President of Russia Dmitry Medvedev: Colleagues,
As was agreed a while ago, we are meeting today in expanded format to discuss measures for fighting alcoholism. At the State Council meeting on youth policy we agreed to address this subject separately, in detail, and make the necessary decisions.
You know just how serious a problem alcoholism has become for our country. Frankly speaking, it has taken on the proportions of a national disaster. According to the Healthcare and Social Development Ministry’s statistics, per capita alcohol consumption in Russia – taking the whole population, including babies – now stands at 18 litres of pure alcohol a year. You can calculate for yourselves how many bottles of vodka this means – quite simply alarming. This is more than twice the level that the World Health Organisation defines as dangerous for people’s health and lives. Such a high level is quite simply a real threat to our country’s and people’s normal life.
We have taken various measures over these last years of course. Tighter rules on production and sale of alcoholic beverages were introduced, and significant restrictions were imposed on their advertising. Tougher penalties were introduced for drunk driving. But so far, we have not seen any real change in the situation. To be really honest, all of these efforts have had no real effect at all. Let’s be up front about this. All they have done is brought some order to the situation.
Alcohol and alcohol surrogates are one of the main causes of our high mortality rate. Our demographic problems are also to a considerable extent linked to the alcohol consumption problem. We all know that alcoholism can cause incurable diseases, above all cardiovascular diseases. It is a cause of suicides, a factor in serious crimes, and also a cause of everyday accidents, of which we have far too many. Indeed, I think that around 80 percent of such accidents take place under the influence of alcohol.
We said at the recent meeting on road safety that drunk drivers were responsible for almost 5,000 road accidents over the first half of this year, killing or injuring 8,000 people. Take a hard look at this figure. Where else in the world do we see such a situation?
Alcohol also has a destructive impact on raising children. What kind of child-rearing can there be in such a situation? None at all. Add to this the fact that alcoholism breaks apart tens of thousands, probably even hundreds of thousands of families every year in our country, and we realise what kind of effect the breakdown of families has on the general microclimate.
Alcoholism also causes huge economic losses. These include the losses from lower labour productivity, damage from fires caused by drunkenness, and other economic costs. The list can go on.
We are realists, I hope, and we realise that alcoholism is a never-ending problem. It is not something that can be simply eradicated overnight, of course, but many countries have made efforts to tackle it. No matter what people say about it being too deep-rooted in our culture, about it being practically impossible to fight alcoholism in Russia, we must recognise that other countries, and you know them yourselves, have been successful in their efforts to address this issue.
Our own experience and that of other countries show that alcoholism can be addressed effectively only through systemic and long-term action. Naturally, this calls for a comprehensive approach. On the one hand, we need to introduce restrictive measures, and on the other hand, we need to carry out educational work, promote a normal, healthy lifestyle. The most important thing of all is to give people the desire and possibility of leading a normal, full, healthy and sober life. We all realise that this is possible only when people have normal living standards. You cannot defeat drunkenness in a poor country. We are aware of this fact. But rising living standards do not automatically lead to a fall in alcohol consumption, and sometimes even the reverse is true. In the 1990s, our living standards were lower, but objectively, we drank less.
I will say a few words about what I think are the priority measures to take.
Our first task should be to stop the rise in alcohol consumption among young people. This is absolutely essential. We know that the habit of drinking at every turn can quickly lead to serious alcohol dependence. The experts note that consumption of beer and low-alcohol beverages is on the rise among adolescents above all. According to the statistics at our disposal, a third of boys and 20 percent of girls consume such drinks every day or every second day.
Order needs to be brought to the way retail outlets operate. Our laws prohibit the sale of alcohol to people under the age of 18. This has always been the case except for a period, the older among you will recall it, when you could not buy alcohol until you were 21. But we all know that this rule is frequently broken. This was not the case during the Soviet period. I think that tougher penalties should be introduced for breaking these laws. The sale of alcohol to minors is unacceptable. Just look at how much of a stir similar cases abroad arouse. Usually it gets in all the media, but here, look how easy it is for anyone to buy a bottle of vodka or pack of cigarettes. In the past (during the Soviet period), they at least asked to see your passport.
Second, there are increasingly frequent calls to change the regulations applying to the production and sale of beer and low-alcohol beverages. There are proposals to bring them under the same regulations and restrictions applying to spirits. We would need to evaluate all of the possible consequences such a step would have, but there is a need for effective measures in this area. Let’s discuss this matter.
This also concerns the ban on selling alcohol near schools, universities, sports and recreation centres. This concerns too, the requirements for retail premises where alcohol can be sold, and the restrictions on alcohol advertising. I think some very serious proposals have been made. As I said, they require thorough analysis and detailed discussion. This is precisely why all of you, including regional governors, are present here today.
Third, life has already shown that officially imposed prohibitions alone cannot resolve the problem. This is obvious. We need to put real effort into prevention of alcoholism, above all among young people. We need to take a new and modern approach in this work and make use of all the possibilities the education system and mass media offer. We need to take into account the interests and mentality of young people today. In other words, we need to avoid tired old stereotypes and we need to get the widest range of public organisations involved in this work. Their representatives are also present today, and so I suggest that we discuss this too.
That is all I wanted to say for a start. Let’s begin our discussions. I give the floor to Ms Golikova, the minister for healthcare and social development.
Minister of Healthcare and Social Development Tatyana Golikova: We have conducted a fairly serious analysis on the history of producing and consuming alcohol, beginning with pre-revolutionary and post-revolutionary Russia and through present time. Indeed, the period we analysed is fairly dramatic. It is dramatic in that every time we saw an increase in alcohol consumption or a changing trend toward greater consumption of stronger spirits, this occurred following actions by the government. Each time the government tried to reduce regulation, take less responsibility over the production or consumption of alcohol, or augment its income from alcohol sales, these processes led to an increase in alcohol consumption and in the share of strong spirits among all alcohol consumed.
Thus, the government’s policies regarding alcohol are a major factor in the nation’s alcohol consumption. It is possible that the church has also played a fairly important role in limiting alcohol consumption during all the periods we studied.
It is easy to observe that between 1914 and 1917, the alcohol consumption level was 3.4 litres per capita. This may have been the lowest alcohol consumption in all of Europe.
Dmitry Medvedev: This was the period during World War I.
Tatyana Golikova: Yes. We then remained at this level for quite some time. But beginning in the 1970s, our alcohol consumption began to double every decade. By the mid-1980s, the consumption level was, according to various expert estimates, between 11 and 14 litres per capita. By 1995, it had grown to 15–18 litres per person. As you rightly noted in your opening remarks, statistical data indicate that Russia’s consumption level is now 10 litres per capita (we are at the same level as Germany and Finland), while experts (who appear to be entirely objective) estimate that our nation is the absolute leader in alcohol consumption, at 18 litres per person – the figure that you yourself gave.
Clearly, the increase in alcohol consumption that began in the late 1960s was caused by the absence of restrictive social and moral mechanisms within our society. In the 1990s, the breakdown of state control mechanism resulted in an uncontrolled growth of alcohol consumption, leading up to today’s critical indicators. In this regard, today we need to establish both a state control mechanism and new social restrictions and reference points, in order to make over-consumption of alcohol socially disgraceful and undesirable on an individual level.
Experience in nations that are already concerned by high alcohol consumption shows that this kind of social reference point can be created through the idea of good public health and a healthy way of life individually. Incidentally (this has already been said multiple times at many meetings), regardless of our attitudes toward the anti-alcohol campaign between 1985 and 1990 and regardless of the organisational mistakes that were made during that period, statistics and expert opinions show one thing: this campaign led to a serious reduction in mortality, particularly among men. In five years, this campaign saved the lives of one million people. This figure seriously demonstrates how important lowering alcohol consumption is in order to lower mortality in Russia and improve the demographic situation.
I am not going to linger on the data regarding average per capita consumption and growth rates. You already spoke about this. I just want to talk about one thing. According to estimates of the World Health Organisation’s experts, once the per capita consumption of pure alcohol exceeds eight litres a year, it becomes a threat to the health of a nation, and each extra litre above a certain consumption limit shortens the average lifespan by eleven months for men and by four months for women. Drinking is the cause of nearly two million deaths around the world [a year], as well as four percent of diseases, if we look at it on a global level.
In 2007, retail sales of alcoholic beverages averaged 10 litres per capita. Beer accounted for nearly 80 percent of sales, while vodka and distilled beverages accounted for 13.2 percent, wine accounted for 6.4 percent, and cognac accounted for 0.6 percent.
Dmitry Medvedev: Do I understand correctly that we are the absolute world champions in alcohol consumption?
Tatyana Golikova: Yes, according to expert data.
Dmitry Medvedev: Because earlier, we had been getting data indicating that we drink a lot, but not as much as certain other countries. We consoled ourselves with this information, but now, according to this data, nobody drinks as much as we do.
Tatyana Golikova: It is no coincidence that at the beginning of my presentation I analysed the situation over the last 100 years. Ultimately, I want to show that Russia does not have an ancient tradition of alcohol abuse, as some experts say. In our view, Russia’s problem can be resolved.
Dmitry Medvedev: I agree.
Tatyana Golikova: Beginning in 1998, we have observed yearly increases in the production and sales of low-alcohol beverages, including beer, within the Russian Federation. By 2006, it had increased nearly six-fold. Meanwhile, the volume of strong alcoholic beverage sales has not gone down in comparison to 1998, thereby significantly increasing per capita alcohol consumption. Low-alcohol beverages are produced with added flavouring agents similar to those of traditional soft drinks, and they come in attractive and colourful package that often use youth-related symbolism (this is important to understand the problem and make decisions). Information about their alcohol content is seldom clearly presented, given in small print, which creates the false impression that these are soft drinks.
Dmitry Medvedev: In other words (I would like to emphasise this again), the hope that higher consumption of low-alcohol beverages, including beer, would lead to a decrease in consumption of strong alcoholic beverages has proven to be false.
Tatyana Golikova: Furthermore, the combination of alcohol and energy components [tonics], such as caffeine, in the energy drinks that are popular among young people can accelerate the formation of alcohol dependence and raise the risk that the alcohol will have a toxic effect on the body.
(Next, Ms Golikova presented specific statistical data on the consumption of alcohol in Russia among various age groups and in different regions, the prevalence of alcoholism, and the provision of medical assistance, highlighting the fact that medical care for treating addiction is a free service.)
Now, here is what the Ministry of Healthcare and Social Development suggests that we do, in conjunction with our colleagues. We suggest drafting a government policy concept by the end of 2009 on lowering alcohol abuse and preventing alcoholism among Russia’s population. Clearly, if you support the development of such a document, then it must incorporate all elements, not only medical, but also social and taxation-related elements, as well as regulation over the clear labelling and packaging of alcoholic beverages.
If the measures we are suggesting are implemented, we estimate that our national alcohol consumption will decrease to 14 litres per capita by 2012. It needs to be said that when we talk about alcoholism, we are discussing a disease and its consequences, rather than a cause. Thus, our long-term actions must be directed toward the formation of healthy lifestyles and the prevention of such diseases.
At the beginning of 2009, my colleagues and I set about a healthy lifestyle project under the National Project on Health, and we will continue gradually moving forward in this direction. Our Ministry suggests that we create and equip 502 health centres at currently-existing health care facilities, one centre per 200,000 residents. Corresponding agreements have been signed by nearly all of Russia’s federal constituent entities. This project should be launched in September of this year. By 2010 or 1012, we plan to increase the number of these centres, such as to have one for every 50,000 residents. Our main priority for 2010 is to create regional health centres for children and teenagers.
We are planning to develop and implement communication campaigns on promoting healthy lifestyles. Of course, similar work will be done by the Ministry of Sport and Tourism, as well as the Ministry of Education and Science. Furthermore, we are currently preparing a programme for developing medical and social rehabilitation, which will include many components.
All of the measures we implement must be thoroughly thought through, because this is a very delicate area. We believe that the set of measures you spoke about in your opening remarks, which we are proposing and which I know will be supported by our colleagues, will be effective and will lead to the expected results in the near future.
Dmitry Medvedev: This is indeed a very large problem. But I would like to say again that this does not imply we should relax, resting under the assumption that it cannot be overcome, that it has always existed in our country, and that we cannot fight it.
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