Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects

Abstract

Issues The last Soviet anti‐alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. Approach The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. Key Findings Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol‐control measures. The so‐called three ‘best buys’ put forward by the World Health Organization to reduce alcohol‐attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications In recent years, evidence‐based alcohol policies have been actively implemented as a response to the enormous alcohol‐attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

How to quantify deaths averted derived from interrupted time-series analyses

“…Overall, the results of the models presented here support the findings of other studies on the effects of alcohol control policies ((Neufeld et al, 2021); for the impact of taxation in general, see (Sornpaisarn et al, 2017)), in that all analyses conducted suggest a sizable effect of taxation increases on all-cause mortality. The different methodologies resulted in point estimates that were substantially different, albeit with highly overlapping confidence intervals.…”

Heterogeneity in trends of alcohol use around the world: Do policies make a difference?

“…Eastern Europe is characterised by an overall upward development, with some smaller ups and downs in the past 10 years. In this region, after an increase in the 1990s, alcohol use has been going down markedly over the past years [1,13], resulting in relatively similar values between 1990 and 2019 (in Figure 2, Russia is shown as the largest country in that region).…”

“…Can these differences in the level of use and harm be explained by alcohol control policy, or in other words, can alcohol policies impact over and above economic factors? The clearest case in this respect can be made for Eastern Europe, Russia and other former Soviet Union countries [1,17]. In this region, alcohol control policies in the last decade markedly changed use levels, thus decreasing attributable health and social harm and clearly contributing to a significantly increased life expectancy [17,18].…”

“…In the context of increasing wealth and economic prosperity in the rapidly developing regions of the world where the large majority of the world's population lives, several conclusions can be drawn from these commissioned policy overviews [1][2][3][4]6]. First, alcohol use in large parts of the world continues to be a major risk factor for disease and mortality [see also 35,36].…”

“…In this issue of Drug and Alcohol Review, in a section entitled 'Alcohol trends and policies in the wider worldbeyond a Eurocentric view', four overview papers are presented [1][2][3][4], which describe regional trends in alcohol use, attributable harm and policy. These papers are part of an effort to expand the base of epidemiological data and policy experience beyond the high-income countries so that other areas of the world are represented.…”