Availability of nonbeverage alcohols in 50 Russian cities in 2015–2017

Abstract

Introduction Nonbeverage alcohols (NAs) in Russia are manufactured alcohol containing liquids not intended for consumption instead of alcoholic beverages, not classed as alcoholic drinks, and not subject for legal regulation as alcoholic beverages, but which may be consumed for drinking. It has been found in a case-control study conducted in Urals in 2003–2005, that their consumption by working age Russian males was associated with a seven-fold increase in odds of death adjusted for smoking, education, and amount of ethanol consumed from alcoholic beverages. Legally produced NAs usually contain highly rectified concentrated ethanol (up to 95% by volume). In 2006 and later Russia implemented a range of legislative measures aimed at reduction of availability of illegal and nonbeverage alcohols. The most recent regulations were put in force at the end of December 2016 and in 2017 in response to deadly outbreak of mass alcohol poisoning with NA, containing methanol, which occurred in Siberian city of Irkutsk in December 2016 resulting in 76 deaths. Since 2007, no research was carried out to investigate the effectiveness of implemented regulations or to assess availability of NAs across the vast geography of Russia. Methods The availability survey was aimed: –to determine if NAs were still available in legal retail sale in cities of the Russian Federation in 2015–2017; –to provide characteristics of different types of NAs that were sold. Between July 2015 and December 2017 six field workers purchased samples of NAs in 50 Russian cities. NAs were defined as containing at least 60% ethanol by volume (as indicated on the label) and generally cost less than 40 rubles per bottle ($0.67, €0.59, £0.50). NAs were purchased in a variety of places, including pharmacies, shops, kiosks, individual persons and other types of retail outlets. Results In total, 2147 samples of NAs were purchased, which can be grouped into the following types: (1) perfumery and cosmetics spirituous liquids, (2) bath additives, (3) medicinal tinctures, (4) medicinal spirituous solutions for internal use, (5) antiseptics, (6) technical/medicinal ethanol, (7) spirituous liquids for oral or body hygiene, and (8) spirituous food flavour enhancers. Ethanol concentration in the vast majority of purchased NAs was above 60% by volume (min: 25%; max: 95%; median: 70%). Unit cost of ethanol in most samples was lower than in standard Russian vodka. The majority of purchased samples of NAs were of sorts, which were reported to be consumed for drinking in our simultaneously conducted in 2015–2017 survey of alcohol consumption among patients of narcology clinic in Kazan, Russia. In 2015 and 2016 we were able to purchase all types of nonbeverage alcohols specified above. However, in 2017 a range of NAs was no longer available in retail. This included specific types of perfumery and cosmetics spirituous liquids, such as cheap spirituous lotions, aftershaves and tonics; spirituous bath additives; and spirituous liquids for oral and body hygiene. However, medicinal tinctures in 25 mL, 40 mL, and 100 mL bottles, medicinal antiseptics, and cheap eau-de-colognes (e.g. Troynoy, Shirp) were still readily available in 2017. Conclusions The wide spectrum of nonbeverage alcohols, which were targeted by 2006 alcohol control regulations were readily available in 2015 and 2016. Regulations implemented at the end of 2016 and in 2017 in response to mass alcohol poisoning with NA were also not comprehensive, since they haven’t prevented production and sale of cheap sources of ethanol in the form of medicinal tinctures, antiseptics and not denatured eau-de-colognes. While these latest regulations banning sale of some sorts of NAs may indeed result in reduction of alcohol-attributable mortality in Russia in 2017, the stronger action is still required to prevent consumption of specific sorts of medicinal and perfumery nonbeverage alcohols, which are still available and affordable for those who may want to drink them.