Education And Debate

Russian Report: Alcoholism and rising mortality in the Russian Federation

BMJ 1995; 310 doi: (Published 11 March 1995) Cite this as: BMJ 1995;310:648
  1. Michael Ryan, senior lecturer in politics and Russian studiesa
  1. a Centre of Russian and East European Studies, University of Wales, Swansea SA2 8PP
  • Accepted 9 December 1994

In the Russian Federation today the high incidence of alcoholism and drunkenness helps to account for rising death rates, more particularly among the male population. During the mid-1980s a significant reduction in deaths from alcohol related diseases was achieved by state action in curtailing the supply of alcohol. However, official data disclose a pattern of sharply increased consumption per head since 1987, with high proof drinks—especially vodka—now forming a larger share in the total. In current economic conditions the effects of a traditional macho drinking culture are exacerbated by a reduction of state control over the quality of alcohol available for purchase. A substantial increase has occurred in deaths from most principal causes, with a disproportionate increase in deaths from non-natural causes, including deaths caused predominantly by alcohol. Average expectation of life at birth has fallen especially sharply for men; by 1993 it had slumped to 59.0 years—that is, to below the age at which a pension starts to be paid.

“To live or to drink?”—that was the chilling question posed recently in Izvestiya. The authors of the article—a doctor of medicine and a leading demographer—gave a starkly pessimistic answer.1 Judging from the evidence available, claimed Nemtsov and Shkol'nikov, Russians are choosing the latter.

Sobriety by order

The association of drunkenness and alcoholism with rising death rates was probably a major determinant of the antialcohol campaign of the past decade. That package of measures, aimed at achieving a sharp and rapid fall in the consumption of alcohol, was initiated by Mikhail Gorbachev shortly after his advent to power as leader of the former Soviet Union in 1985.

Table I shows the effectiveness and ineffectiveness of the Gorbachev administration's strategy. For the masters of the command economy it may well have seemed unproblematic to achieve a reduction in sales from sources controlled by …

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