Alcohol Affordability and Epidemiology of Alcoholism in Belarus

INTRODUCTIONSince the alcohol abuse has numerous adverse health and social consequences, the consumers' response to changes in alcohol affordability is an important issue of alcohol policy debates.1-3 Over the past several decades a number of papers were published that examine the impact of the affordability of alcohol on alcohol consumption.4-'3 Studies from many countries have shown an inverse relationship between alcohol prices and alcohol drinking and concluded that affordability of alcohol is one of the most important predictors of alcohol consumption in a population.14-20Several studies evaluated the effects of changes in a price or taxes on various outcomes related to harmful alcohol consumption, including alcohol dependence, known to be specifically attributed to long-term alcohol abuse.7,15 Accumulated research evidence showed clearly that alcohol prices were significantly and inversely related to alcohol-related morbidity and mortality 4-6-7 A recent systematic review of studies examining the effects of alcohol prices and taxes on alcohol-related morbidity and mortality yields meta-estimates -0.347 for liver cirrhosis and other alcohol-related outcomes.19There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking.21 Therefore, additional studies are needed to elucidate the effect of alcohol affordability on liver cirrhosis mortality. Against this background, it would be interesting to evaluate the relationship between vodka affordability and epidemiological parameters of alcoholism (alcohol dependence prevalence rate and the number of patients undergoing treatment for alcohol dependence) in post-Soviet Belarus.METHODIn Belarus, there is a network of specialized medical establishments belonging to the state narcological service of the Health Ministry. Before 1976, narcological treatment was carried out in the framework of medical establishments, specialized in psychiatry. As the level of alcohol-related problems was constantly growing, it was decided to organize a narcological service. Since then, its structure and principles of work have have remained unchanged. The main establishment in the network of narcological service is a health center (dispensary), which includes a polyclinic and a hospital and works according to regional principle. Its aim is to prevent and diagnose alcohol and drug dependencies, to provide free treatment, to carry out dynamic moni- toring of patients under registration. Statistical data of narcological service reports turned out to be a unique source of information regarding magnitude of alcohol-related problems in the society. In this study we will examine the link between affordability of vodka and prevalence of alcohol dependence in Belarus. Here we specified the number of registered alcohol dependent persons per 100.000 as prevalence of alcohol dependence. We also adopted the number of liters of vodka the average salary could buy, as the affordability of alcohol. To examine the relation between alcohol affordability and epidemiological parameters of alcoholism regression analysis was performed using the statistical package »Statistica«. RESULTSIn the period from 1990 to 2010 the prevalence of alcohol dependence in Belarus increased by 42,7% (from 1419,1 to 2024,4 per 10.000 of the population). As can be seen from Figure 1, trends in the affordability of alcohol and in the prevalence of alcohol dependence follow each other across the 1990-2010 time series. A Spearman cor- relation analysis suggest the high degree of co-variation between the two variables (r=0.92;p