Hazardous drinking causes nearly half of deaths in working-age Russian men

Hazardous alcohol drinking causes 43% of deaths in Russian men aged 25-54, conclude authors of a study published in The Lancet.

Hazardous drinking includes both excessive consumption of regular beverage-alcohol such as beer, wine, and sprits; and drinking of non-beverage alcohol such as colognes, medical tinctures and cleaning agents.

But an accompanying comment warns that many factors might have affected death rates in Russia during the time covered by the study, with non-beverage alcohol “highly unlikely to the main contributor to the change of mortality.”

Russia has an exceptionally low life expectancy for an industrialised country – 59 years for males, and 72 years for females. Russian men aged 25-54 years are more than three-and-a-half times more likely to die than UK men in the same age group. As well as regular alcoholic beverage consumption, Russian men are much more likely drink alcohol containing products not meant for human consumption such as colognes, medical tinctures and cleaning agents. This is because they can be much more highly concentrated (60-97% alcohol by volume), and as they do not qualify for alcohol excise duty they can be up to six times cheaper per unit of alcohol.

Professor David Leon, London School of Hygiene and Tropical Health, London, UK and colleagues did their study on Izhevsk – a typical Russian industrial city in the Ural mountains. They analysed 1,750 men who died between 2003 and 2005, and 1,750 control cases who were still alive.

They found that men who were problem drinkers of alcoholic beverages, or who drank non-beverage alcohol, were six times more likely to die than men who did not drink at all or did not have a drinking problem. Men who specifically drank non-beverage alcohol were nine times more likely to die than those who did not – an effect that was independent of the volume of alcohol consumed from beverage alcohol or of their level of education.

The authors conclude: “Almost half of all deaths in working age men in a typical Russian city may be accounted for by hazardous drinking. Our analyses provide indirect support for the contention that the sharp fluctuations seen in Russian mortality in the early 1990s could be related to hazardous drinking as indicated by consumption of non-beverage alcohol.”

In the accompanying Comment, Dr Jürgen Rehm, Centre for Addiction and Mental Health, Toronto, Canada, and Dr Gerhard Gmel, Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme, Lausanne, Switzerland, warn that people who drink non-beverage alcohols often live in poor housing conditions and have poor diets, which could be contributory factors to their increased mortality. They add that illegally produced alcoholic beverages are a major source of alcohol consumption in Russia not covered by the study.

The comment authors conclude: “There are remaining questions that should be answered in future research, such as improved measurement of ethanol intake from non-beverage alcohol and better control of confounding, before specific measures on alcohol policy are suggested.”