Academic journal article Alcoholism

Beverage Specific Alcohol Sale and Mortality in Russia

Academic journal article Alcoholism

Beverage Specific Alcohol Sale and Mortality in Russia

Article excerpt

(ProQuest: ... denotes formulae omitted.)

INTRODUCTION

Although alcohol is among the major risk factors for the burden of disease and mortality worldwide, Eastern Europe has the highest rate of alcohol-related problems.12 There is a common belief that alcohol has been implicated in the mortality crisis observed in many former Soviet republics during the last decades.3-6 In Russia, for example, it has been estimated that alcohol may be responsible for more than 30% of all deaths,7 while a case-control study in Izhevsk suggests that 43% of all male deaths between 25 and 54 years of age were attributed to hazardous drinking.8 Amore recent study in the Siberian city of Barnaul based on proxy information on alcohol consumption and other lifestyle factors from families of 48 557 adults who died in the period from 1990 to 2001 showed that alcohol was responsible for 59% of all male and 33% of all female deaths between 15 and 54 years of age.9 The driving forces behind the mortality crisis in this country are a combination of the higher overall level of alcohol consumption and harmful drinking pattern. A worldwide assessment of drinking pattern showed that Russia and former Soviet Union countries had the most hazardous pattern of drinking.2

Evidence of a major effect of alcohol on Russian mortality pattern comes from both time series analyses and studies on individual level. The link between mortality and population drinking in Russia has been analyzed in a number of aggregate-level studies. For example, Nemtsov reported that 1 -litre increase in alcohol consumption is expected to increase mortality by 3.6% for the total population (5.9% for men and 1.9% for women).7 Amore recent update suggests that there was a statistically significant alcohol effect in Russia between 1960 and 1998, implying that a 1-litre increase in alcohol consumption would result in 2.7% increase in male mortality.10

The findings suggest that population drinking and death rate from cardiovascular diseases are positively related phenomena in Russia.11 Using a pooled cross-sectional analysis, Gmel et al. showed that in countries with favorable drinking pattern (e.g. France and Italy), per capita consumption was negatively associated with ischemic heart disease (IHD) mortality whereas a positive link was found in countries with the binge drinking pattern (e.g. Russia).12

The results from recent time series analysis based on Russian data from 1959 to 1998 highlight the positive and statistically significant association between alcohol consumption and both overall and premature male IHD mortality ; 1 liter change in per capita consumption was associated with a 3.6% increase in overall male IHD mortality and a 4.5% increase in the age group of 30-54 years. 13 The results of another study, covering the period from 1956 to 2005 suggest a positive association between fatal alcohol poisoning (as a proxy for binge drinking) and cardiovascular mortality rates. 14

The existing research evidence supports a positive aggregate level association between alcohol consumption and alcohol-related mortality in Russia. In particular, positive and statistically significant association was found between alcohol consumption and liver cirrhosis mortality time trends between 1 960 and 2002 suggesting that 1 liter increase in per capita consumption is associated with a 12.6% increase in cirrhosis mortality for the total population (14% for men and 10.6% for women).15

Alcohol is increasingly implicated in the fluctuation of deaths from external causes in Russia during the last decades. The results from recent time series analysis suggest that changes in per capita consumption have a significant impact on violent mortality rates.6 However, we should keep in mind potential limitations of these studies, i.e. that the estimation of the overall alcohol consumption is more vulnerable to bias than sales data. Therefore, alcohol sale data per capita are generally recognized as the most valid estimate for level of drinking in society. …

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