In the course of a case-control study examining determinants of premature death among working age men, it became clear that a significant percentage of the population (7.3%) were drinking a variety of surrogate alcohol products (products not legally sold for consumption). In this population, where there is a high death rate from alcohol-related causes, including acute alcohol poisoning, it was important to know what these products contained.
The identity of products being consumed was identified from the survey of controls. Representative samples were obtained and subjected to analysis using gas chromatography and mass spectrometry to determine their composition.
Three broad groups of product were identified: samogon (home-produced spirits); medicinal compounds; and other spirits (mainly sold as aftershaves). Commercially produced vodkas were used for comparison. Samogon contained lower quantities of ethanol than vodka [mean, 39 vs. 44 volumetric percentage (v/v%), respectively] but in addition contained certain toxic long-chain alcohols. Medicinal compounds contained only ethanol, at a higher concentration that vodka (mean, 66 v/v%), while the other spirits, which were also essentially pure ethanol, contained a mean of 94 v/v%.
A significant number of Russian men are drinking products that have either very high concentrations of ethanol or contaminants known to be toxic. These products are untaxed and thus much less expensive than vodka. There is an urgent need for policy responses that target their production and consumption.
The aim of this study was to determine the impact of a set of 2006 Russian alcohol policies on alcohol-related mortality in the country.
We used autoregressive integrated moving average interrupted time series techniques to model the impact of the policy on the number of sex-specific monthly deaths of those aged 15+ years due to alcohol poisoning, alcoholic cardiomyopathy, alcoholic liver cirrhosis, and alcohol-related mental and behavioral disorders. The time series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006.
The alcohol policy resulted in a significant gradual and sustained decline in male deaths due to alcohol poisoning (?o = -92.631, p
To determine the impact of a suite of 2006 Russian alcohol control policies on deaths due to traffic accidents in the country.
We used autoregressive integrated moving average (ARIMA) interrupted time-series techniques to model the impact of the intervention on the outcome series. The time-series began in January 2000 and ended in December 2010. The alcohol policy was implemented in January 2006, providing 132 monthly observations in the outcome series, with 72 months of pre-intervention data and 60 months of post-intervention data.
The outcome variables were the monthly number of male- and female-specific deaths of those aged 15+ years due to transport accidents in Russia.
The 2006 set of alcohol policies had no impact on female deaths due to traffic accidents (?0 ?= -50.31, P = 0.27). However, the intervention model revealed an immediate and sustained monthly decrease of 203 deaths due to transport accidents for males (?0 ?= -203.40, P = 0.04), representing an 11% reduction relative to pre-intervention levels.
The implementation of the suite of 2006 Russian alcohol control policies is partially responsible for saving more than 2400 male lives annually that would otherwise have been lost to traffic accidents.
Prior studies on spatial inequalities in mortality in Russia were restricted to the highest level of administrative division, ignoring variations within the regions. Using mortality data for 2239 districts, this study is the first analysis to capture the scale of the mortality divide at a more detailed level.
Age-standardised death rates are calculated using aggregated deaths for 2008-2012 and population exposures from the 2010 census. Inequality indices and decomposition are applied to quantify both the total mortality disparities across the districts and the contributions of the variations between and within regions.
Regional variations in mortality mask one-third (males) and one-half (females) of the inequalities observed at the district level. A comparison of the 5% of individuals residing in the districts with the highest and the lowest mortality shows a gap of 15.5 years for males and 10.3 years for females. The lowest life expectancy levels are in the shrinking areas of the Far East and Northwest of Russia. The highest life expectancy clusters are in the intercity districts of Moscow and Saint Petersburg, and in several science cities. Life expectancy in these best-practice districts is close to the national averages of Poland and Estonia, but is still substantially below the averages in Western countries.
The large between-regional and within-regional disparities suggest that national-level mortality could be lowered if these disparities are reduced by improving health in the laggard areas. This can be achieved by introducing policies that promote health convergence both within and between the Russian regions.
CommentIn: J Epidemiol Community Health. 2020 Feb;74(2):107 PMID 31676668
William Alex Pridemore is with the Department of Criminal Justice and Criminology, Andrew Young School of Policy Studies, Georgia State University, Atlanta. Mitchell B. Chamlin is with the Department of Criminal Justice, Texas State University-San Marcos. Evgeny Andreev is with the Center for Demographic Research, the New Economic School, Moscow, Russia.
We took advantage of a natural experiment to assess the impact on suicide mortality of a suite of Russian alcohol policies.
We obtained suicide counts from anonymous death records collected by the Russian Federal State Statistics Service. We used autoregressive integrated moving average (ARIMA) interrupted time series techniques to model the effect of the alcohol policy (implemented in January 2006) on monthly male and female suicide counts between January 2000 and December 2010.
Monthly male and female suicide counts decreased during the period under study. Although the ARIMA analysis showed no impact of the policy on female suicide mortality, the results revealed an immediate and permanent reduction of about 9% in male suicides (Ln ?0 = -0.096; P = .01).
Despite a recent decrease in mortality, rates of alcohol consumption and suicide in Russia remain among the highest in the world. Our analysis revealed that the 2006 alcohol policy in Russia led to a 9% reduction in male suicide mortality, meaning the policy was responsible for saving 4000 male lives annually that would otherwise have been lost to suicide. Together with recent similar findings elsewhere, our results suggest an important role for public health and other population level interventions, including alcohol policy, in reducing alcohol-related harm.