Over one third of Ukrainians were tobacco smokers in 2019, according to the results of the first nationwide, large-scale STEPwise approach to surveillance (STEPS) survey on the main risk factors for noncommunicable diseases (NCDs) in Ukraine. The data also demonstrate a large gender gap: 50.3% of men smoked compared to 16.7% of women.

“While NCDs represent a significant global public health challenge, this is particularly so in Europe, where they cause 89% of deaths and 84% of years lived with disability. The current COVID-19 pandemic serves as a reminder of the impact of NCD comorbidities, which have a detrimental effect on both disease severity and sickness duration,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.

“The STEPS survey in Ukraine makes an important and relevant contribution to the European Programme of Work, as it measures not only the prevalence of NCD risk factors but also the coverage and effectiveness of selected priority interventions,” Dr Kluge added.

“WHO has supported Ukraine in addressing NCDs in the country in the past years,” explained Dr Jarno Habicht, WHO Representative and Head of the WHO Country Office in Ukraine. “To complement actions with population-level surveillance, the STEPS survey, conducted in Ukraine for the first time, allows us to determine the behavioural and biological risk factors for NCDs, and to collect extensive relevant data across the country to evaluate progress, set priorities, and plan policies, interventions and actions to protect Ukrainian people’s health and reduce the rate of mortality due to NCDs in coming years.”

Tobacco and alcohol use, physical inactivity, and unhealthy diets are the major risk factors for NCDs, including cardiovascular diseases, cancers, diabetes and chronic lung diseases. NCDs cause 91% of all deaths in Ukraine.

To assess the major behavioural and biological NCDs risk factors among the Ukrainian population, the nationwide population-based health examination survey was conducted in 2019 using the WHO STEPS methodology. In total, 4409 adults aged 18–69 years were interviewed and examined to collect data on key NCDs risk factors, including tobacco and alcohol consumption, unhealthy diets and physical inactivity.

The study revealed very high prevalence of NCDs and their risk factors in Ukraine, including high tobacco and alcohol consumption, very high salt intake, and low fruit and vegetable intake. Despite relatively low levels of insufficient physical activity, overweight and obesity are widespread in the country.

“Ukraine, like most other European countries, is characterized by a significant prevalence of NCD risk factors, which are responsible for the critical health indicators of the Ukrainian population,” said Mr Maxym Stepanov, Minister of Health of Ukraine.

“As the STEPS survey was conducted in Ukraine for the first time, it was mainly aimed at obtaining basic information on the main NCD risk factors, both behavioural and biological. The country included some additional questions related to mental health, cervical and breast cancer, and injury and violence in the survey. In this way, the information obtained can serve as a starting point for monitoring NCD risk factors in Ukraine, allowing the effectiveness of the National Plan implementation to be monitored,” he added.

The study results were presented during an online event in Ukraine on 17 November 2020. They will allow the country to track progress on the health-related Sustainable Development Goals as well as national, regional and global action plans and commitments related to the prevention and control of NCDs and their risk factors.

The survey was conducted by WHO, the Ministry of Health of Ukraine, the Public Health Centre of the Ministry of Health and the Oleksandr Yaremenko Ukrainian Institute for Social Research, with support from the World Bank.

The WHO STEPS tool is a standardized method for collecting, analysing and disseminating comprehensive data on NCDs, their risk factors and the responses of health-care systems. Data are collected on a wide range of behavioural and biological risk factors, as well as on individuals’ medical history of NCDs.