A new study by an international team of public health researchers documents the devastating impact of alcohol abuse on Russia — showing that drinking caused more than half of deaths among Russians aged 15 to 54 in the turbulent era following the Soviet collapse.
The 52 percent figure compares to estimates that less than 4 percent of deaths worldwide are caused by alcohol abuse, according to the study by Russian, British and French researchers published in Friday's edition of the British medical journal The Lancet.
The Russian findings were based on a survey of almost 49,000 deaths between 1990 and 2001 among young adult and middle-aged Russians in three industrial towns in western Siberia, which had typical 1990s Russian mortality patterns.
Professor David Zaridze, head of the Russian Cancer Research Center and lead author of the study, estimated that the increase in alcohol consumption since 1987, the year when then-Soviet leader Mikhail Gorbachev's restrictions on alcohol sales collapsed, cost the lives of 3 million Russians who would otherwise be alive today. "This loss is similar to that of a war," Zaridze said.
Dr. Murray Feshbach, a senior scholar at the Woodrow Wilson Center for Scholars and a leading expert on Russian public health, called the study "very impressive, very substantive" and the overall methodologically sound. He was not part of the research team.
The tragic die-off was largely invisible outside of Russia, but devastated Russian society — claiming the lives of millions during what should have been their most productive years. The study is part of a long-running debate among public health scientists as to the causes of an unprecedented spike in mortality among Russians in the post-Soviet era.
Some researchers have blamed the crumbling of the Soviet health care system, increased smoking, changes in diet or a loss of jobs that raised stress levels for the mysterious rise in deaths.
Many others, like Zaridze and his team, pin the blame squarely on increased drinking, which the report says roughly doubled in Russia between 1987 and 1994 — from the equivalent of about 5 liters (1.3 gallons) of pure alcohol annually to about 10.5 liters (2.8 gallons).
"If you look at the dynamics of death and the dynamics of alcohol consumption in Russia, it is obvious that all these sharp increases and decreases of the mortality level are caused by increases and decreases in alcohol consumption," Zaridze said.
The scientist argued that the social and economic shocks of the late 1980s and 1990s drove people to drink.
"Alcohol consumption is always connected with poverty," he said. "It's been associated with social crisis. If we take our mortality statistics, it will be obvious that it's parallel to our social crisis, to our social instability."
Russia and some of its Eastern European neighbors still have the world's highest levels of alcohol consumption, according to another study also published in the Lancet on Friday as part of series on alcohol and global health.
Two other papers in the series called for stronger government policies worldwide to reduce the dangers of alcohol abuse.
Double the global average
Russians currently consume almost twice the global average, the equivalent of 6.2 liters (1.64 gallons) of pure ethanol alcohol per year, the global report found.
Although life expectancy here has risen slightly in recent years, Russia still has one of the lowest in Europe.
According to the most recent U.N. National Human Development Report on Russia, males born in Russia in 2006 could only expect to live to just over 60 years, while a woman born that year could expect to live on average about 73 years. By comparison, the average western European man could expect to live to be 77, about 17 years longer than his Russian counterpart.
The average western European woman could expect to live to be 82, about nine years longer than the average Russian woman.
The Lancet's Russian study was based on a long-term, large-scale study of drinking patterns and deaths in three industrial cities in western Siberia: Barnaul, Biysk and Omsk.
Researchers conducted tens of thousands of personal interviews and mined death records in gathering data for the report. They reported finding a strong link between heavy drinking and causes of death associated with high alcohol abuse, including alcohol poisoning, trauma, pneumonia and liver disease.
The link between life expectancy and alcohol in Russia has long been the subject of study. Mortality rates fell sharply in Russia from late 1985 to 1987, when then Soviet leader Mikhail Gorbachev imposed strict limits on alcohol sales. During the period of political and social revolution that followed, death rates soared to levels unprecedented in modern industrialized nations.
By 2000, the reported noted, the chances that a 15 year old Russian male would die before his 35th birthday was one in ten. In Europe, the chances of a 15-year-old male dying by age 35 was one in 50.
Vodka's integral role
Part of the problem may be the important cultural role vodka and alcohol play in Russian society. Moderate drinking is considered healthy by many Russians, and few major events are celebrated without raising a 100-gram glass or two — or three — of vodka.
"If the soul needs it — we drink, if the soul doesn't need it — we don't drink," said Alexei Kitayev, a St. Petersburg cab driver. "Do I drink often? Beer after work to relax, vodka and beer at the weekends with my family at dinner — it's good for me and the soul is happy."
Russians generally blame alcohol deaths on the consumption of adulterated or industrial alcohol. Maxim Vdovin, an unemployed St. Petersburg resident, voiced the commonly-held view here that many Russians die because the state does not control the sale of adulterated spirits.
"No one gives a damn," Vdovin said. "So many people are dying because of this raw vodka and they don't give a damn, everybody is drinking and so many people die," he said.
A previous study carried out by British and Russian researchers and published in the Lancet in 2007 estimated that drinking alcohol not meant for consumption like cologne and antiseptics was responsible for nearly half of all deaths among working-age Russian men.
A recent government crackdown on the sale of alcohol not intended for human consumption appears to have significantly cut those deaths, experts say.
But there is relatively little recognition here that excessive drinking of alcohol in any form, including beer and wine, can lead to serious health problems.