Vodka blamed for high death rates in Russia
The high number of early deaths in Russia is mainly due to people drinking too much alcohol, particularly vodka, research suggests.
The study, in The Lancet, says 25% of Russian men die before they are 55, and most of the deaths are down to alcohol. The comparable UK figure is 7%.
Causes of death include liver disease and alcohol poisoning. Many also die in accidents or after getting into fights.
The study is thought to be the largest of its kind in the country.
Researchers from the Russian Cancer Centre in Moscow, Oxford University in the UK and the World Health Organization International Agency for Research on Cancer, in France, tracked the drinking patterns of 151,000 adults in three Russian cities over up to 10 years.
During that time, 8,000 of them died. The researchers also drew on previous studies in which families of 49,000 people who had died were asked about their loved ones' drinking habits.
Study co-author Prof Sir Richard Peto, from the University of Oxford, said: "Russian death rates have fluctuated wildly over the last 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka."
In 1985, the then Soviet leader Mikhail Gorbachev drastically cut vodka production and did not allow it to be sold before lunch-time.
Researchers say alcohol consumption fell by around a quarter when the restrictions came in, and so did overall death rates. Then, when communism collapsed, people started drinking more again and the death rates also rose.
Sir Richard said: "When President Yeltsin took over from President Gorbachev, the overall death rates in young men more than doubled. This was as society collapsed and vodka became much more freely available.
"There was a huge increase in drinking and they were drinking in a destructive way. They were getting drunk on spirits and then buying and drinking more, producing a big risk of death."
The consumption rates for women also fluctuated according to political events, but they drank less so mortality rates were also lower.
Most drinkers were smokers as well which researchers say "aggravated" the death rates.
Russia brought in stricter alcohol control measures in 2006, including raising taxes and restricting sales.
Researchers say alcohol consumption has fallen by a third since then and the proportion of men dying before they reach 55 years old has fallen from 37% to 25%.
Half a litre of vodka costs around £3.00 (150 roubles). Heavy drinkers in this study were getting through at least a litre and a half of vodka a week.
In 2011, each Russian adult drank on average 13 litres of pure alcohol every year, of which eight litres was in spirits, mainly vodka.
In the UK the comparable figure is 10 litres per adult - but just less than two litres of that is in spirits.
Researchers say the key problem driving the high death rate is the way Russians drink alcohol.
Researcher Prof David Zaridze, from the Russian Cancer Research Centre, said: "They binge drink. That's the main problem. It's the pattern of drinking not the per-capita amount they are drinking."
"Russians have always drunk a lot. They sometimes say it's because of the cold weather but this is just an excuse. This is the nation's lifestyle that needs to change.
"Since the average life expectancy from birth for men in Russia is still only 64 years, ranking among the lowest 50 countries in the world, more effective alcohol and tobacco policy measures are urgently needed."