concentration in the blood is increasing as a result of the consumption of alcohol with a high concentration of toxic elements.

Annex 8-1 Estimation of Real Alcohol Consumption in Russia

The formula for estimation of real alcohol consumption in Russia is based on observations of sugar sales, alcohol sales, and deaths from accidents and violence in Moscow in the period 1984-1987 (Nemtsov, 1992; Nemtsov and Nechaev, 1991). The level of illegal production of samogon in Moscow was always one of the lowest among territories of the Russian Federation. This can be explained by the higher educational level of the population and the relatively good development of the state alcohol trade. Nearly all samogon distilled in the city has been produced from sugar (this is not the case for many other areas: see note 3).

Just after June 1, 1985, fear of the anti-alcohol measures resulted in a decrease in the illegal production of samogon. As a result, sales of sugar in Moscow were unusually low in the period August to December. We took the level of annual sugar consumption for the year 1985 as the baseline (24.88 kilogram [kg] of sugar per capita). This estimate is rather close to the Soviet nutritional standard promulgated by the Institute of Nutrition (Academy of Medical Sciences of the Soviet Union), which was 24.0 kg in 1980. It is possible to produce about 1.3 liters of 40 percent samogon from 1 kg of sugar (Goskomstat estimate). The levels of sugar consumption in both 1984 and 1986 were substantially higher than the 1985 baseline. This allows us to calculate illegal samogon production in 1984 and 1986 in Moscow as 0.61 and 1.49 liters per capita, respectively. Finally, we can add these estimates for samogon production to the official figures for alcohol sales per capita and derive estimates of true alcohol consumption in Moscow in 1984 and 1986 of 11.89 and 8.48 liters, respectively. These figures, as well as the results for the period 1981-1983, are close to the corresponding estimates by Goskomstat.

Until 1988, it was possible to continue evaluating samogon production on the basis of sugar consumption in Moscow. Unfortunately, in 1988 the trend in sugar consumption shifted as a result of the deficit of sugar in the state trade, which resulted in a ''sugar panic." When sugar once again became available, the level of sugar sales rose as high as 37.8 kg per capita. Thus after 1988, it became impossible to evaluate samogon production from sugar consumption.

Under these circumstances, it is reasonable to look for an indicator of alcohol consumption other than sugar sales that is less sensitive to external influence. The ratio of accidental and violent deaths with alcohol present in the blood (VDA) to "sober" accidental and violent deaths (VDS) satisfies this condition. (Accidental poisonings by alcohol are excluded from VDA and VDS figures because in this case, alcohol causes death independently of other factors.)

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