A MAN raises a glass to his friends, toasts the end of sobriety and flings the vodka in a single, sudden action to the back of his throat. The bottle, once opened, must be finished. The man and his drinking buddies might stay drunk for days, sometimes weeks, riding the hangovers with practised hair-of-the-dog dosing until one day, a little dazed, they wake like dreamers to rejoin the real world.
This is binge drinking, Russian style. It is known as zapo茂, the art of getting unconscious as quickly as possible by means of alcohol. Practised mainly by men, zapo茂 represents machismo, a code of friendship, an excuse for time off work and a salve for the stress caused by economic uncertainty. And according to economists Betsy Brainerd and David Cutler at Harvard University, it is killing huge numbers of people.
What have they found? They concluded that alcoholism is the principal cause of what they refer to as Russia鈥檚 mortality crisis, a more significant contributor than the deterioration of the universal healthcare system or the decline in quality of life triggered by the break-up of the Soviet Union in 1991 (Journal of Economic Perspectives, vol 19, p 107). Most seriously affected are men in the prime of life, a group that is vital to the Russian economy.
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How bad is it? Between 1989 and 1994, the life expectancy of Russian men tumbled by six years; female life expectancy fell by three. The death rate often rises in the very old and the very young in countries experiencing severe economic difficulties, but in Russia the biggest increase in mortality in those five years was among men aged between 35 and 44. Today Russian men can expect to live to 58 鈥� the lowest life expectancy among industrialised nations and comparable with that of Senegal. The causes of death speak volumes. Top of the list is cardiovascular disease (CVD), followed by murder, suicide, unspecified violent deaths and accidental alcohol poisoning.
鈥淒eaths peak from Saturday to Monday, which could be due to weekend binges鈥�
How much of this is down to zapo茂? Men who binge drink are nearly four times as likely to die by accidental death as non-drinkers. Heavy alcohol consumption puts people at greater risk of CVD, but whether binge drinking is a particular risk factor is uncertain. The evidence is mounting, though: deaths from CVD among Russian men peak from Saturday to Monday, a finding Brainerd and Cutler suggest could be linked to weekend binges.
Alcohol alone cannot explain the crisis. According to the World Health Organization, Russians actually consume less alcohol per head than other Europeans. But it鈥檚 the way they use it that is killing them: Russians drink more spirits, and they drink them zapo茂-style. The practice has come to symbolise an expression of the Russian soul. Now it appears to be taking its toll on the Russian body.
