A large study shows that alcohol - and, in particular, vodka - is responsible for Russia's high and sharply fluctuating death rates. Russia currently has an abnormally high early death rate in men - 25% of all Russian men will die before the age of 55.
One of the authors of the new study, Prof. Sir Richard Peto, explains:
"Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka. This has been shown in retrospective studies, and now we've confirmed it in a big, reliable prospective study."
Prof. Peto and his colleagues note that under Mikhail Gorbachev's alcohol restrictions in the mid-1980s, alcohol consumption and death rates both fell by 25%.
Following the collapse of communism there was a steep rise again in both alcohol consumption and death rates. More recently, there has been a drop in consumption of spirits as a result of Russia's 2006 alcohol policy reforms. Again, the death rates have corresponded, with a fall in risk of death before age 55.
Study leader Prof. David Zaridze, from the Russian Cancer Research Centre in Moscow, says:
"The significant decline in Russian mortality rates following the introduction of moderate alcohol controls in 2006 demonstrates the reversibility of the health crisis from hazardous drinking. People who drink spirits in hazardous ways greatly reduce their risk of premature death as soon as they stop."
Risk tied to drinking three or more bottles of vodka a week
However, the risks of early death are still substantial. The new study, which is published in The Lancet, recorded for up to a decade the vodka-drinking habits of 151,00 Russians. By the end of the study period, 8,000 of the participants had died.
The study found that men who drank three or more bottles of vodka a week were much more likely to die than men who drank less than one bottle each week.
The risk of death for men aged between 35 and 54 who drank three or more half-liter bottles of vodka a week was 35%. Men who drank less than one bottle in the same age group had a risk of death of 16%.
Between the ages of 55 and 74, the risk of death for the heavier drinkers was 64%, and 50% for the men who drank less than one bottle a week.
The main causes of death among the heavy drinkers were alcohol poisoning, accidents, violence, suicide, throat cancer, liver cancer, tuberculosis, pneumonia, pancreatitis, liver disease and heart disease.
More effective alcohol policy is needed
"Because some who said they were light drinkers later became heavy drinkers, and vice-versa," says co-author Dr. Paul Brennan, "the differences in mortality that we observed must substantially under-estimate the real hazards of persistent heavy drinking."
Commenting on the study, Dr. Jürgen Rehm, from the Centre for Addiction and Mental Health in Toronto, Canada, says, however, that the overall volume of alcohol consumed in Russia cannot explain on its own the high mortality rates.
"It is the combination of high overall volume with the specific pattern of episodic binges that is necessary to explain the high level and fluctuating trends of total and alcohol-attributed mortality in Russia," he says.
"Since the average life expectancy from birth for men in Russia is still only 64 years, ranking among the lowest 50 countries in the world, more effective alcohol and tobacco policy measures are urgently needed."
In 2012, Medical News Today reported on a study comparing the health implications of drinking vodka with drinking wine.