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Drinking Patterns in the Russian City of Novosibirsk, with a Specific Focus on Hazardous Drinking

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Drinking Patterns in the Russian City of Novosibirsk, with a Specific Focus on Hazardous Drinking Alcohol and hazardous drinking in Russia: a mixed design study Natalia Bobrova Thesis submitted for the degree of Doctor of Philosophy University College London 1 Declaration ‘I, Natalia Bobrova, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis.' 2 Abstract This thesis investigated drinking patterns in the Russian city of Novosibirsk, with a specific focus on hazardous drinking. It explored the relationship between hazardous drinking and social-economic characteristics, depressive symptoms and self-reported health. The study also provided an in-depth description of drinking patterns, consumption of ‘surrogate’ alcohol, and perceptions of the Russian drinking culture and the state’s alcohol policies. The research used a combination of quantitative and qualitative methods. First, it assessed alcohol consumption and drinking patterns using data from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) cohort. Second, a series of 44 semi-structured interviews were conducted with men and women sampled from the HAPIEE cohort. Third, 40 semi-structured interviews were conducted among clients of an alcohol treatment facility. These interviews were focused on hazardous drinking. The main findings were as follows. First, hazardous drinking was common among men, but rare among women (30% of men and 1% of women reported binge drinking, 19% of men and 1% of women reported problem drinking, and 9% of men and less than 1% of women reported more than two negative consequences of drinking). Second, hazardous drinking was associated with lower education (e.g. men with secondary education were 1.9 times more likely to binge drink than men with university education), unemployment, poor health (men and women rating their health as good were more likely to binge than people with poor health), and with certain occupations (e.g. drivers or construction workers were likely to report binge drinking). Third, high accessibility of alcohol and a need to relieve withdrawal symptoms were common reasons for surrogate consumption given in interviews by participants from alcohol treatment facility. Finally, the Russian drinking culture was perceived as characterised by heavy drinking and strongly influenced by the interplay of individual and structural factors. 3 Contents ABSTRACT ................................................................................................................................................ 3 CONTENTS ................................................................................................................................................ 4 LIST OF TABLES ..................................................................................................................................... 7 LIST OF FIGURES ................................................................................................................................... 9 ACKNOWLEDGEMENTS ..................................................................................................................... 10 1. INTRODUCTION ................................................................................................................................ 11 1.1 Outline of the thesis .................................................................................................................... 12 2. BACKGROUND .................................................................................................................................. 15 2.1 DRINKING IN RUSSIA - HISTORICAL OVERVIEW ................................................................................ 15 2.1.1 Pre-Soviet Russia ..................................................................................................................... 15 2.1.2 Drinking in Soviet Russia ........................................................................................................ 18 2.1.3 Alcohol consumption in the 90s, and in contemporary Russia ................................................ 20 2.1.4 Illegal production of alcohol ................................................................................................... 23 2.1.5 Alcohol surrogates, non-beverage alcohol .............................................................................. 24 2.2 ALCOHOL AND MORTALITY IN RUSSIA ............................................................................................. 28 2.2.1 Other explanations................................................................................................................... 32 2.3 THEORIES OF PROBLEM DRINKING .................................................................................................... 33 2.3.1 Theories of rational choice ...................................................................................................... 34 2.3.2 The disease model .................................................................................................................... 35 2.3.3 Social-learning theory ............................................................................................................. 36 2.4.1 Drinking patterns and their consequences .............................................................................. 40 2.4.2 Measuring drinking patterns ................................................................................................... 41 2.4.3 Gender, socio-economic status, age and drinking patterns ..................................................... 43 2.4.3.1 Gender............................................................................................................................................... 43 2.4.3.2 Socio-economic status....................................................................................................................... 45 2.4.3.4 Age .................................................................................................................................................... 45 2.5 DRINKING PATTERNS IN RUSSIA ....................................................................................................... 46 2.5.1 Gender, socio-economic status, and age ................................................................................. 47 2.5.1.1 Gender............................................................................................................................................... 47 2.5.1.2 Socio-economic status....................................................................................................................... 48 2.5.1.3 Age .................................................................................................................................................... 49 2.4 CONCLUSIONS FROM THE LITERATURE REVIEW AND IMPLICATIONS FOR THE RESEARCH DESCRIBED IN THE THESIS ............................................................................................................................................. 50 3. AIMS AND OBJECTIVES ................................................................................................................. 52 THIS CHAPTER DESCRIBES THE OVERALL AIMS AND IT LISTS THE SPECIFIC OBJECTIVES OF THE RESEARCH DESCRIBED IN THE THESIS. ..................................................................................................................... 52 3.1 AIMS ................................................................................................................................................ 52 3.2 OBJECTIVES ...................................................................................................................................... 52 4. RESEARCH DESIGN AND METHODOLOGY .............................................................................. 54 4.1 GENERAL METHODOLOGY-MIXED DESIGN ........................................................................................ 54 4.2 SETTING ........................................................................................................................................... 56 4.3 QUANTITATIVE DATA ....................................................................................................................... 58 4.3.1 The HAPIEE cohort ................................................................................................................. 58 4.3.2 Data Collection ........................................................................................................................ 59 4.3.4 Questionnaire .......................................................................................................................... 60 4.4 QUESTIONS AND MEASURES USED IN THE STUDY .............................................................................. 61 4.4.1 Demographics .......................................................................................................................... 61 4.4.2 Socioeconomic status ......................................................................................................... 61 Education ...................................................................................................................................................... 61 Occupation .................................................................................................................................................... 62 Household assets ..........................................................................................................................................
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