian regions (Arkhangelsk, Sverdlovsk and Tver regions) among the population aged 35-64 years (n=1674), who signed a consent to participate in the study. We analyzed data on the status of smoking and consumption of ENDS, passive smoking, attempts to quit smoking, as well as the presence of depression, anxiety (Hospital Anxiety and Depression Scale (HADS) score ≥8) and stress (Perceived Stress Scale (PSS) >21). Elements of urban infrastructure (data collection: January-March 2022) selling TPs and ENDS were assessed using aт OpenStreetMap-based program. Associations were established using logistic regression analysis.Results. With a twofold increase in the distance of TP and ENDS outlets from the place of residence, the depression probability was reduced by 13% (odds ratio (OR) 0,87; 95% confidence interval (CI): 0,79-0,96) and by 12% (OR 0,88; 95% CI: 0,78-0,99), respectively. With increase in distance from of TP outlets, the anxiety decreased probability by 12% (OR 0,88; 95% CI: 0,81-0,97). With an increase in the number of TP outlets within a radius of 1000 m from the place of residence, there were an increase in the probability of depression (OR 1,18; 95% CI: 1,031,36), anxiety (OR 1,12; 95% CI: 1-1,26) and stress (OR 1,24; 95% CI: 1,05-1,46). A greater number of ENDS outlets within a radius of 1000 m and 400 m was associated with a high likelihood of depression (OR 1,17; 95% CI: 1,02-1,34 and OR 1,25; 95% CI: 1,04-1,47, respectively). An increased depression probability was found in those exposed to tobacco smoke at home (OR 1,88; 95% CI: 1,27-2,73) and at work (OR 1,67; 95% CI: 1,14-2,41). An increase in the number of attempts to quit smoking doubles the odds of depression (OR 2,40; 95% CI: 1,35-4,23) and anxiety (OR 2,00; 95% CI: 1,18-3,38).Conclusion. Unfavorable environmental factors, including the proximity and density of TP and ENDS outlets, can increase the probability of depression, anxiety and stress among the population living in these areas.

Aim. To analyze availability and affordability of alcoholic beverages in Russian cities. Material and methods . We assessed the actual state of urban infrastructure in the Arkhangelsk, Tver and Sverdlovsk regions. Data were collected in three districts of Arkhangelsk, three districts of Tver, three districts of Yekaterinburg and Revda, where participants of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study (2021) lived. The study objects were elements of the city infrastructure where alcoholic beverages were sold. To assess the infrastructure, special software was developed to collect and analyze the necessary data using Open Street Maps. Data were collected from January to March 2022. Results . In total, 1180 alcohol-selling outlets were identified in the study areas: in Arkhangelsk — 450, in Yekaterinburg and Revda — 444, and in Tver — 286. Mainly alcoholic beverages in Sverdlovsk and Tver regions can be purchased in the alcohol section of a grocery store (n=260, 58,6% and n=185, 41,4%, respectively), and in the Arkhangelsk region — in a specialized liquor stores (n=263, 58,4%). The median number of alcohol stores located within a radius of 1000 m from the place of residence of the ESSE-RF3 participant was 33, and within a radius of 400 meters — 8. In Arkhangelsk, the alcohol was sold in a grocery store located in the same building as the college branch. In the Sverdlovsk region, the nearest alcohol store was located at a distance of 50 m from the kindergarten, in the Tver region — 44 m from the college. A 0,5 liter bottle of vodka was sold below the price floor in 55,1% of specialized liquor stores in the Sverdlovsk region and in 66,8% of such liquor stores in the Tver region. Conclusion. As a result of the study, availability and affordability of alcoholic beverages in Arkhangelsk, Tver, Yekaterinburg and Revda was assessed. The findings reflect the high availability of alcohol and indicate the need for interventions at both the national and local government levels. The used method of collecting and analyzing data demonstrated sufficient research effectiveness and can be recommended for wider use.

Cardiovascular diseases (CVDs) are the leading threat to the population health in the Russian Federation (RF), ranking first in the mortality structure. Demonstration of the economic impact of CVD is a rationale for investing in prevention and treatment. The economic damage caused by CVD in 2016 in the RF amounted to RUB 2,7 trillion, which is equivalent to 3,2% of gross domestic product (GDP). In the structure of damage by diseases, coronary artery disease occupies a leading position — RUB 1 trillion or 1,3% of GDP, while cerebrovascular diseases, stroke and myocardial infarction — RUB 560, 424 and 213,2 billion, respectively. Evaluation of cardiovascular prevention measures is not an easy task because the effect develops over a significant period of time. At the same time, various processes can affect the effect. The RF analysis showed that the potential economic effect from anti-tobacco and anti-alcohol measures, reducing salt consumption and increasing physical activity will be RUB 8,1 trillion in labor productivity increase over 15 years (equivalent to 7,8% of GDP in 2018), with most of the effect from the prevention of CVD deaths. Analyzing the economic impact of CVDs, preventive and curative measures provide a rationale for investment and is an important step in making informed decisions.

Aim. To assess the potential need for expanding medicine assistance programs for patients with coronary artery disease (CAD) and comorbidities, as well as to model its health and social effectiveness in the Russian Federation.Material and methods. To assess the scope and cost of medicine assistance for the healthcare system, the number of patients with CAD and comorbidities was determined based on data from 5 registers of cardiovascular patients organized by the National Medical Research Center for Therapy and Preventive Medicine. We took into account the frequency of drug provision according to standard therapy regimens for stable CAD in combination with comorbidities and (or) conditions that increase the risk of adverse events. To determine the cost of medicine assistance, we used data from the state register for maximum ex-works prices for the medicinal products included in the list of vital and essential drugs. To assess the impact of medicine assistance for patients with CAD and the highest cardiovascular risk on survival prognosis in the period 2023-2025, the number of deaths prevented was calculated. A one-year forecast and a cumulative forecast were performed, taking into account annual increase in the patient population.Results. Patients with CAD and the highest cardiovascular risk (myocardial infarction, stroke, diabetes, chronic obstructive pulmonary disease in history), including in combination with hypertension, heart failure, atrial fibrillation, are priority groups where the prophylaxis of cardiovascular events and death, the expansion of medicine assistance programs will save a greater number of lives. With a one-year forecast, the potential number of deaths prevented by 2025 will be 33582 cases per year, with a cumulative total of 90500 cases over three years, with the costs of 114,8 billion rubles for three years (40 billion rubles per year).Conclusion. Considering the potential of modern therapy in patients with CAD, comorbidities and high cardiovascular risk, the expansion of current of medicine assistance programs for such patients, along with medical follow- up programs, seems to be an important component in health improvement, mortality reduction and life expectancy increase in the population.

Objective. To assess the distribution of cardiac troponin I (cTnI) in a sample of the Kyrgyz Republic population, to study its associations with risk factors and to identify the possible ethnic differences. Design and methods. This observational cross-sectional study includes a representative sample of the Kyrgyz Republic population aged 20–64 years (n = 1256). The analysis of cTnI levels in the population and associations of cTnI levels with socio-demographic parameters (sex, age, education, etc.), risk factors (smoking, obesity, hypertension, etc.), blood biochemical parameters (triglycerides, lipid profile, glucose) and an anamnesis of cardiovascular diseases and total cardiovascular risk according to the SCORE scale. The statistical significance level was considered equal to 0,05. Results. The median cTnI level in the Kyrgyz sample was 0,90 pg/ml [0,40; 1,80]. The 99 th percentile for the entire sample was 21,4 pg/ml in men and 12,2 pg/ml in women. The median cTnI in the Slavs sample was 1,40 pg/ml [0,60; 2,20]. The 99 th percentile for the entire sample was 21,2 pg/ml in men and 25,2 pg/ml in women. The cTnI level log increases significantly with age in both men and women. At the age of 20-30 years, the cTnI level in men is higher than in women in both ethnic groups. However, with age, the increase rate of cTnI in women is higher than in men in both ethnic groups. In a multivariate analysis, significant associations of cTnI levels with sex, age, hypertension, stroke, blood levels of total cholesterol and triglycerides were obtained. Insufficient accuracy of classification of study participants by SCORE risk was revealed. Conclusions. cTnI is a potential strong biomarker that complements traditional risk scales and is applicable in the framework of cardiovascular diseases primary prevention strategies, which was confirmed in this study on the Kyrgyz Republic population.

Aim. To present first results of the study on the assessment of municipal infrastructure using specialized software in a pilot subject of the Russian Federation (Sverdlovsk Oblast). Material and methods . The following infrastructure elements of four municipalities of the Sverdlovsk Oblast have been assessed in the period from January to March 2022: sports facilities, grocery stores, fairs/markets with fresh vegetables and fruits, alcoholic drinks in shops and supermarkets, special liquor stores, tobacco outlets, fast food restaurants). The assessment was made with specialized software developed using Open Street Map (OSM) that allows real-time recording of objects for interactive map data visualization. Results. The density of sales outlets for tobacco, alcohol, fresh vegetables and fruits was 2,3, 3,4 and 2,4 per 1 km², respectively; the density of sports facilities, fast food and restaurants — 1,3, 0,9 and 0,5, respectively. The number of sales outlets for tobacco, alcohol, fresh vegetables and fruits per 100 thousand people was 111,6, 167,7 and 116,5, respectively, while the number of sports facilities, fast food and restaurants — 63,5, 44,1, 25,0, respectively. Conclusion . Creation and implementation of integrated system for assessing a unified preventive environment for promoting health and maintaining a healthy lifestyle at the municipal level using a combination of objective (GIS technologies, paraclinical tests) and subjective assessment methods (personal survey), as well as the introduction of interactive maps of municipal infrastructure, will make possible use of evidence to make decisions on the development and implementation of programs for the prevention of cardiovascular diseases and health promotion, as well as their management at the regional/municipal level.

AIM: Assessment of the School-Aged Childrens Physical Activity (PA) in the Russian Federation before and during the COVID-19 pandemic and its compliance with the WHO recommendations. METHODS: This was a multi-national cross-sectional study. More than 24,000 children aged 618 years from nine European countries (Hungary, Spain, Portugal, Russian Federation, Poland, Italy, Slovenia, Germany, and Denmark) participated in the online survey. In the Russian Federation, the online survey was conducted from 28th January to 10th February 2021. The questionnaire was completed by 13,392 children or their parents from 64 Russian regions. In total, 11,763 respondents were included in the study, i.e., 50.8% boys (n=5985) and 49.2% girls (n=5778), 72% urban residents, and 28% rural residents. The mean age (MSD) was 11.242.93 years. The questionnaire contained five sections questions about the socio-demographic data; physical activity, play, or sedentary behavior in the last seven days; comparison of the child's PA at the moment with PA during the first wave of COVID-19; comparison of the child's PA at the moment with the PA before the COVID-19 pandemic; compliance with WHO global recommendations on PA and sedentary lifestyle; questions about the socio-demographic background of the parent/guardian. Survey data were obtained via online platforms. Meeting the WHO Global Guidelines was defined as 60-minute MVPA per day for a week; total screen time of fewer than 2 hours per day. Data were presented as absolute values and percentages. Chi-Square (2) test was used to compare percentages to identify significant differences. A p-value of 0.05 indicated statistical significance. RESULTS: Outcomes of this online survey revealed that only a small percentage of children followed the PA guidelines. Therefore, the proportion of children following the WHO recommendations was only 7.5%. An increase in screen time on weekdays during the pandemic was observed in 21.9% of the participants, and on weekends 20.3%. CONCLUSION: These results should be used to develop and implement targeted measures to prevent low levels FA among school-age children.

Важнейшей мерой сокращения негативного влияния пандемии COVID-19 является выполнение рекомендаций, направленных на сокращение передачи вируса, таких как соблюдение режима самоизоляции для определенных групп населения, социальной дистанции, использование защитных масок для лица, перчаток, снижение количества посещений общественных мест, общественного транспорта и т.п. ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить приверженность к соблюдению рекомендаций по ограничению распространения новой коронавирусной инфекции в России и отдельных регионах в осенне-зимний период 2020—2021 гг. на основании онлайн-опроса. МАТЕРИАЛ И МЕТОДЫ ФГБУ «НМИЦ ТПМ» Минздрава России с ноября 2020 г. по февраль 2021 г. провел всероссийский онлайн-опрос «Изучение влияния ограничений по причине COVID-19 на образ жизни населения». Участники — взрослые россияне в возрасте 18 лет и старше. РЕЗУЛЬТАТЫ В опросе приняли участие 5537 человек из 62 регионов России. Наибольшее число респондентов было из Москвы (n=1157), Ульяновской области (n=735), Иркутской области (n=595), Омской области (n=452) и Республики Коми (n=408). Средний возраст опрошенных составил 40,7±12,2 года. В качестве мер ограничения распространения новой коронавирусной инфекции 97,3% респондентов использовали маски, 87,3% — часто мыли руки, 71,1% — соблюдали социальную дистанцию, наименее распространенной мерой (42,9%) названо использование перчаток. Респонденты с высшим или незаконченным высшим образованием чаще выполняли рекомендации по профилактике COVID-19, за исключением использования перчаток (n=11 257, 38,9%). Выявлены определенные региональные различия приверженности рекомендованным мерам, которые могли быть обусловлены особенностями эпидемиологической ситуации и вводимых ограничений. ЗАКЛЮЧЕНИЕ В целом по стране и в ряде регионов в осенне-зимний период 2020—2021 гг. выявлена высокая приверженность к соблюдению мер профилактики, направленных на ограничение распространения COVID-19, однако существуют региональные различия.

Aim. To analyze the availability and affordability of alcohol and tobacco outlets using the specialized software developed by the National Medical Research Center for Therapy and Preventive Medicine in the pilot subject of the Russian Federation — the Sverdlovsk Oblast.Material and methods. For the first time, experts from the National Medical Research Center for Therapy and Preventive Medicine conducted a pilot study to assess the actual state of the infrastructure of a separate subject of the Russian Federation (Sverdlovsk Oblast). The study objects were the urban infrastructure elements in which alcohol and tobacco products are sold. In order to assess the infrastructure, special software was developed using Open Street Maps to perform data collection tasks. The infrastructure data collection for the pilot study took place from January to March 2022.Results. The total number of tobacco outlets is 299, most of which are located in supermarkets (82,6%, n=247). The share of individual tobacco outlets accounts for 13,7% (n=41). Out of 357 supermarkets, 247 (69%) have tobacco sales section. The average lowest price of a cigarette pack is 121,6±15,7 RUB (minimum — 30 RUB, maximum — 207 RUB). Twentyseven (10,9%) of 247 supermarkets located <100 m from educational institutions carry tobacco products. The minimum distance is 64 m. There are 449 alcohol outlets in total, most of them are located in supermarkets — 57,0% (n=256). Individual alcohol outlets account for 40,8% (n=183). Out of 357 supermarkets, 256 (71,7%) have alcohol sales section. Out of 158 individual alcohol outlets, vodka is available in 101 (63%) outlets, wine — in 112 (68,3%) out of 162 outlets, beer — in 112 (68,3%) out of 164 outlets, alcoholic cocktails — in 71 (45,2%) out of 57 outlets. The average lowest selling price of vodka is 255,9±62,2 RUB (minimum — 230 RUB), wine — 180,2±89,3 RUB (minimum — 110 rubles), beer — 51,2±15,5 RUB (minimum — 33 rubles), alcoholic cocktails — 58,9±15,4 RUB (minimum — 37 rubles). In addition, 27 (10,5%) of 256 supermarkets with a liquor section (minimum distance of 64m) are located <100 m from educational institutions, as well as 10 (5,4%) out of 183 individual stores specializing in the alcohol sale (minimum distance of 50 m).Conclusion. The results obtained with the help of the developed tool can be used as arguments for strengthening monitoring of compliance and making changes to the current legislation that restricts the availability of tobacco and alcohol products. The use of the developed tool will make it possible using evidence to make informed decisions in the development and implementation of public health programs at the municipal level.

Высокая распространенность избыточной массы тела и ожирения среди детского населения представляет серьезную угрозу для общественного здоровья. Маркетинговое продвижение продуктов питания препятствует рациональному питанию и укреплению здоровья детей с раннего возраста. ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить доступность и состав готовых продуктов питания для детей грудного и раннего возраста (6—36 месяцев) в России в соответствии с рекомендациями ВОЗ и национальными рекомендациями по питанию детей этой возрастной группы. МАТЕРИАЛ И МЕТОДЫ По международной методике проведен анализ выборки продуктов детского питания, доступных в интернет-магазинах и обычных супермаркетах. Отобранные продукты закодированы в соответствии с Моделью профилей питательных веществ Европейского регионального бюро ВОЗ, 2019 г. На этикетке каждого продукта зафиксирован минимальный целевой возраст, для которого продукт рекомендован к употреблению, собраны сведения о пищевой ценности. Статистическую обработку проводили в программе Microsoft Excel 2016. РЕЗУЛЬТАТЫ В общей сложности проанализированы данные о 227 продуктах детского питания. Результаты исследования не позволили отнести изучаемые продукты к категории разрешенных к маркетингу детям в возрастной группе 6—36 месяцев в соответствии с Моделью ВОЗ. Значительная доля исследуемых продуктов питания (около 40%) маркирована как подходящая для детей в возрасте до 6 месяцев, что нарушает Международный свод правил по сбыту заменителей грудного молока и Рекомендации ВОЗ по грудному вскармливанию. На этикетке большей части продуктов питания отсутствует информация о количественном содержании соли (78% продуктов), добавленного сахара (95%) и насыщенных жиров (95%). ЗАКЛЮЧЕНИЕ В ходе исследования выявлена важная проблема — необходимость совершенствования требований к информации, содержащейся на этикетках продуктов питания, и ограничения ненадлежащего маркетинга детского питания в России.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить физическую и ценовую доступность овощей и фруктов для населения муниципалитетов пилотного субъекта Российской Федерации с помощью специализированного программного обеспечения, разработанного ФГБУ «НМИЦ ТПМ» Минздрава России. МАТЕРИАЛ И МЕТОДЫ В Российской Федерации в рамках реализации государственного задания «Разработка комплексной системы оценки единой профилактической среды для укрепления здоровья и ведения здорового образа жизни на муниципальном/региональном уровне» проводится наблюдательное исследование по оценке фактического состояния инфраструктуры муниципалитетов и анализу ассоциаций элементов инфраструктуры с распространенностью поведенческих факторов риска основных хронических неинфекционных заболеваний. В настоящей статье представлены результаты первого этапа пилотного исследования, в ходе которого изучалось фактическое состояние инфраструктуры муниципалитетов Свердловской области (продуктовые магазины, супермаркеты, ярмарки/рынки, киоски с выбором свежих овощей и фруктов, а также точки общественного питания — фастфуд, кафе, рестораны и др.). Проведена оценка ценовой доступности свежих овощей и фруктов для населения с расчетом средних минимальных цен в различных точках продаж. Статистическая обработка выполнена с помощью программы SPSS Statistics v. 20 (IBM, США). РЕЗУЛЬТАТЫ Продуктовые магазины и супермаркеты являются ожидаемо основными элементами торговой сети, обеспечивающими население свежими фруктами и овощами. Однако только в 66% продуктовых магазинов и супермаркетов имеются отделы по продаже свежих овощей и фруктов. Цены на свежие овощи и фрукты, предлагаемые в киосках, оказались выше, чем цены на сопоставимые продукты в супермаркетах. ЗАКЛЮЧЕНИЕ Реализация мер, направленных на повышение доступности свежих овощей и фруктов для населения, возможна за счет стимулирования потребительского спроса. В этом отношении могут быть внедрены региональные программы поддержки наиболее уязвимых групп населения, особенно семей с низким доходом. Кроме того, необходимы финансовые меры поддержки строительства супермаркетов и продовольственных магазинов с выбором овощей и фруктов в случае их недостатка.

Chronic obstructive pulmonary disease (COPD) is characterized by a high level of morbidity and mortality and is associated with significant social and economic losses for the health care system and society. Aim. To predict the socio-economic burden of COPD in the Russian Federation in 2022, including the cost of drug treatment. Methods. The socio-economic burden of COPD in the Russian Federation in 2022 was predicted with and without taking into account the impact of COVID-19. The analysis of the cost of illness included the calculation of direct and indirect costs due to COPD. Data of Federal State Statistics Service, the State Guarantee Program of Free Medical Care for Citizens of Russian Federation, and data from the regional register of drug treatment of patients with COPD were used. Costs of medical care (ambulatory, hospital, and emergency care) were calculated based on compulsory health insurance tariffs. The disability benefits payments were calculated based on number of disabled persons and the amount of the disability benefit in each group. Indirect costs (or economic losses) included losses from products which were not produced due to disability and premature mortality of working-aged adults. Results. The predicted total economic losses due to COPD in 2022 will be 428.5 billion rubles when taking into account the impact of COVID-19, and 378.9 billion rubles when not accounting for COVID-19. Losses in the economy due to decreased labor productivity because of premature deaths (86%) are major part of the main burden. The cost of drug therapy for patients with COPD in outpatient settings will amount to over 17 billion rubles. Conclusion. Potential economic burden of COPD in 2022 depends on the incidence of COVID-19 and could be 0.34% of the GDP. Priority should be given to measures aimed at preventing the occurrence of COPD by correcting risk factors in the population, early diagnosis, slowing the progression of the disease and preventing exacerbations. Prevention of respiratory infections including COVID-19 in patients with COPD plays a special role.

Aim. To assess the impact of lockdown measures during coronavirus disease 2019 (COVID-19) pandemic on physical activity (PA) of the adult population in Russia.Material and methods. The online survey was conducted during the period of strict restrictions in Russia from April 26, 2020 to June 6, 2020. The survey involved respondents aged ≥18 years. Participants reported the frequency and duration of moderate to high-intensity PA, as well as walking and other types of exercise, before the pandemic and during the last seven days during the survey period.Results. In the country as a whole, there was a decrease in all types of PA during the pandemic. The proportion of participants who met the World Health Organization recommendations for any type of PA decreased from 68 to 49% (p<0,001). Proportion of those who followed the World Health Organization recommendations for strength training for ≥2 days per week decreased from 53 to 45% (p<0,001).Conclusion. The results of the study are the evidence base to substantiate the feasibility of measures aimed at correcting the lifestyle of the population in the context of the COVID-19 pandemic.

Introduction: The high prevalence of behavioral risk factors in Russia has a significant impact on the health of the population being a serious threat for both current and future generations. There is substantial evidence on heath differences between and within countries. Aim: To estimate the 7-year survival rate and the association between risk factors and all-cause and cardiovascular mortality among rural residents of the Samara region of Russia. Methods: This is a prospective cohort study conducted in the framework of the "Interepid» international project. The analysis included the data from a representative sample of the 20-64 years old rural residents of the Volzhsky district of the Samara region of the Russian Federation (n=1050). A cross-sectional survey was carried out in 2011-2012. Vital status and deaths from all causes and from cardiovascular diseases were analyzed twice, after 4 years and after 7 years of the follow-up. Results: Smoking, hypertension, excess intake of meat offal, whole milk and yogurt were significantly associated with all-cause mortality among men while hypertension and obesity were the main contributors to all-cause mortality among women. CVD mortality was associated with smoking, hypertension, excess salt intake, excess intake of meat offal among men while hypertension, low physical activity and excess salt were the main risk factors among women. Conclusions: We observed significant contribution of many risk factors to all-cause and CVD mortality over a 7-year follow-up period. The importance of the risk factors significantly varied across genders. The results of the study can be used in planning, implementation and evaluation of the effectiveness of public health interventions.

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The Russian Federation reported one of the largest number of COVID-19 infections. In spring 2020 social distancing, travel bans, the cancellation of sporting and other mass participation events, and changes to work practices have dramatically affected daily life throughout the country. Major restrictions were introduced on the 28th March 2020 with the level of restrictions varied depending on the epidemiology of the virus from region to region. Cities with a large number of cases had the most strict restrictions such as limitations on any outdoor activities. In cities with a smaller number of cases limitations were less strict, especially with outdoor activities. Indoor sport activities were limited across the country and outdoor sports were restricted – depending on the situation in the region. The aim of this study is to estimate the impact of COVID-19 on the levels of physical activity among adults in Russia. Methods Cross-sectional data were collected during the period of tightest restrictions between 26 April 2020 and 6 June 2020. The link on the on-line survey was distributed through the regional centers of public health. Eligible participants included all Russian adults aged 18 years and over. Participants reported frequency and duration of walking, moderate- and vigorous-intensity physical activity, and muscle strengthening activities before COVID-19 and during the past seven days. Results A convenience sample of 2432 adults from 62 regions of Russia completed a 15-min self-report questionnaire. Participants were primarily female (83%). Compared with before COVID-19, physical activity was adversely affected during COVID-19. The average time spent in MPA and VPA each declined by around 12 minutes per day (42.43 ± 37.57 to 30.44 ± 35.35 and 37.79 ± 37.80 to 26.56 ± 34.69, respectively [all P < 0.001]). The number of minutes per day spent walking decreased by around 20 minutes from 60.5 ± 38.66 to 40.83 ± 38.6 (P < 0.001). The proportion of participants who met the WHO Guidelines for physical activity declined from 68% to 49% (P < 0.001). The proportion who participated in muscle strengthening activities for 2 or more days per week declined from 53% to 45% (P < 0.001). Compared with those who did not use online PA resources, those who did were 1.4 (95%CI 1.3, 1.5) and 1.9 (95%CI 1.8, 2.1) times more likely to meet the recommendations for PA and for muscle-strengthening activities, respectively. Conclusion Effective health promotion strategies directed at adopting or maintain positive health-related behaviors such as targeted social media messaging and balanced media reporting, should be used to increase the physical activity during these unprecedented times.

Alcohol and tobacco consumption remain significant risk factors (RFs) for morbidity and mortality from noncommunicable diseases (NCDs), including cardiovascular ones, in Russia. The main risk factors contributing to NCDs in addition to traditional risk factors and lifestyle also include the neighborhood environment (NE). The term “neighborhood environment” describes the relationship between the area in immediate vicinity of a person's place of residence, environmental factors, social characteristics of the area, which can have both positive and negative effects on human health. The aim of this review was to analyze alcohol and tobacco outlets availability as a factor effecting health of people living in a certain area. It was demonstrated that a high density of alcohol outlets is associated with increased alcohol consumption among both adults and adolescents, with drunk driving and road traffic accidents, injuries, violent crimes, the risk of acute and chronic diseases. A high density of tobacco outlets is associated with an increase in smoking intensity among both adults and adolescents, as well as an increase of secondhand smoke, which increases the risk of NCDs. The consumption of alcohol and tobacco is associated with a significant increase in risk of NCDs, including cardiovascular ones, and injuries, leading to disability and death. The effectiveness of measures aimed at reducing the consumption of alcohol and tobacco may be reduced due to high density of outlets selling these products. It is necessary to conduct studies aimed at assessing the outlets density and its associations with prevalence of RFs and health status of Russian population. These data will stimulate intersectoral collaboration for planning health protection strategy at municipal level.