Half of all premature deaths of Russian adults down to alcohol

More than half of all deaths of people of working age in Russia are caused by alcohol, according to research by Oxford University and the Russian Cancer Research Centre in Moscow. The results of the case-control study are published in The Lancet.

The researchers asked the families of 30,000 dead men and 20,000 dead women in the Russian cities of Tomsk, Barnaul and Biysk what the deceased person used to drink, and determined the cause of death from official death records.

They found that 59% of deaths in men and 33% of deaths in women between the ages of 15–54 were caused by alcohol. Most of these alcohol-attributed deaths were from alcohol poisoning, accidents, violence, or one of eight disease groups strongly related to alcohol, such as TB, pneumonia, pancreatitis or liver disease.

‘Russian health continues to be devastated by the effects of alcohol and tobacco,’ says Professor David Zaridze of the Russian Cancer Research Centre, who led the study in Russia. ‘Many Russians die in their twenties, thirties or forties from disease, accidents, violence or suicide caused by drinking.’  

Professor Sir Richard Peto of the Clinical Trial Service Unit (CTSU) at the University of Oxford, who led the statistical analyses said: ‘If current Russian death rates continue, then about 5% of all young women and 25% of all young men will die before age 55 years from the direct or indirect effects of drinking.

Our analyses are just of mortality, and ignore any other adverse or beneficial effects of alcohol use on individuals, families or society,’ he added.

Russian deaths from disease are further aggravated by widespread smoking. Male lung cancer rates (which are driven by smoking and not by drinking) are about 50% higher in Russia than in Western Europe or North America. After the age of 55, tobacco may well cause more deaths than alcohol, but at younger ages alcohol has been shown to cause, in Russia, even more deaths than tobacco. 

National mortality statistics show that the overall risk of death among people of working age in Russia is now more than four times as great as in Western Europe. (It is five times as great in Russian men as in West European men, three times as great in Russian women as in West European women.) Alcohol and, to a lesser extent, tobacco can account for most or all of the large difference in premature death between Russia and Western Europe in adults of working age. 

Whereas West European death rates have been decreasing steadily for the past few decades, chiefly due to decreases in tobacco deaths as people stop smoking, Russian death rates at ages 15–54 years have fluctuated wildly. They decreased suddenly when alcohol consumption fell by a quarter in 1985 under President Gorbachev’s 1985–8 anti-alcohol laws, then doubled between 1988 and the peak mortality in 1994. Since then, they have zig-zagged sharply but have remained fairly high.

Professor Peto said: ‘When Russian alcohol sales decreased by about a quarter, overall mortality of people of working age immediately decreased by nearly a quarter.  This shows that when people who are at high risk of death from alcohol do change their habits, they immediately avoid most of the risk.’