Smoking rates have traditionally been high in Russia (1) as well as in former Soviet Union states (2). Among 15-year-old adolescents, the smoking rates are 15 % for boys and 9 % for girls (3). After the dissolution of Soviet Union, the smoking prevalence of women has strongly increased and smoking has become more common among young women (2, 4). However, Russia is a geographically widely spread and heterogenic area where the prevalence of smoking varies strongly between areas and only some regions offer up-to-date information about smoking, particularly for adolescents (5, 6). Adolescents in Eastern Europe smoke more than their counterparts in Finland (1). However, in Finland, adolescent smoking rates are reasonably high despite the fact that adolescent smoking has decreased in Finland among girls since the 2000s and among boys since the 1990s and this trend seems to continue (7).

Previous studies have indicated that smoking behaviors begin to develop during early adolescence (8). It has been pointed out that the younger one starts smoking, the greater the risk for habitual smoking later in life (9). This leads to serious dependence on nicotine and extensive health problems and has far-reaching consequences on later life and health (10). Therefore, it is important to prevent experimenting with smoking and initiation to smoke in the early stages of adolescence and thus prevent inequalities in later health.

The study is a part of a more extensive project "Addressing challenging health inequalities of children and youth between two Karelias (AHIC)", which is administered by the University of Eastern Finland and receives funding from the Karelia ENPI CBC program. The aim of this study was to compare and find out how smoking prevalence has changed during the time between the years 1995-2013 in North Karelia, Finland and the Pitkyaranta district, Republic of Karelia, Russia, and between the genders. Moreover, the study aim was to find out how easy it is to smoke in the school area during the school day. These results provide new valuable information on the currents smoking situation among the pupils of local schools in North-Karelia, Finland and Republic of Karelia, Russia.

The following study questions were formulated:

1. How have adolescents’ smoking tendencies changed in North Karelia, Finland and the Republic of Karelia, Russia from 1995 to 2013? 
2. How easy is it to smoke in the school area during the school day?

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