Hazardous alternatives to alcohol beverages are still widely available in Russian cities

Federal restrictions on product availability have been effective but have not gone far enough, say researchers.

• "Non-beverage alcohols" are manufactured liquids that contain alcohol but are not intended for consumption, such as medicinal tinctures, aftershave, alcohol-based anti-freeze, antiseptics, and eau-de-colognes.
• A survey of 17 Russian cities has found that these products are widely available, highly concentrated, and cheaper than standard Russian vodka.

The term "non-beverage alcohols" refers to manufactured liquids that contain alcohol but are not intended for consumption, such as medicinal tinctures, aftershave, alcohol-based anti-freeze, antiseptics, and eau-de-colognes. Drinking these products is very hazardous to one's health. Prior research (see the October 2005 issue of Alcoholism: Clinical & Experimental Research ) had found a high availability of non-beverage alcohols in one city in Russia; this follow-up study of 17 Russian cities has found they are still widely available.

Results will be published in the January 2009 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"From earlier work, we knew that drinking non-beverage alcohols is not very widespread in Russia, with fewer than one in 10 - or seven percent - of working-age men having drunk any non-beverage alcohol in the preceding year," said David A. Leon, professor of epidemiology at the London School of Hygiene and Tropical Medicine, and corresponding author for the study. "However, this consumption appears to be a strong predictor of mortality, probably indicating someone is in the final stages of a long and damaging history of heavy and hazardous drinking."

Furthermore, added Denny Vagero, professor and director of the Centre for Health Equity Studies (CHESS) in Stockholm, this kind of consumption is associated with the breakdown of families, loss of employment, and poverty. "We have learned in the last couple of years that this is a serious and previously under-estimated problem," he said.

The purpose of this study was two-fold, said Leon. "The primary purpose was to establish whether non-beverage alcohols were available in a wide range of cities throughout Russia, and not simply an oddity of the city in the Urals where we first identified non-beverage alcohols as important predictors of mortality among working-age men," he said. "A secondary objective was to see how effective the new 2006 federal regulations were." The Russian government issued regulations designed to restrict the availability of these products in January 2006.

Leon and his colleagues surveyed 17 cities - representative of a wide range of city types - in the Russian Federation, excluding the Far East, during the first half of 2007. Fieldworkers visited pharmacies and other types of retail outlets in order to purchases samples of various kinds of non-beverage alcohols. Guidelines for purchases included 10 - 15 roubles per bottle, with an alcohol concentration of at least 60 percent by volume.

"We found that non-beverage alcohols were widely available throughout the 17 Russian cities we surveyed," said Leon. "This empirically provides a very important basis for arguing that further tighter regulation of these substances is necessary. On the positive side, and somewhat contrary to our expectations, it appears that the 2006 federal regulations have resulted in a decline in the availability of eau-de-colognes, but not medicinal tinctures." Medicinal tinctures, sold almost exclusively in pharmacies, were particularly common - with an average concentration of 78 percent alcohol by volume.

"These concentrations are very high compared to spirits," noted Leon, "and are often prominently displayed on labels and packaging as they attract people to buy them, knowing that they will get a lot of alcohol for the cheap price they pay. However, it should be noted that it is not known what proportion of people drink these substances straight from the bottle. An appreciable proportion probably dilute the products with water and hence have a large volume to drink, much like buying concentrated fruit juice that needs dilution to drink."

Neither Leon nor Vagero were surprised by the findings. "They will not come as a surprise to ordinary Russians," said Leon.

"Distributing alcohol in illegal and semi-legal ways has been a frequent practice in Russia for decades," added Vagero. "However, the Russian alcohol situation is not unique in Europe."

Leon agreed. "These findings do not suggest that all Russians drink non-beverage alcohols and no one else does. As I indicated earlier, our study in the Urals found that only seven percent of the men drank these things, but the impact on their health was very severe. Furthermore, the reality is that Finland, and other Nordic countries, have also had big problems in the past with drinking non-beverage alcohols. Finland's problems were quite serious even as recent as the 1970s."

Another key finding for Russian policy makers to ponder, said Leon, is that the majority of the 271 products purchased were a cheaper source of alcohol than standard Russian vodka. "In other words, it is economically rational for those individuals without much money to consume them," he said. "All in all, we can see that the 2006 regulations were a step in the right direction, but they have not gone far enough."

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