KEY POINTS:
Nearly half of Russian men of working age die from excessive drinking, researchers report today.
But it is not just vodka that is doing the damage.
The nation with the world's most prodigious appetite for alcohol is turning to other products to fuel its addiction.
British researchers who investigated drinking habits in one town in the Urals found men were imbibing colognes, medical tinctures and cleaning agents containing up 97 per cent alcohol to get their fix.
The researchers from the London School of Hygiene and Tropical Health, who studied all deaths among men in the town of Izhevsk in the two years to October 2005, concluded that 43 per cent were due to hazardous consumption of alcohol - much higher than previous estimates.
Past studies have suggested that Russian men drink more than 15 litres of pure alcohol a year on average - equivalent to a 70cl bottle of spirits a week.
That is twice as much as British men.
But Professor David Leon and colleagues from the London School of Hygiene and the Social Technologies Institute in Izhevsk say earlier research has neglected the "vast area of manufactured alcohol" and the significant contribution it makes to the death rate.
"We only came across it when we were sitting round a table with our colleagues in Izhevsk and asking what could men be drinking. They mentioned tinctures and eau de colognes. We had no idea this was going on." Professor Leon described visiting a pharmacy in the town and watching a Russian colleague buy a bottle of Hawthorn tincture, which comes in small 100ml bottles and is supposed to be taken as a few drops in a glass of water for use as a tonic.
"It was a smart pharmacy, brightly lit with polished glass. The woman behind the counter didn't have to move when my colleague asked her for the tincture.
There was a pile of boxes of it behind the counter. It was probably the main thing they sell."
A 100 ml bottle of Hawthorn tincture contains over 90 per cent alcohol and costs 15 roubles (35 pence), compared with the cheapest vodka which is 70 roubles for a standard bottle (700 ml) and only 40 per cent alcohol. Not only is it cheaper unit for unit of alcohol, but because it comes in smaller bottles it is cheaper to buy.
"If you are drunk and begging your wife for money she is more likely to give you 10 roubles, which is almost enough for a bottle of tincture, than she is to give you the price of a bottle of vodka," Professor Leon said.
The research team, whose findings are published in The Lancet, visited shops and pharmacies in other towns to observe the way products containing ethanol (the chemical name for alcohol) were displayed and sold.
"We have pictures of eau de colognes - shelves and shelves of them displayed like a drinks counter in a supermarket rather than an aftershave counter. In Omsk we visited a shop where the top shelf carried a row of Eau de Colognes, the next one bottles of anti-freeze and the one below that cleaning fluids. They all contained ethanol - the way they were displayed was testimony to the fact that they were being sold for their ethanol."
A medical history of drinking tinctures and colognes among the 3,500 men in the study increased the risk of death seven-fold, even after adjusting for the amount of vodka and other spirits consumed and the effects of low income and education.
All the men had homes and wives or girlfriends - they were not down and outs.
Had they been included, the death rate could have been higher.
Professor Leon said men who turned to these products had entered on a downward spiral that accelerated as their drinking increased.
Urgent measures should be taken to curb the availability of cheap alcohol in this form.
"Our view is that if these products were made far more expensive or far less available it would not end drinking but it would make it less dysfunctional and less likely to kill the drinkers. What we are seeing in Russia as a result of the availability of these products is an acceleration of the end stage of drinking."
Russia has one of the lowest life expectancies among industrialised countries - 59 for men and 72 for women - and its record beating alcohol consumption is a key factor.
As well the highest consumption in the world, Russian men are also notorious for their binges on vodka.
Studies since the 1990s have shown huge quantities of spirits, mainly vodka, consumed on single occasions.
- INDEPENDENT
