Vodka and Russian men: a tempestuous (and tragic) love affair

This post has been corrected. See the note below for details.

"Vodka is our enemy, so we'll utterly consume it!" goes the old Russian proverb. That love-hate relationship is thought to have helped send 37% of Russian men in 2005 to the grave before they had toasted their 55th birthday. And a new study finds that, despite fitful campaigns to stem heavy drinking, vodka continues to exact a huge toll on Russian men.

Among male Russian smokers, 35% of those in the hardest-drinking category -- those who consumed more than a liter and a half of vodka per week -- died between the ages of 35 and 54, the study found. That death rate was more than twice as high as it was for "lighter" drinkers, 16% of whom died before age 54.

The heaviest drinkers were a minority, at 8% of subjects in that age group, while 78% were classified as lighter drinkers. But fully 24% of the Russian men in the study were classified as heavy or intermediate drinkers, meaning they drank more than a bottle of vodka -- half a liter -- per week.

Among the intermediate male drinkers -- those who said they consumed between half a liter and and a liter and a half of vodka weekly -- 20% died between ages 35 and 54.

A dismal 50% of Russia's male smokers who were in the lightest drinking category died between ages 55 and 74, the study found. But among the hardest drinkers, 64% died somewhere between those ages.

Among the intermediate male drinkers -- those who said they consumed between half a liter and and a liter and a half of vodka weekly, 20% would die between ages 35 and 54, and 54% would expire between ages 55 and 74.

Virtually all of Russia's male drinkers also smoke, so the authors of the latest research largely found they were comparing the death rates of male smokers as a function of how much vodka they drank. The basic unit of measurement they used were bottles of vodka consumed per week -- a bottle being a half-liter  (the equivalent of roughly 18 single servings of alcohol by U.S. standards).

The latest research, published Thursday in the journal Lancet, improves on past efforts to assess vodka's wages on the Russian populace. For existing studies, researchers have visited the homes of random Russians after they died and asked family members to report on the extent of their drinking. Such methods can be unreliable, because families' recollections are often colored by the circumstances of the death.

The latest study is prospective, meaning that researchers, starting in 1998, recruited 151,000 Russian participants older than 35 while they were still alive and healthy, and asked them how much vodka they consumed (as well as other forms of alcohol, which were not as common and which generally tracked with vodka consumption). Most were re-interviewed three years after the first occasion to assess whether their drinking habits had markedly changed -- many had, but in differing directions. Then the authors let the clock tick till 2011 and counted which of their subjects had died, and how.

The authors of this study hailed from several research centers in Russia, and from Oxford University, the French Cancer Research Agency in Lyon and Icahn School of Medicine at Mt. Sinai, New York. The group's earlier research had found that the bulk of premature deaths of heavy drinkers in Russia were attributable to a cluster of "external" causes -- accident, suicide, violence, alcohol poisoning -- or a group of diseases including liver cancer, cancer of the upper aerodigestive tract, tuberculosis, pneumonia, liver or pancreatic disease, or acute ischemic heart disease that is not heart attack.

The average life expectancy of men in Russia is only 64 years, putting it  among the lowest 50 countries in the world. In a commentary published alongside the new study, Juergen Rehm of Toronto's Center for Addiction and Mental Health wrote that, since alcohol is clearly a contributor to those early deaths, state-sanctioned policies that reduce the availability of alcohol, including price increases, can be a valuable tool for improving Russian men's longevity.

After the collapse of the Soviet Union in 1991, deaths among Russian men younger then 54 rose steeply, peaking in 1993, declining a bit when the ruble collapsed in 1998 and then climbing again until 2005. Since strict new policies restricting alcohol sales in 2005, premature death rates among Russian men have begun to fall, but by 2011, had not yet reached levels that prevailed in the final years of the Soviet Union, when the then-President Mikhail Gorbachev imposed significant strictures on alcohol sales.

[For the Record, 10:44 a.m. PST Jan. 31: An earlier version of this post was unclear concerning the statistical relationship between two groups in the study, indicating that "lighter" drinkers had higher death rates than heavy drinkers. The death rate for heavy drinkers was more than twice as high as it was for "lighter" drinkers.]



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