Politics and health do not mix well in Russia

▸ Zaridze D, Brennan P, Boreham J, et al. Alcohol and cause-specific mortality in Russia: a retrospective case–control study of 48,557 adult deaths. Lancet 2009;373:2201–14.

Although most of the world’s populations do not drink, harms of alcohol excess remain a major potentially preventable global health problem. This is exemplified in a retrospective case–control study carried out in Russia. In three Russian industrial cities, the addresses of 60 416 residents who had died at ages 15–74 years in 1990–2001 were visited in 2001–2005. Cases (n = 43 082) were those certified as dying from causes judged beforehand as substantially affected by alcohol or tobacco; controls were the other 5475 decedents. As one would expect, the associations with a number of gastroenterological diseases were significantly elevated for the highest consumption group: liver disease (relative risk (RR), 6.21; 95% CI, 5.16 to 7.47); upper aerodigestive cancer (3.48; 2.84 to 4.27); liver cancer (2.11; 1.64 to 2.70) and pancreatic conditions (6.69; 4.98 to 9.00).

Many …