Utilizing data from the nationwide Russian Longitudinal Monitoring Survey (RLMS), this paper analyzes health lifestyles in Russia. Heavy alcohol use and smoking, a high-fat diet, and lack of leisure-time exercise are the principal culprits in fostering high rates of heart disease and other causes of premature mortality. This is especially the situation for middle-age, working-class males whose mortality is greater than any other segment of society. This paper focuses on alcohol use as a particularly lethal component of male lifestyles and presents a theoretical argument, grounded in the work of Weber and especially Bourdieu, that poor health lifestyles practices are largely the outcome of structural conditions (life chances) rather than agency (life choices). Societal and group norms and routine practices can adversely affect longevity and this is the case for Russian male blue-collar workers in the middle period of their life course.