Introduction:
Aim: To present a report comparing tobacco, alcohol and illicit drugs in the Russian Federation it terms of use, impact, production and supply, economic aspects, prevention and control policies, in order to provide evidence for more effective prevention and control of these major addictions, taking into consideration gender aspects.

Methods:
Review of available statistical data, official publications, research evidence.

Results:
In spite of popular opinion on illicit drugs as the main threat, in general, tobacco use prevention and control based on WHO FCTC compliance, is of primary importance for the Russian Federation in terms of impact on population health. Based on IHME sources, in 2015 313,683 individuals of all ages died because of tobacco use, including 31,104 from second hand smoke (23,863 of these – women). Alcohol use was the cause of death of 223,556 individuals, including 89,840 women. Illicit drugs use killed 41,351 (including 31,909 men). Gender difference is profound: men have much higher risk of dying from each of three addictions; at the same time for women alcohol use is still more important as cause of death, compared to tobacco use. According to available estimates, about 45% of total social costs (direct costs – medical+non-medical and indirect – premature deaths, disability) attributed to three addictions were related in 2008 to alcohol issues, about 30% - to illicit drugs use and 25% - to tobacco use. This is in part explained by various degree of criminalization of three addictions. Previous governmental tobacco control strategy expired in the end of 2015, and revised strategy had to be approved in early 2016, and it is still a draft. Among probable explanations of the delay is that tobacco industry is pushing for promotion of "alternative approaches of nicotine use - nicotine containing products with lowered risk" into this strategy, involving business associations, medical associations, and State Duma as a platform and a vehicle. Policy on tobacco, alcohol and illicit drugs is increasingly formulated at the supranational level of the Eurasian Economic Union, where industry position is dominating public health concerns. Russian Federation is insisting on criminalization of illicit drugs use, does not accept harm reduction approach to drug use issues, and this might be linked with continuing HIV epidemic.

Conclusions:
Russian Federation example suggests that it is appropriate to consider three major addictions together to prevent/correct possible bias in assessment of impact and allocation of resources aimed at prevention and control of disease and premature death.