prior levels. It is not surprising that real alcohol consumption in Russia increased sharply during this period of economic crisis and reduction in real wages (see Table 8-1).

The anti-alcohol campaign was of rather short duration, but it led to very important consequences for the public health and mortality in Russia. These consequences are discussed next.

Variations in Mortality Levels and Deaths Prevented by the Campaign

The favorable effect of the anti-alcohol campaign on Russian mortality was strong and rapid. Mortality began to decrease immediately after the introduction of restrictions on the sale of alcohol in June 1985 and continued month by month in parallel with the reduction in alcohol consumption (Shkolnikov and Vassin, 1994). The largest mortality decrease was observed at adult ages both for males and females during the year 1986. From 1984 to 1987 (mostly in 1986), life expectancy at birth rose from 61.7 to 64.9 years for males and from 73 to 74.3 years for females. Decreasing mortality from external causes of death at working ages and from cardiovascular diseases at ages 40 to 65 contributed most to the total increase in expectation of life at birth. In 1988 the pattern reversed, and mortality began to increase. Between 1987 and 1992 (mostly in 1992), life expectancy declined to 62 years for males and 73.8 years for females.5 Finally, in 1992, mortality returned approximately to the level of 1984 (in fact, in 1992 it remained a little lower).

As suggested in the introduction, we can assume that the above short-term fluctuations in Russian mortality and life expectancy were induced largely by the anti-alcohol campaign and its termination (see also the discussion in the next section). If we assume for analysis purposes that these fluctuations were caused entirely by variations in alcohol abuse, it is possible to assess the number of deaths avoided as a result of the campaign.

In the period 1985-1992, mortality rates deviated from what might have been expected in light of the rates for prior years. What might this "natural" trend have been like? To evaluate the expected age-specific death rates during 1985-1992, we apply three realistic scenarios, corresponding to three different basic levels of mortality. For the first (low-mortality) scenario, we suppose that the death rates in 1985-1992 are equal to the average level of the period 1980-1984 (in the period 1981-1983, the level of mortality was significantly lower than in 1980); for the second (medium-mortality) scenario, we continue the long-term linear trends of the period 1970-1983; and for the third (high-mortality) scenario, we use the fixed death rates of 1984.

An estimate of the total number of deaths prevented by the anti-alcohol campaign can be derived from the difference between the observed and expected age-specific death rates for the period 1985-1992. According to the above three



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