Elsevier

Drug and Alcohol Dependence

Volume 71, Issue 2, 20 August 2003, Pages 161-168
Drug and Alcohol Dependence

Suicides and alcohol consumption in Russia, 1965–1999

https://doi.org/10.1016/S0376-8716(03)00094-2Get rights and content

Abstract

Background: Abrupt changes in the alcohol consumption level and the suicide rate associated with the anti-alcohol campaign of 1985–1991 and the market reforms of 1992. Methods: Epidemiological investigation of total Russian suicide rate and per capita alcohol consumption utilizing the Box–Jenkins technique and regression analysis. Results: The decrease of per capita consumption from 14.2 to 10.5 l in 1985–1987 and the growth of this index after 1987 (14.6 l in 1994) saw a respective decline and increase of suicides per litre of alcohol: eight males and one female per 100,000 of the corresponding population (13 or 6% of male or female suicides and 12% total suicides). The maximum suicide rate was reached in 1994 (41.8 per 100,000 population, in 1981–1994 r=0.91). In 1984–1986 and 1991–1994 the distribution of suicides’ age was close to that of the age distribution from fatal alcohol poisoning. Changes in the level of BAC-positive suicides are closely correlated with changes in the alcohol consumption level (r=0.98), whereas changes in the number of BAC-negative suicides were not related to changes in consumption. Conclusion: Alcohol consumption level plays a considerable role in the suicide rate, especially for male suicides. The rate of alcohol-related suicides is very high in Russia, owing to the very high alcohol consumption rate in the country.

Introduction

For a long time, the relationship between alcohol consumption and suicide was backed by the large number of findings at individual level. A large proportion of people suffering from alcoholism commit suicide (Combs-Orme et al., 1983, Goldstein, 1985, Kutko et al., 1988, Murphy and Welzel, 1990). For young heavy drinkers, the risk of suicide is 5.1 times greater in comparison with teetotalers (Andreasson et al., 1988) and for alcoholics, nine times greater than for the population at large (Berglund and Tunving, 1985). The risk of suicide is much higher from drinking than from various social and medical factors (Grant and Hasin, 1999). A large number of people who commit suicide are alcoholics and heavy drinkers (Haberman and Baden, 1978, Crombie et al., 1998, Hintikka et al., 1999, Pirkola et al., 2000), a much greater number than that of people with other diagnoses (Cuiiberg et al., 1988). Alcohol is discovered in the blood of the vast majority of suicides (Haberman and Baden, 1978, Abel and Zeidenberg, 1985, Hayward et al., 1992).

Ten years ago, Skog (1993) wrote “sociological research seems to have more or less ignored alcohol as a potentially important factor at the aggregate level”. Since then, the situation has changed. Now it is incontestable that alcohol consumption level is a considerable factor behind suicides. It has been shown at the international level (Norström, 1988, Norström, 1995, Skog, 1993, Schmidke et al., 1999, Ramstedt, 2001) and at the national level (Smart and Mann, 1990, Lester, 1993, Lester, 1999, Marusic, 1998, Hintikka et al., 1999, Lunetta et al., 2001, Conner et al., 2001), although this factor differs from country to country (Skog, 1993, Norström, 1988, Norström, 1995). Many details of this relationship require additional study: the national features of the unexplored countries, the gender ratio and the lag effects amongst others. Russia has become a remarkable research field for the subject due to two State experiments: the anti-alcohol campaign in 1985 and the market reforms in 1992. These government actions caused considerable fluctuations of consumption in connection with the anti-alcohol campaign.

The campaign was launched on June 1, 1985 and was accompanied by a 62% cut-back in the authorized sale of liquor and a powerful anti-alcoholic pressure from the authorities. The population reacted to these government measures by intensifying production and sale of ‘samogon’ (home-brew or moonshine). As a result, a slow increase in consumption began as soon as 1987 and continued until 1992. Market reforms began in the country and the state monopoly on production and sale of alcoholic beverages was temporarily suspended. This was accompanied by a new sharp increase in the illegal production of cheap, often highly toxic, drinks and accordingly, an increase in alcohol consumption.

The object of this paper is to estimate the relationship between suicide rate and alcohol consumption level in Russia in the past decades and to determine the gender particulars and their lag effects.

Section snippets

Data on total suicides

Data on total suicides per 100,000 population and age distribution were obtained from the State Statistics Committee. From 1965 to 1999, it registered a total of 1,566,537 suicides, with the minimum figure, 33,482, in 1986 and the maximum, 63,795, in 1994. Males accounted for 80% of the cases. In the main parts of our study, we used a new European suicide mortality standard that takes into account the age structure of the population. This gives an opportunity to compare mortality in different

Methods

The data was processed by means of a package of statistical programs (Windows statistics; version 5). At the recommendation of Norström and Skog (2001), we used the Box and Jenkins (1976) technique to process the time series of mortality figures along with the regression of raw data.

All-Russia indicators

In 1965–1975 (1980) there was a nearly uninterrupted accretion of suicides both among males and females (Fig. 1a). After the stabilization of the number of suicides in 1976–1982, there was an increase in 1983–1984. However, after the anti-alcohol campaign was launched, a sharp decline in the number of suicides followed: in 1984–1986 there was a drop from 37.9 to 23.1 per 100,000 population (a drop of 39.1%), while alcohol consumption decreased from 14.2 to 10.5 l (26.8%).

After 1986–1987, a slow

Discussion

In the past 20 years, the suicide rate in Russia has been very high (41.4 per 100,000 in 1994 and 39.1 in 1999, State Statistics Committee). These figures exceed the mean figure for Europe 2-fold and are only lower than in Lithuania (47.3 in 1994, Report of WHO, 1999), although the number of Russian male suicides was close to that for Lithuania (74.1 vs. 81.9, Schmidke et al., 1999). Russian suicide figures differed sharply with respect to BAC-positive suicides from those in countries where

Acknowledgements

The study was carried out with the support of The John D. and Catherine T. MacArthur Foundation (Grant No. 00-62823). The author would like to thank Vladimir M. Shkolnikov (Max Planck Institute for Demographic Research) for his advice and valuable information.

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