How to Reduce Harmful Drinking

Harmful drinking features prominently in Russia's public policy for good reason: The country has the world's fourth-highest rate of per capita alcohol consumption. Alcohol misuse has been a major social, economic and public health problem for decades, and the prevailing drinking pattern has been characterized as "most risky" by the World Health Organization, or WHO. ? 

A significant portion of the alcohol consumed in Russia is noncommercial alcohol — that is, alcohol informally or illegally produced and sold, which avoids government regulation and control. According to WHO statistics, unrecorded alcohol accounts for one-third of all consumption in Russia. Ironically, as national and local governments step up measures to reduce harmful drinking by restricting access to commercially available alcohol beverages or raising their prices, these policies drive the growth of the much more dangerous black market.

A recent study conducted by the International Center for Alcohol Policies, or ICAP, in conjunction with Russian researchers found that the vast majority of Russians cited their lower cost and greater availability as important reasons for drinking noncommercial alcohol beverages.

Not surprisingly, the state's focus on population-level restrictions, such as limiting physical availability or limiting access through impact on price, has been repeatedly shown to be ineffective. In the mid-1980s, efforts to restrict alcohol consumption during perestroika were thwarted by Soviet citizens turning to noncommercial alcohol, which also had the effect of sharply reducing government revenues from taxes on commercial alcohol beverages.

As production and sales move underground, the government loses its ability to regulate, assess and control alcohol intake, which can result in serious public health risks.

The poorest and heaviest drinkers in Russia and elsewhere are likeliest to purchase products with dangerous "surrogate" alcohol, found in substances not meant for human consumption. These substances include shoe polish, after-shave and industrial alcohol.

The unrecorded alcohol market is very difficult to regulate. Russia has national regulations governing the sale and production of noncommercial alcohol beverages — for example, banning nonfood-based ethanol in alcohol beverages — but it is unclear if such policies have much impact. Part of the problem is that little is known about the production, quality and patterns of consumption of noncommercial beverages, making it challenging to propose and implement effective measures.

The passage of new regulations that can all too easily be broken is clearly not the answer. Sadly, a case in point may be restrictions imposed last year on alcohol sales — including beer sales — between 11:00 p.m. and 6:00 a.m. Although well-intentioned, such measures do not address the serious problems associated with sales of black market and other noncommercial alcohol, which can be unintended outcomes of increasingly limited legal trade. Yet there are a number of other potentially effective approaches to addressing these problems, including raising awareness of the risks and changing people's attitudes toward noncommercial beverages.

Care must be taken that more stringent regulations don't inadvertently push alcohol consumers toward the black market. Persistent government crackdowns on alcohol availability to reduce harmful drinking could in fact create bigger problems in terms of illegal alcohol production and consumption.

Since drinking will likely always remain a significant component of Russian culture and social life, blunt, prohibitory measures are doomed to fail. Instead, research and policy must work hand in hand, using accurate statistics to shape the laws, educate consumers and save the country from an epidemic of harmful drinking.