Social aspects of alcohol consumption in Russia.

To the Editor: South African readers of the SAMJ may be interested to know that some recently described features of alcohol consumption1-3 appear too in parts of Russia, where there are similar factors that predispose to alcohol abuse: relative cheapness of alcoholic products, ease of access, boredom, unemployment, peer pressure, etc.1 Concerning alcohol advertising,2 there has not been much advertising of wines and spirits since 1985, when the anti-alcohol campaign began. Previously, however, there had been some indirect advertising.4 Beer is widely advertised, which probably contributes to its growing consumption. The pattern of alcohol consumption is changing, with heavy binge drinking declining while moderate consumption of beer is increasing. This trend agrees with World Health Organization data.5 Indeed, to an inside observer, a decrease in vodka consumption appears to be more significant, especially in large cities such as Moscow. There are fewer individuals who drink large amounts of vodka, but they are not as left to themselves as they were 25 years ago. In Moscow, in contrast with the recent past, even marginalised people are rarely seen drunk in public (Fig. 1). The pattern of alcohol consumption has changed among the youth, too, who may drink several cans of beer during an evening, but not the large quantities of vodka with beer or fortified wine as in the 1970s and 1980s.4 The changing pattern of alcohol consumption is largely the result of economic decline among the urban social classes that included the majority of alcohol consumers, i.e. workers and intelligentsia. Although workers were often sceptical about Soviet ideology, they were influenced by platitudinous propaganda about the supremacy of the working class, etc., and were confident about their future. This confidence has largely been lost in the course of the economic reforms of the 1990s. Many factories closed, and the workers were confronted with unemployment in an inadequate social security system and with low unemployment benefits. The same fate befell the intelligentsia, as many scientific institutions were closed or their personnel cut back. At the same time, crime against alcoholics in the form of theft, assault, undue pressure, etc. has become widespread, and is tolerated by society and its institutions. Even police have participated in mobbing socially unprotected citizens – including alcoholics – coercing them to vacate their places of residence, when these flats or houses were wanted by property dealers.6 All this does not predispose to leisure drinking. Furthermore, indigenous working people have been gradually replaced by immigrants from Central Asia and the Caucasus, where alcohol consumption is less widespread. The changes are less conspicuous in small towns and rural areas, but in many places there is increasing tension and competition because of immigration from regions where less alcohol is consumed, such as the North Caucasus.