Regulation After Transition: Russia's 2013 Alcohol Policy Package, Drinking and Alcohol Poisoning

ABSTRACT Between July 2012 and January 2014, Russia raised excise duties on spirits by a third and then by a quarter, raised the minimum retail price of vodka from 89 rubles per half‐litre in 2010 to 220 rubles in 2014, prohibited retail sales nationwide between 11 p.m. and 8 a.m. and from kiosks, and removed alcohol advertising from all mass media. Using the synthetic control method with a donor pool of former Soviet and Eastern European countries, I show that this package reduced drinking well beyond the regional trend. Recorded alcohol consumption fell by 28.0% relative to synthetic Russia over 2013–2019, the largest post‐2013 divergence relative to pre‐treatment fit among the 20 units in the placebo distribution ( p = 0.05). Total consumption, which includes WHO estimates of unrecorded drinking, fell by 14.4% ( p = 0.14); on WHO's estimates, substitution towards unrecorded alcohol offset only a small part of the recorded decline. Consistent with a response among heavy drinkers, deaths from accidental poisoning, a category that in Russia includes a large share of acute alcohol poisoning, declined by 37.8% relative to the donors (difference‐in‐differences, permutation p = 0.08), with the relative decline concentrated at the end of the window. Liver‐disease mortality, by contrast, followed the regional trend over the 7 years that Russia's vital‐registration data allow, and a panel distributed‐lag model finds no detectable response of liver mortality to consumption within 6 years. The health returns to a large fall in drinking appear first in acute causes of death; within a 7‐year window, cirrhosis mortality is a slow and insensitive endpoint for evaluating an alcohol policy.