Hazardous Alcohol Consumption Is a Major Factor in Male Premature Mortality in a Typical Russian City: Prospective Cohort Study 2003–2009

Abstract

IntroductionRussia has experienced massive fluctuations in mortality at working ages over the past three decades. Routine data analyses suggest that these are largely driven by fluctuations in heavy alcohol drinking. However, individual-level evidence supporting alcohol having a major role in Russian mortality comes from only two case-control studies, which could be subject to serious biases due to their design.Methods and FindingsA prospective study of mortality (2003–9) of 2000 men aged 25–54 years at recruitment was conducted in the city of Izhevsk, Russia. This cohort was free from key limitations inherent in the design of the two earlier case-control studies. Cox proportional hazards regression was used to estimate hazard ratios of all-cause mortality by alcohol drinking type as reported by a proxy informant. Hazardous drinkers were defined as those who either drank non-beverage alcohols or were reported to regularly have hangovers or other behaviours related to heavy drinking episodes.Over the follow-up period 113 men died. Compared to non-hazardous drinkers and abstainers, men who drank hazardously had appreciably higher mortality (HR = 3.4, 95% CI 2.2, 5.1) adjusted for age, smoking and education. The population attributable risk percent (PAR%) for hazardous drinking was 26% (95% CI 14,37). However, larger effects were seen in the first two years of follow-up, with a HR of 4.6 (2.5, 8.2) and a corresponding PAR% of 37% (17, 51).InterpretationThis prospective cohort study strengthens the evidence that hazardous alcohol consumption has been a major determinant of mortality among working age men in a typical Russian city. As such the similar findings of the previous case-control studies cannot be explained as artefacts of limitations of their design. As Russia struggles to raise life expectancy, which even in 2009 was only 62 years among men, control of hazardous drinking must remain a top public health priority.

Estimating the causal effect of alcohol consumption on well-being for a cross-section of 9 former Soviet Union countries

“…It is now clear that alcohol is the main proximal cause of the large fluctuations in life expectancy that have characterised this region in the past two decades (Leon, et al, 1997;Shkolnikov, McKee, & Leon, 2001) and research using individual-level data has found that approximately 40% of deaths of working age men in a typical Russian city could, conservatively, be attributed to hazardous alcohol consumption (Leon, Shkolnikov, & McKee, 2009;Tomkins, et al, 2012). In Ukraine it was estimated that alcohol was responsible for 24% of male deaths and 6% of female deaths in 2004 at all ages (Krasovsky, 2009).…”

Alcohol drinking pattern and total cardiovascular risk in able-bodied people

“…Часто встречаемый в Российской Федерации «опас-ный стиль» (опасная модель, опасный тип) потребления алкоголя (потребление суррогатов алкоголя, регулярный похмельный синдром или существенные отклонения в поведении, вызванные приемом большого количества ал-коголя) [3,15] является одной из причин высокой преж-девременной смертности мужчин, что показано в про-спективном исследовании в Ижевске [22].…”

Screening for Hazardous Drinking in Migrant Workers in Southeastern Spain

“…Gender is also significantly associated with alcohol consumption 38,39) . Our results revealed that 34% of women drank alcohol compared with 50% of men and that 8% of the women and 16% of men could be considered hazardous drinkers.…”