Beverage Specific Alcohol Sale and Mortality in Russia
Razvodovsky, Y. E., Alcoholism
High mortality rates in Russia and their profound fluctuation over the past decades have attracted considerable interest. The mounting body of evidence points to binge drinking pattern as a potentially important contributor to mortality crisis in Russia. In line with this evidence we assume that higher level of vodka consumption in conjunction with binge drinking pattern results in close aggregate-level association between vodka sale and mortality rates in Russia. To test this hypothesis, trends in beverage-specific alcohol sale per capita and mortality rates in Russia between 1980 and 2005 were analyzed employing ARIMA time series analysis. The results of analysis indicate that mortality rates tend to be more responsive to change in vodka sale per capita than in the total level of alcohol sale. The analysis suggests that 1 litre increase in vodka sale per capita would result in a 5.3% increase in the total mortality rate, a 4.4% increase in cardiovascular mortality, an 11.3% increase in violent mortality, a 10.9% increase in liver cirrhosis mortality, a 7.1% increase in number of deaths from pancreatitis, a 21.9% increase in fatal alcohol poisoning rate. The outcomes of this study provide support for the hypothesis that alcohol played a crucial role in the fluctuation in mortality rates in Russia during the last decades. Assuming that drinking vodka is usually associated with intoxication episodes, these findings provide additional evidence that binge drinking pattern is an important determinant of the mortality crisis in Russia.
Keywords: beverage specific alcohol sale; mortality; ARIMA time series analysis; Russia; 1980-2005
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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. …