The shocking toll of alcohol in Russia during the decade after the fall of the Soviet Union is revealed by a large international study published in the Lancet.

More than half of all deaths in Russian 15 to 54-year-olds between 1990 and 2001 were due to excessive drinking, the authors say. Alcohol is the main reason why even in 2006 mortality in this age group was five times higher for men and three times higher for women than in western Europe.