15
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Issues.

          The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign’s policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign’s end, the region faces diverse challenges in relation to alcohol.

          Approach.

          The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments.

          Key Findings.

          Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three ‘best buys’ put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries.

          Implications.

          In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions.

          Conclusion.

          Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

          Related collections

          Most cited references108

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          The relationship between different dimensions of alcohol use and the burden of disease—an update

          Abstract Background and aims Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Methods Systematic review of reviews and meta‐analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. Results In total, 255 reviews and meta‐analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD‐10 three‐digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in‐depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Conclusions Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Huge variation in Russian mortality rates 1984-94: artefact, alcohol, or what?

            According to published data, between 1984 and 1994 mortality rates in Russia initially underwent a rapid decline followed by an even steeper increase. In 1994, male life expectancy at birth was 57.6 years, having fallen by 6.2 years since 1990. There has been concern that such striking fluctuations in mortality are an artefact, although, among other factors, alcohol consumption has been implicated. We analysed the age-specific and cause-specific patterns of mortality decrease and increase by use of data from a newly reconstructed mortality series for Russia so that we could examine the plausibility of various explanations for the mortality trends. All major causes of death, with the exception of neoplasms, showed declines in mortality between 1984 and 1987 and increases between 1987 and 1994. In relative terms, these tended to be largest for the age-group 40-50 years; surprisingly, they were of the same magnitude among women and men. The largest declines and subsequent increases in proportional terms were observed for alcohol-related deaths and accidents and violence. However, pronounced effects were also seen for deaths from infections, circulatory disease, and respiratory disease. No substantial variations were seen for neoplasms. The stability of mortality from neoplasms in contrast to other causes over the period 1984-94 largely precludes the possibility that the changes in life expectancy are mainly an artefact, particularly one due to underestimation of the population. Although factors such as nutrition and health services may be involved, the evidence is that substantial changes in alcohol consumption over the period could plausibly explain the main features of the mortality fluctuations observed. These results provide a major challenge to public health in Russia and to our understanding of the determinants of alcohol consumption and its role in explaining mortality patterns within and between many other countries.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The relation between different dimensions of alcohol consumption and burden of disease: an overview.

              As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses. Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose-response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol-disease relationships.
                Bookmark

                Author and article information

                Journal
                9015440
                27403
                Drug Alcohol Rev
                Drug Alcohol Rev
                Drug and alcohol review
                0959-5236
                1465-3362
                2 February 2021
                05 November 2020
                March 2021
                07 March 2021
                : 40
                : 3
                : 350-367
                Affiliations
                [1 ]WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
                [2 ]Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
                [3 ]Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
                [4 ]Institute of Economics, National Academy of Sciences, Minsk, Belarus
                [5 ]Health Research Institute, Faculty of Medicine, Al-Farabi Kazakh National University Almaty, Almaty, Kazakhstan
                [6 ]Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
                [7 ]Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
                [8 ]Department of Economics, University of Potsdam, Potsdam, Germany
                [9 ]Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
                [10 ]Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
                [11 ]Department of Psychiatry, University of Toronto, Toronto, Canada
                [12 ]Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
                [13 ]Department of International Health Projects, Institute for Leadership and Health Management, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
                Author notes

                Maria Neufeld Dipl Psych, Consultant, WHO European Office for Prevention and Control of Noncommunicable Diseases, Anastacia Bobrova PhD, Head of Department for Human Development and Demography, Kairat Davletov PhD, Director, Mindaugas Štelemėkas PhD, Head of the Health Research Institute, Faculty of Public Health, Relika Stoppel MSc, Research Associate, Chair of Public Economics, Fiscal and Social Policy, Carina Ferreira-Borges PhD, Programme Manager, João Breda PhD, Head of the Office, Jürgen Rehm PhD, Senior Scientist, Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health.

                Correspondence to: Ms Maria Neufeld, WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation. Tel: +7 916 9872013; neufeld.maria@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-6364-3765
                http://orcid.org/0000-0002-2040-6900
                http://orcid.org/0000-0003-2910-2572
                http://orcid.org/0000-0001-5665-0385
                Article
                NIHMS1668274
                10.1111/dar.13204
                7936953
                33155370
                6c1f6dfe-0b33-4bff-9142-9047347bf07f

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Article

                alcohol,alcohol policy,eastern europe,former soviet union,mortality

                Comments

                Comment on this article