Alcohol, Narcotics, and Tobacco
Russia's rate of alcohol consumption, traditionally among the highest in the world and rising significantly in the 1990s, is a major contributor to the country's health crisis, as well as to low job productivity. Rated as Russia's third most critical health problem after cardiovascular diseases and cancer, alcoholism has reached epidemic proportions, particularly among males. In the twentieth century, periodic government campaigns against alcohol consumption have resulted in thousands of deaths from the consumption of alcohol surrogates. The latest such campaign was undertaken from 1985 to 1988, during the regime of Mikhail S. Gorbachev (in office 1985-91). Although some authorities credited reduced alcohol consumption with a concurrent drop in Russia's mortality rate, by 1987 the production of samogon
(home-brewed liquor) had become a large-scale industry that provided alcohol to Russians while depriving the state of tax revenue. When restrictions were eased in 1988, alcohol consumption exceeded the pre-1985 level. According to one study, between 1987 and 1992 annual per capita consumption rose from about eleven liters of pure alcohol to fourteen liters in 1992; current consumption is estimated at about fifteen liters. (According to World Health Organization standards, consumption of eight liters per year is likely to cause major medical problems.)
A 1995 Russian study found that regular drunkenness affected between 25 and 60 percent of blue-collar workers and 21 percent of white-collar workers, with the highest incidence found in rural areas. Because alcohol remains cheap relative to food and other items, and because it is available in most places day and night, unemployed people are especially prone to drunkenness and alcohol poisoning. In 1994 some 53,000 people died of alcohol poisoning, an increase of about 36,000 since 1991. If vodka is unavailable or unaffordable, Russians sometimes imbibe various combinations of dangerous substances. The Russian media often report poisonings that result from consumption of homemade alcohol substitutes. Production of often-substandard alcohol has become a widespread criminal activity in the 1990s, further endangering consumers. Alcohol consumption among pregnant women is partly responsible for Russia's rise in infant mortality, birth defects, and childhood disease and abnormalities.
Smoking, a widespread habit, especially among women and teenagers, compounds Russia's health crisis. Chain-smoking is endemic in Russia; in 1996 an estimated 55 percent of Russians were regular smokers, and health authorities believed that the figure was rising. However, rather than urge patients to quit, doctors often recommend the purchase of American cigarettes, which are more expensive but have less tar and nicotine than Russian brands. When import restrictions ended in the early 1990s, the American cigarette industry found a large new market in Russia. A modest government antismoking campaign paralleling Gorbachev's anti-alcohol campaign in the late 1980s had little effect. In January 1996, cigarette advertising in the print media was prohibited, and smoking in theaters and workplaces generally was restricted to designated locations.
The increasing incidence of drug abuse was belatedly acknowledged by the Russian government as a public health problem. In 1995 an estimated 2 million Russians used narcotics, more than twenty times the total recorded ten years earlier in the entire Soviet Union, with the number of users increasing 50 percent every year in the mid-1990s. In the Soviet era, drugs were viewed officially as a capitalist vice, but that attitude disappeared soon after the Soviet Union dissolved. Russia legalized drug use (but not possession or sale) in 1991. According to experts, laws against possession are not dissuasive. Narcotics use has spread to new elements of society in recent years, including alcoholics seeking a new means of escape. Russian experts rate the new class of Russian businesspeople as the group with the highest percentage of drug users; for them, success often includes the ability to purchase the most expensive narcotic. The drug scene, once dominated by students and intellectuals, now includes large numbers of housewives and workers. Synthetic drugs now are manufactured in small laboratories by professional chemists; some are easily fabricated by amateurs as well. Legally produced drugs often are stolen and move into the black market (see The Crime Wave of the 1990s, ch. 10).
Medical treatment and educational programs now include hot lines in major cities and walk-in clinics that provide advice and treatment on an anonymous basis. Some schoolteachers have begun class discussions of drug-related issues and have distributed antidrug literature to students. Nevertheless, Russia's drug problem remains largely intractable. Many addicts overdose, and some who cannot afford heroin inject themselves with other substances that cause illness or death.