As several former East Bloc countries now become EU members, we will be witnessing the merger between quite diverse social, economic, and political cultures-including the encounter between divergent drinking patterns and alcohol policies. In 2000, a survey was carried out in six EU countries as part of the European Comparative Alcohol Study in which respondents were asked about drinking habits and other alcohol-related issues. Several of these questions were also used in a survey in the Baltic republics and Poland in 2001, thereby providing an opening for comparisons across the traditional east-west divide in Europe. Thin article provides a broad outline of the main findings in the comparison between the two groups of countries as European integration enters its next phase. The main focus is on frequency of drinking, prevalence of alcohol-related harms, and attitudes toward alcohol policy. Although country comparisons are at the center of attention, gender differences are also highlighted.
KEY WORDS: Alcohol, Baltic republics, Poland, EU enlargement, survey, attitudes.
The so-called transition in the former Soviet Union and Eastern Europe at large is usually associated with profound changes in three main areas: politics, economy, and social conditions. Although not equally highlighted in the public debate, this transition was also marked by an immense deterioration of public health in some of the former East Bloc countries. An extraordinary upsurge in mortality, commonly referred to as the "public health" or "mortality" crisis, was above all observed in Russia, the Baltic republics, Byelorussia, and the Ukraine. These countries belong to a cluster of former communist republics in which the transition was marked by an extremely high adult mortality, particularly among men (Kaasik et al., 1998). Between 1992 and 1994, life expectancy in Russia fell by 6.1 years for men and by 3.3 years for women (Shkolnikov et al., 1998). Interestingly, most of the former Soviet republics hit their low point in the same year, 1994 (Reamy & Oreskovic, 1999). This was the case in both Russia and the Baltic republics, where average life expectancy at birth in 1994 varied from 64 years (58 years for men) in Russia to 69 years (63 years for men) in Lithuania. For Poland, a former communist country-but not a Soviet republic-the situation was somewhat different. The Polish transition to post-communism was, in public health terms, not nearly as dramatic as in the former Soviet republics. Poland did see a slight decrease in average life expectancy between 1988 and 1991, but it has risen steadily since 1992.1
The driving forces behind the public health crisis are many, and opinions differ about how to explain these trends (Shapiro, 1995; Watson, 1995; Chen et al., 1996). Because this sharp rise in mortality during the early 1990s was preceded by a notable increase in life expectancy during the late 1980s, many analysts relate these fluctuations to corresponding changes in alcohol availability and alcohol consumption. During the late 1980s alcohol availability was severely restricted during an anti-alcohol campaign initiated by Mikhail Gorbachev, the Soviet general secretary. When the Soviet Union collapsed, the campaign was in effect already over, but there were now no longer any effective political institutions able or willing to regulate the alcohol market adequately. The latter part of the 1990s was therefore spent trying to re-regulate the alcohol market (Reitan, 2000). Given this variability in alcohol policies and fluctuations in life expectancy, in addition to the composition of the mortality increase during the early 1990s, there is growing acceptance that harmful lifestyles such as detrimental alcohol consumption are indeed associated with public health developments in the region during the past 10-15 years-at least in the former Soviet Union (McKee & Chenet, 1995; Cockerham, 1997; Leon et al., 1997). The Baltic countries are generally perceived as particularly burdened by high levels of recorded as well as unrecorded alcohol consumption, particularly in Latvia and Lithuania (Lehto, 1997; Harkin et al. …