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Aims: To investigate variations in smoking and associated factors on individual and aggregate level among adolescents in Tallinn (Estonia), Helsinki (Finland) and Moscow (the Russian Federation)., Methods: The data was collected in Tallinn (N=1268 in Estonian and N=901 in Russian schools), in Helsinki (N=1396) and in Moscow (N=618) from pupils aged 13-18 by self-administered questionnaire. Multilevel analysis was used to estimate the possible effects of background characteristics, of the proximity of other smokers and the school context on the tobacco use of pupils., Results: The prevalence rate of smoking among girls in Russian schools in Tallinn (34.6%), among girls in Helsinki (39.5%), and in Moscow (32.1%) was higher than that among girls in Estonian schools in Tallinn (17.6%). Smoking was slightly less prevalent among boys in Helsinki (27.5%), compared to boys in Estonian (33.6%) and Russian (35.6%) schools in Tallinn, and to boys in Moscow (32.8%). Smoking increased with age. Multilevel analysis showed that smoking differed by school among pupils. Individual determinants of smoking as study site, grade, friends', siblings' and parental smoking behaved differently depending upon school. Friends and siblings' smoking showed interaction with study site to the smoking among girls., Conclusions: Strategies aimed at influencing smoking behaviour need to be directed not only towards the individual, but also towards the influences within the child's school environment.

Social inequalities in health are widely documented in the western countries including Finland, but research on Russia has so far been scarce. This article compares self-reported ill health of men and women and its social patterning in Helsinki and Moscow on the basis of a survey. The data (Helsinki N = 824, Moscow N = 545) were collected by mailed questionnaires in 1991. The Muscovites fared more poorly on perceived and psychological health, but the differences in self-reported morbidity (prevalence of chronic illnesses) between the cities were quite small. The sex differentials were greater in Moscow and Muscovite women had the poorest health of all. Education, family income and occupation had the most consistent associations with perceived health and morbidity among Helsinki women and the weakest among Muscovite women. With few exceptions, men of both cities fell between these groups. The differences in health between the cities were smaller in groups with low education. Thus, the role of education as a protective resource was more pronounced in Helsinki, and more notably among women. The possibility of a different impact of social stratification on health in a transitional socialist society compared to a western market economy is discussed.