Wednesday, May 28, 2014

Smoking in the South Caucasus and tobacco policy in Azerbaijan

May 31st is World No Tobacco Day as declared by the United Nations. According to the World Health Organization (WHO), tobacco usage is the primary reason for chronic diseases including “cancer, lung diseases, cardiovascular diseases” among other diseases. According to WHO, as of July 2013, “nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.” Moreover, the general consumption of tobacco products has increased, although a tendency towards decreased consumption is observed in high-income and upper middle-income countries. In Azerbaijan, along with economic development, there is a tendency of declining consumption of tobacco products. This fact might also be associated with rising social awareness about the harm that tobacco causes to overall health.

The 2001 law of the Republic of Azerbaijan on tobacco and tobacco products covers several issues such as the prohibition of sales of tobacco products to individuals younger than 18 years old, restrictions on promoting the sale of tobacco products, and prohibition of smoking in health-care facilities, workplaces in public buildings, in all types of public transport, and in educational facilities except universities. Yet, the issue of banning smoking in public places in Azerbaijan has been consistently raised during sessions of the government’s legislative body (the Milli Majlis). However, the adoption of the law has been consistently postponed. Azerbaijan joined the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2005 which implies that the signatories should apply six main tobacco control measures to reduce the demand for tobacco and its use.

These measures are known as “MPOWER” - “Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn people about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, and Raise taxes on tobacco.” Unfortunately, the legal basis for enforcing these measures in Azerbaijan remains unsettled and unimplemented even though a national strategy on tobacco control was developed in 2010.

In Azerbaijan, according to Caucasus Barometer data, the number of smokers has decreased from 31% of the population in 2008 to 25% in 2013. 75% of Azerbaijanis say they don’t smoke which is similar to results in Armenia (70%) and Georgia (73%). Notably, Azerbaijan and Georgia have a lower number of hard smokers (those who smoke more than 251 cigarettes per week) which is 3% and 2%, respectively, compared to Armenia where 8% say the same.

In general, smoking is not popular among women in the South Caucasus; 98% of women in Armenia, 99% in Azerbaijan, and 95% in Georgia say they do not smoke at all. There are negative perceptions associated with women who smoke in the South Caucasus, and this attitude might affect the number of women who claim to smoke in the countries of the region. The situation among males is different; 48% of men in Azerbaijan and Georgia, and 37% of men in Armenia say they do not smoke. Additionally, the number of hard smokers in Armenia is several times larger than in the other two countries.

Smoking is most popular among middle-aged men (36-55 years old), and they also report smoking more cigarettes than younger (18-35 years old) and older (56+ years old) men.

Overall, there is a positive trend in the decreasing number of Azerbaijanis who say they smoke. This is particularly notable among young males. According to the CB, the number of non-smokers among men aged 18-35 has increased from 46% in 2008 to 54% in 2013. The situation with other age groups has not changed significantly. One reason for this may be that young people are usually more socially active, and the media and other pro-health organizations can easily communicate anti-tobacco messages to them. If you are interested in more data on smoking in the South Caucasus, please visit the Caucasus Barometer data here as well as the WHO website’s page devoted to tobacco issues here.

 By Aynur Ramazanova

Monday, May 19, 2014

Paternalism in Georgia

According to the Stanford Encyclopedia of Philosophy, paternalism is “the interference of a state or an individual with another person against their will motivated by a claim that the person interfered with will be better off or protected from harm” (from the Latin pater for father). Simply put, paternalism refers to treating people as if they were children. The Caucasus Barometer (CB) assesses attitudes toward governance among Georgians. Who thinks citizens should be treated like children by the government (i.e. the paternalistic view) rather than as employers? Using data from the CB 2013, this blog post focuses on the following qualities of citizens: education level, economic condition and source of household income in order to better understand this paternalistic view in Georgia.

According to the data, from 2009 to 2012 a plurality of Georgian citizens reported that people are like children and the government should take care of them like a parent. This trend changed in 2013 when slightly more Georgians felt that the government should behave like an employee (53%) rather than a parent (47%) – although this difference is just outside of the margin of error.

What role does education play in these attitudes? In Georgia, the negative connection between education and the paternalistic view is well evidenced; 58% of people with a secondary education or below say that the government should be like a parent, whereas 37% of Georgians with more than a secondary education share the same view.

The economic conditions of Georgians also plays a role. 53% of Georgians who say they do “not [have] enough money for food” think the government should be like a parent. A much smaller fraction (23%) of Georgians who say they have “enough money for everything needed” share the same belief. 

Additionally, there is an interesting link between a paternalistic attitude toward the role of government and the source of household monetary income in the last 12 months. A paternalistic attitude is less common (41%) when a salary is mentioned as a source of income for a household. The distribution of paternalistic and non-paternalistic attitudes splits into two equal parts if the household had monetary income from pensions and government benefits in the last 12 months.

This blog examines qualities related to support for the Georgian government behaving as a parent or as an employee. According to data from the CB 2013, education level, economic condition and sources of monetary income for a household are related to approval for a paternalistic view of government in Georgia.

More information about Georgian citizens’ paternalistic attitudes toward government can be found by reading this blog post or by exploring our data here.  

By Tamuna Chkhaidze

Tuesday, May 13, 2014

Common Challenges Facing the Elderly in Georgia

According to the World Health Organization (WHO), “Multiple social, psychological, and biological factors determine the level of mental health of a person at any point in time. In addition to the typical life stressors common to all people, older people are more likely to experience events such as bereavement, a drop in socioeconomic status with retirement, or a disability.” According to the WHO, these factors, among others, can result in isolation, loss of independence, loneliness and psychological distress in older people. D. Srinivasan, psychiatrist, at Kovai Medical Center and Hospital in Tamil Nadu, India has highlighted some common social and psychological problems faced by the elderly including, loss of confidence and sensitivity to minor symptoms of illness, a chronic state of depression when losing financial independence or mobility, emptiness syndrome when children no longer live with parents, and a sense of worthlessness and hopelessness. This blog looks at whether these factors affect the elderly population’s health in Georgia. For this reason, the blog examines the extent to which elderly (56+) people in Georgia are influenced by a sense of emptiness and loneliness, as well as the types of economic conditions in which they live.

According to survey results from the Caucasus Barometer (CB) 2011, 20% of Georgians 56 and older experienced a general sense of emptiness. By comparison, the proportion of younger age groups (18-35 and 36-55) who reported experiencing emptiness was half of that (9% and 11%, respectively).

The following chart shows that 40% of Georgians, 56 and older felt that there were enough people to whom they felt close, and 49% who more or less thought that there were enough people close to them. Only 12% rejected the idea of having a sufficient amount of close people around. However, it is also worth mentioning that exactly the same percentage (12% for each) of individuals was present in the other two younger age groups (18-35 and 36-55) who also turned down the idea (‘there are enough people to whom I feel close’).

According to survey results, a sense of emptiness (20%) and loneliness (12%) among Georgia’s elderly population is not high. One of the explanations of this tendency could be that in Georgia it is common for elderly people to continue living with their children and grandchildren. This likely gives them the opportunity to stay actively engaged in family life through taking care of grandchildren, helping other family members with running the household, as well as being taken care of whenever necessary.

This way of living gives a smaller place to thoughts of being unwanted or useless, lonely or depressed and can be considered as an alternative to some common recommendations doctors give in scope of organizing manner of living for aged people according to Amutha Kannan.

If problems are not very visible for the aged population in Georgia (from a social perspective), their economic state gives a significantly different picture. According to the CB 2011 survey results, 40% of elderly people (56+) in Georgia reported living in poor economic conditions not having enough money for food in the household. Younger Georgians, by comparison, attested to living in similar poor economic conditions and not having enough money for food in the household (24% of the 36- 55 age group and 15% of the 18 – 35 age group).

This blog post reviewed factors that negatively affect the elderly’s mental health in Georgia. Hence, in comparison to social settings for older people in Georgia, their economic conditions can be considered a serious challenge to remain physically and mentally healthy. To further explore this subject and other issues influencing aging people’s health in Georgia, we recommend exploring our data using the ODA tool here.

Monday, May 05, 2014

Abortion Rates in Azerbaijan

The Merriam-Webster dictionary defines abortion as a “termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus.” According to the United Nations' publication, World Abortion Policies, 2011, by 2009 roughly 97% of countries in the world had made abortion legal to save a woman’s life. The legal grounds and regulations on the issue of abortion vary from country to country. World Abortion Policies data from 2011 distinguishes seven main grounds for the permission of abortion: (1) to save a woman’s life, (2) to preserve a woman’s physical health, (3) to preserve a woman’s mental health, (4) in case of rape or incest, (5) because of fetal impairment, (6) for economic or social reasons, and (7) upon request.

The issue of abortion is complicated in Azerbaijan. Results from the Caucasus Barometer 2013 (CB) show that 36% of Azerbaijanis think that having an abortion can never be justified. This is lower than 62% of Georgians and 46% of Armenians who say the same. Notably, 20% of the population of Azerbaijan in 2013 did not know whether having an abortion should be justified or not, and 10% refused to answer – much higher number than in the other two countries.

According to the UN World Abortion Policies data from 2013, Azerbaijan has the lowest rate of abortion among the three South Caucasus Republics. The rate is 11.4 per thousand women aged 15-44, whereas it is 16.9 per thousand in Armenia and 26.5 per thousand in Georgia. The State Statistical Committee of Azerbaijan's (AzStat) data shows similar results – 11.5 per thousand women aged 15-49 (in 2012). However, according to AzStat the abortion rate in Azerbaijan has been steadily rising from 7.8 per thousand in 2000 to 11.5 per thousand in 2012 (this increase can be partially attributed to better reporting procedures introduced in the 2000s, however, the anecdotal evidence still suggests that not all cases are registered and reported). Moreover, the highest percentage of women having an abortion is among those who are 25-29 years old and 30-34 years old (Figure 1).

Figure 1: Percentage of abortions among different age groups in Azerbaijan (2012).


Azerbaijan has the lowest abortion rate among the three South Caucasus Republics and it has the highest fertility rate. According to the World Abortion Policies 2013, Azerbaijan has 2.1 births per woman, followed by 1.7 births per woman in Armenia and 1.5 births per woman in Georgia.

When asked about the ideal number of children per family, about 22% of Azerbaijanis said “whatever number God will give us”, whereas in Armenia and Georgia 1% and 9%, respectively, said the same. Moreover, Azerbaijanis are more likely to desire more children than in Armenia and Georgia. In Azerbaijan, fewer people say they want one or two children, and 36% consider four or more children to be ideal.

If you are interested in reproductive health and family planning, we encourage you to access more Caucasus Barometer data here. You might also find statistics from the State Statistical Committee of Azerbaijan and the United Nations World Abortion Policies data useful.

By Aynur Ramazanova