The Gorbachev Anti-Alcohol Campaign and Russia's

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The Gorbachev Anti-Alcohol Campaign and Russia's Reform Models THE GORBACHEV ANTI- We find that alcohol consumption declined substan- tially during the campaign years and resulted in ALCOHOL CAMPAIGN AND fewer alcohol-related deaths between 1985 and 1988. RUSSIA’S MORTALITY CRISIS Our findings also show that a significant share of deaths during the mortality crisis were due to the campaign coming to an end, suggesting that Russia’s transition to capitalism and democracy was not as CHRISTINA GATHMANN*AND deadly as often suggested. MARIJKE WELISCH* The mortality crisis in Russia Introduction Between 1990 and 1994, crude death rates in Russia Following the demise of the Soviet Union, Russia soared by 40 percent, rising from 11 to nearly 15.5 experienced a 40 percent surge in deaths between per thousand. By 2009 standards, the decline in male 1990 and 1994. The average life expectancy for men life expectancy at birth to only 57.6 years puts declined by 6.6 years from 64.2 years to 57.6 years as Russian men on a par with their counterparts in a result. The magnitude of this surge in deaths – cou- Bangladesh, and means that male longevity in pled with the Soviet Union’s international promi- Russia is even lower than in less-developed coun- nence – has prompted observers to term this demo- tries such as Haiti or North Korea. graphic catastrophe as the “Russian Mortality Crisis.” Most explanations for this development are more or less directly linked to economic and political transi- What caused this dramatic rise in mortality? Many tion in Russia during that period. Specific transition- people attribute the Russian mortality crisis to the related explanations include the decline in econom- political and economic turmoil that followed the ic output and employment (Cornia and Paniccia breakup of the Soviet Union and the economic and 2000; Brainerd 2001), rapid privatization (Stuckler, political reforms that began in 1991. In King and McKee 2009; Stuckler, King and McKee Bhattacharya, Gathmann and Miller (2012), we pro- 2012), physiological and psychological stress pose an alternative explanation for the observed pat- (Shapiro 1995; Bobak and Marmot 1996; Kennedy, tern, namely the demise of the supposedly successful Kawachi and Brainerd 1998; Leon and Shkolnikov 1985–1988 Gorbachev Anti-Alcohol Campaign. 1998; Gavrilova et al. 2001), reductions in the relative price of vodka (Treisman 2010), and the deteriora- The campaign efficiently implemented a broad set of tion of the medical care system (Ellman 1994). measures to reduce alcohol supply and fight exces- sive alcohol consumption. Although the campaign Between 1990 and 1993 alcohol consumption officially ended in late 1988, it took some time for increased dramatically, accompanied by a high num- production to adjust accordingly; and prices ber of alcohol-related deaths (with the causes of remained above pre-campaign levels even after the death linked both directly (alcohol poisoning and campaign’s official end. Some researchers (Nemtsov violent deaths) or indirectly (heart attacks and 2000, for example) suggest that the campaign’s de strokes) to alcohol consumption). Working class facto end was as late as 1991 and thus coincided with men, the demographic group that drinks the most in the breakup of the Soviet Union and the beginning Russia, saw a particularly sharp increase in their of Russia’s economic and political transition. mortality rate. Recent estimates suggest that alcohol abuse is responsible for over half of all deaths in Russian cities among the 15–54 year old age group * Heidelberg University. (Leon et al. 2007; Zaridze et al. 2009). CESifo DICE Report 4/2012 62 Reform Models Figure 1 adult males consuming about AGE-ADJUSTED DEATH RATES half a liter of vodka every two Russia 1960–2005 days (Ryan 1995). In addition per 1,000 population to the quantity consumed, the 16 type of alcoholic beverages con- 14 1994 sumed and drinking patterns 2003 2002 1995 2004 2001 2005 1993 2000 also have a large impact on 1999 1996 1997 mortality. A disproportionate 12 1998 1984 1980 1979 1992 1981 1985 1983 1977 amount of consumption in 1978 1976 1982 1975 1973 1991 1972 1970 1990 1969 1971 1974 1962 1988 1987 1989 1986 1967 Russia is hard liquor and can be 1968 10 1963 1961 1965 1966 1964 Pre-campaign linear prediction characterized as ‘binge drink- 8 ing’ (defined as three or more alcoholic drinks within 1 to 6 2 hours). Alcohol abuse and 1960 1970 1980 1990 2000 2010 binge drinking are linked not Note: Pre-campaign linear trend estimated using ordinary least squares regression of mortality per 1,000 population on pre-campaign year. only to accidents and violent Source: Human Mortality Database (2011). deaths, but more importantly in quantitative terms, they repre- Our research explores a different explanation for the sent key risk factors for heart attacks and cardiovas- mortality crisis, namely the demise of the supposed- cular disease (McKee and Britton 1998; McKee, ly successful Anti-Alcohol Campaign launched by Shkolnikov and Leon 2001; Rehm et al. 2009; Mikhail Gorbachev in 1985. The basic logic of our Tolstrup et al. 2006). approach is shown in Figure 1. Russian death rates, which increased linearly between 1960 and 1984, By the early 1980s, alcohol abuse was widely recog- plummeted abruptly with the start of the campaign nized as a major cause of death, absenteeism and low in 1985, remained below the campaign trend labor productivity in the Soviet Union. Although throughout the latter 1980s, rose again rapidly dur- difficult to estimate, observers suggest that alcohol’s ing the early 1990s to a temporary peak in 1994, and cost to the Soviet economy during the 1980s totaled then largely reverted back to Russia’s long-run about 10 percent of national income (Treml 1987; trend. Segal 1990; Tarschys 1993; White 1996). In response, the Politburo and the Central Committee led by The crisis could therefore be the combined result of Secretary General Mikhail Gorbachev passed a lagged ‘catch-up’ mortality (with relatively weak a resolution entitled “Measures to Overcome marginal survivors saved by the campaign dying at Drunkenness and Alcoholism” in May of 1985. The higher rates) and a reversion to the long-run trend. directives passed by the Central Committee and the The lagged effect of alcohol consumption on mortal- Presidium of the Supreme Soviet as a result of the ity is consistent with findings in medical literature on resolution ushered in the country’s most stringent the delayed effects of alcoholism on both liver cir- anti-alcohol policies since the 1919–1925 prohibi- rhosis and heart disease (see, for instance, Holder tion. Consisting of seven broad measures, the main and Parker 1992 and Laonigro et al. 2009). goal of the Gorbachev Anti-Alcohol Campaign was to raise the effective price of drinking whilst subsi- dizing substitute activities. Alcohol consumption in Russia and the Gorbachev Anti-Alcohol Campaign State production of alcohol was drastically reduced (the government was the sole legal producer and dis- The Soviet Union – and Russia in particular – his- tributor of alcohol in the Soviet Union at that time), torically ranks among the world’s heaviest drinking prices for alcoholic beverages were increased and countries. Immediately prior to the anti-alcohol cam- restrictions were placed on alcohol sales. Between paign, annual consumption of pure alcohol in the June 1985 and May 1986 alone, state production of Soviet Union exceeded 14 liters per capita – com- vodka and hard liquor declined by 30–40 percent pared to 8 liters in the United States and 13 liters (Segal 1990) and cognac production fell by 44 per- in Germany (Nemtsov 2000; World Health Orga - cent (White 1996). In 1985, the price of vodka, nization 2011). This figure is roughly equivalent to liqueurs, and cognac rose by 25 percent (McKee 63 CESifo DICE Report 4/2012 Reform Models 1999), and prices were increased by another 25 per- and 1988 (White 1996). Official figures overstate the cent in 1986 (White 1996). decline in alcohol consumption, however, because they do not capture the home-brewing response to Liquor stores were not allowed to sell vodka or wine the campaign. Russians have a long-standing tradi- before two pm on business days, restaurants were no tion of producing samogon (literally, “distillate longer permitted to sell hard liquor, and the official made by oneself,” a generic term for illegal alcoholic drinking age rose from 18 to 21. Sales near factories, beverages made from sugar, corn, beets, potatoes, educational institutions, hospitals, and airports were and other ingredients) – and did so more vigorously prohibited, and many stores selling alcohol were during the campaign when access to legal alcohol shut down. In addition, high fines were introduced was restricted. for public drunkenness and other alcohol-related offenses. Fines for workplace intoxication, for As comprehensive estimates of oblast-year samogon instance, were one to two times the mean weekly production are not available, we extend the work of wage, and home production of alcohol, as well as the Nemtsov (2000) to generate estimates of this figure possession of homebrew equipment, was punishable for the 1980s and early 1990s. Nemtsov (2000) used by large fines or imprisonment. an indirect technique to infer total alcohol consump- tion based on forensic records from oblast forensic Action was also taken to reduce demand for alcohol bureaus. Since these autopsy records were not made – leisure facilities (such as sports clubs and parks) public during the Soviet era, manipulation for exter- were heavily subsidized and promoted, media cam- nal political purposes is unlikely to be of concern. paigns and health education programs were Both the Soviet Union and the Russian Federation launched together with bans on glamorous media mandate autopsies for all violent and accidental depictions of drinking.
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