Public Health

Russia’s alcohol problem

BMJ 2011; 343 doi: (Published 17 August 2011)
Cite this as: BMJ 2011;343:d5240

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Alcohol causing annually 2.5 million deaths globally is the 3rd leading cause of death & disability.1

In Russia in 2009 there were 500,000 alcohol related deaths.

Can lessons can be learned from the problem of alcoholism in Russia ? Do they help highlight possible measures to control the global epidemic of NCDs.

Causes of alcoholism in Russia

Causative factors for the high level of alcoholism in Russia include amongst others cultural, climatic, unemployment & stress.

Additionally, significant causes are wide-spread availability of relatively low cost alcohol from legal & non-legal sources and alcohol -substitutes and, importantly, agendas of vested interests, namely the alcohol industry & government. In 1860 vodka was the source of 40% of annual Russian revenue. In 2000 revenue in Russia from alcohol sales was $US 3.2 billion (5% total revenue). It is estimated that the proposed incremental tax increases on alcohol will create extra revenue of $US 11.2 billion.2

Effects of alcoholism

* At personal and family level it increases stress & depression, reduces family income through illness and death, creates more widows and thus destabilises families.3

* At the State level, NCDs in 2005 reduced the Russian annual GDP by 1% ($US 11 billion). By 2015, the annual loss will increase to 5% of GDP ($US 66 billion). Alcoholism has a significant aetiological role in development of NCDs in particular CVD, hepatic cirrhosis & some cancers. Thus causing increased medical costs, reduced productivity and tax revenue, decreased savings, increased absenteeism from work, fewer workers, increased regional disparities, fewer military conscripts and increased potential risks of federal instability.3

Measures undertaken to reduce alcoholism in Russia

Gorbachev's anti alcohol measures in 1985-88 increased life expectancy by 2 years.4

Restrictions on sales of alcohol from kiosks & railway stations, bans on sales of alcohol after 10pm, restriction in size of containers, acknowledgement that beer is alcoholic, arguably, may decrease alcohol consumption.

Public awareness campaigns on television & radio, media, internet and posters.5

Promotion of healthy life styles in health centres & health schools. 5

Lessons to be learned from Russia

Causes of alcoholism are multifactorial. Thus a combination of measures will be necessary to reduce alcohol consumption.

Some of these, political will, legislation to reduce alcohol availability & usage, education of medical profession and the public are already in place in Russia or planned. All these approaches are transferable to other nations, with modifications for local requirements. To be maximally effective cooperation between nations is necessary with transfer of know-how. Governments, NGOs, civil society, commercial and private organisations must all be involved.

1. WHO Global status report on Alcohol & Health 2011

2. NY Times 16 April 2011

3. Dying Too Young Human Development Department World Bank 2005

4. Mckee M Alcohol in Russia Oxford Journal 34 (6) 824-829

5. Healthy Russia programme 2000-2012 Ministry of Public Health & Social Development of Russian Federation

Competing interests: None declared

Harald M Lipman, Executive director

International Cardiac Health & RiskFactor Modification

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