Aim: to study the prevalence of smoking among residents of two cities in the North-West region of Russia and the exposure of the population to second-hand smoke. Materials and methods. A cross-sectional study of a random sample of 3133 residents of St. Petersburg and Arkhangelsk aged from 35 to 70 years was performed. Socio-demographic indices, smoking status and exposure to second-hand smoke were studied. Results. Average age was 54.0±9.3 years, 31.8% of respondents were men. The socio-demographic status of the participants did not differ depending on gender and place of residence. The incidence of smoking was 29.4% for the entire population; it was higher in St. Petersburg than in Arkhangelsk (30.9 and 26.4%, respectively, p<0.0001); it depended on the level of education and was lower in people with higher education in comparison with people with secondary or specialized secondary education. The incidence and smoking index in men were 2 times higher than in women (46 and 21.7%, respectively, p<0.05; smoking index 26.6 and 13.3 pack-years, respectively, p<0.0001). In 41.3% of respondents (58.9% of men and 24.2% of women), the intensity of smoking exceeded 20 pack-years. A third (35.2%) of the respondents lived with smoking relatives in one apartment for more than 10 years, 19.5% worked together with smokers in the same room for more than 10 years. Interviewees from Arkhangelsk were more often exposed to passive smoking at home and at work. Smoking respondents were more likely to report exposure to second-hand smoke at home and at work. Conclusion. The data obtained indicate a high incidence of smoking in the study population and exposure to second-hand smoke.