Public health successes and missed opportunities

Monitoring alcohol exposure
The Russian Federation is the most populous country in eastern Europe, and has a long history of heavy drinking associated
with considerable alcohol-attributable harm, which persists into the present (5,53–55). Fig. 7 shows that in the past
two-and-a-half decades, consumption levels have continued to be high (and in 2014, higher than the central-eastern EU
countries). There is a good indication, however, that over the past seven years, consumption has decreased in the Russian
Federation. This decrease may have been due to recent changes in alcohol policies (56,57).
Fig. 7. Trends in adult per capita alcohol consumption for the Russian Federation with several comparator
regions, 1990–2014
Litres of pure alcohol
18
16
14
12
10
8
6
4
2
Russian Federation
Central-eastern EU
Mediterranean
WHO
European Region
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
The trends in alcohol consumption have been contrasted with two more regions (for definitions, see Box 2, page 5) to
illustrate how different the trends in the Russian Federation have been. In 1990, shortly after an anti-alcohol campaign
Mediterranian c.
was initiated in 1985, the alcohol consumption level in the Russian Federation was relatively low, below the WHO
WHO Euro
European Region average, slightly below the average of the Mediterranean countries and markedly below the average
Central Eastern countries in EU
of the central-eastern EU countries. In the following years, consumption levels increased markedly until 2007, when the
Russian Federation population consumed 3 litres more per capita of pure alcohol than central-eastern EU countries, 5
WHO Euro
litres more than the average of the WHO European Region, and 8 litres more than the Mediterranean countries. In 2014,
the three averages came closer together, with the Russian Federation decreasing consumption levels again, but there
are still marked differences, as both the WHO European Region average and the average of the Mediterranean countries
decreased as well.
There is considerable variation in the alcohol consumption levels among countries in central south-eastern Europe (Fig. 8)
over the past decades, both between and within countries, with no clear overall trend and no convergence. Many of these
countries were part of the former Yugoslavia, and some of the observed variation may also reflect the establishment of
national recording systems. Bulgaria, Croatia and Serbia have had levels above the WHO European Region average for
almost a decade, whereas Bosnia and Herzegovina, the former Yugoslav Republic of Macedonia and Albania are clearly
below the WHO European Region average levels of alcohol consumption. In the latter countries, there is a marked
proportion of people who follow the Muslim faith (52).
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