Khaltourina Daria, Korotayev Andrey
Council for the Public Health and the Problems of Demography, Moscow, Russia National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
National Research University Higher School of Economics, Moscow, Russia
Alcohol Alcohol. 2015 Sep;50(5):588-601. doi: 10.1093/alcalc/agv042. Epub 2015 May 11.
To elucidate the possible effects of alcohol control policy measures on alcohol-related mortality in Russia between 1998 and 2013.
Trends in mortality, alcohol production and sales were analyzed in conjunction with alcohol control legislative measures. Correlation analysis of health and alcohol market indicators was performed.
Ethyl alcohol production was the strongest correlate of alcohol-related mortality, which is probably due to the fact that ethyl alcohol is used for both recorded and unrecorded alcohol production. Measures producing greatest mortality reduction effect included provisions which reduced ethyl alcohol production (introduction of minimum authorized capital for ethyl alcohol and liquor producers in 2006 and the requirement for distillery dreg processing), as well as measures to tax and denaturize ethanol-containing liquids in 2006. Liquor tax decrease in real terms was associated with rising mortality in 1998-1999, while excise tax increase was associated with mortality reduction in 2004 and since 2012. Conventional alcohol control measures may also have played a moderately positive role.
Countries with high alcohol-related mortality should aim for a reduction in spirits consumption as a major health policy. Alcohol market centralization and reduction of the number of producers can have immediate strong effects on mortality. These measures should be combined with an increase in alcohol taxes and prices, as well as other established alcohol policy measures. In 2015 in Russia, this is not being implemented. In Russia, legislation enforcement including excise tax collection remains the major challenge. Another challenge will be the integration into the Eurasian Economic Union.
阐明1998年至2013年间酒精控制政策措施对俄罗斯酒精相关死亡率的可能影响。
结合酒精控制立法措施分析死亡率、酒精生产和销售趋势。对健康和酒精市场指标进行相关性分析。
乙醇产量是与酒精相关死亡率最密切的关联因素，这可能是因为乙醇既用于有记录的酒精生产，也用于无记录的酒精生产。产生最大死亡率降低效果的措施包括减少乙醇产量的规定（2006年对乙醇和白酒生产商引入最低法定资本以及对酒糟加工的要求），以及2006年对含乙醇液体征税和变性的措施。1998 - 1999年实际酒税降低与死亡率上升相关，而2004年及2012年以来消费税增加与死亡率降低相关。传统的酒精控制措施可能也起到了一定的积极作用。
酒精相关死亡率高的国家应将减少烈酒消费作为主要卫生政策目标。酒精市场集中化和生产商数量减少可对死亡率立即产生显著影响。这些措施应与提高酒精税和价格以及其他既定的酒精政策措施相结合。在俄罗斯，2015年并未实施这些措施。在俄罗斯，包括消费税征收在内的执法仍是主要挑战。另一个挑战将是融入欧亚经济联盟。
