Background Seat-belt wearing is the single most effective road safety measure a car occupant can take to prevent deaths and injury. However its use in the Russian Federation remains low.

Aims To increase seat-belt use in Lipetsk Region (1,2 million inhabitants).

Methods Under the framework of the project Road Safety in 10 Countries, WHO implemented a large social marketing campaign and worked in collaboration with police officers to strengthen enforcement on seat-belt wearing. Qualitative research was conducted to explore the public's motivations behind wearing or not wearing seat-belts. Based on these results, the campaign targeted the following audiences: youth, families and businessmen. For each target group a series of video and radio clips were tested through focus groups under the campaign motto ‘Do not break the line of life’. The social marketing campaign was launched on World Day of Remembrance for Road Traffic Victims in 2010 and was followed by a series of public relation initiatives which ran for 40 days and repeated on a regular basis thereafter. During the campaign, enforcement operations by police officers were increased 10-fold compared to pre-campaign measures.

Results The baseline wearing rates of 56% for drivers and 46% for passengers in October 2010 (pre-campaign measures) reached the level of 65% and 54% in February 2011 and steadily increased afterwards to 75% and 70% in December 2011.

Significance Tailored campaigns based on sound research in connection with concerted strengthened enforcement by police officers represented a successful way to increase seat-belt use in the Russian context.