Vodka is a major cause of early death in Russia and has a direct impact on mortality rates in men, research has shown.
Over the past 30 years, changes in the availability of the national drink have been reflected in premature death statistics, say scientists.
When men could get their hands on more vodka, more of them died young.
A new forward-looking study has now found that Russian men who drink three or more bottles of vodka a week are far more likely to go to an early grave than those who consume less than one.
“Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under presidents Gorbachev, Yeltsin and Putin, and the main thing driving these wild fluctuations in death was vodka,” said study co-author professor Sir Richard Peto, from Oxford University.
“This has been shown in retrospective studies, and now we’ve confirmed it in a big, reliable prospective study.”
The researchers asked 57,361 men in three Russian cities how much vodka they drank and watched their progress for a decade.
They estimated that, over a 20-year period, more than a third of male smokers drinking at least three half-litre bottles of vodka a week could expect to die between the ages of 35 and 54.
This compared with a death rate of 16 per cent for men who consumed less than a bottle a week. For men aged 55 to 74, the corresponding rates were 64 per cent and 50 per cent.
Excess deaths among heavy drinkers were linked to alcohol poisoning, accidents, violence, suicide, and specific diseases such as throat and liver cancer, tuberculosis, pneumonia and pancreatitis.
The findings are published in the latest edition of The Lancet medical journal.
Co-author Dr Paul Brennan, from the World Health Organisation International Agency for Research on Cancer in Lyon, France, said: “Because some who said they were light drinkers later became heavy drinkers, and vice versa, the differences in mortality that we observed must substantially under-estimate the real hazards of persistent heavy drinking.”
Commenting on the research in The Lancet, Canadian expert Dr Jurgen Rehm, from the Centre for Addiction and Mental Health in Toronto, said binge-drinking was a major cause of the alcohol-related deaths.
“It is the combination of high overall volume with the specific pattern of episodic binges that is necessary to explain the high level and fluctuating trends of total and alcohol-attributed mortality in Russia,” he said.
Christopher Allen, senior cardiac nurse at the British Heart Foundation, said: “This study graphically highlights the toll that heavy drinking has wreaked on communities in Russia. With the Winter Olympics fast approaching, it’s a timely reminder of what we already know about drinking too much alcohol — it not only raises your risk of heart and circulatory disease, but also your risk of liver disease and some cancers.”