Source: US Congress, Joint Economic Committee, GORBACHEV'S ECONOMIC PLANS, Volume 2, November, 1987, pp. 297-311 Vladimir G. Treml* GORBACHEV'S ANTI-DRINKING CAMPAIGN: A "NOBLE EXPERIMENT" OR A COSTLY EXERCISE IN FUTILITY? By the early 1980s heavy drinking and alcohol abuse in the USSR reached crisis proportions. Drinking reached 16 liters of ab- solute alcohol per person and was significantly affecting labor productivity, mortality and other health indicators. Gorbachev's campaign introduced increased penalties for drunkenness, restrictions on sale, higher prices, and reductions in production of alcohol. In 1986 the legal consumption of alcohol was cut by a remarkably high fifty percent. Media reports a commensurate decline in adverse consequences of alcohol abuse. Increased consumption of illegal homemade alcohol, losses of state revenues, and unexpected side effects produced by the campaign suggest that its success should be viewed with caution and its long term prospects as uncertain. 1.DRINKING AND ALCOHOL ABUSE IN THE USSR IN THE EARLY 1980's (1) Gorbachev's "perestroika" or restructuring of the Soviet system is proceeding at a brisk pace. Administrative reforms have been announced, laws changes, experiments launched, and key party and state officials have been moved around or dismissed. It is too early to speculate on the progress of reforms or to rank them in terms of their impact on the system, but the all-out attack on drinking and alcohol abuse is one of the most significant of Gorbachev's programs. Discussed at a Politburo meeting in April (Pravda, April 5, 1985, p. 1) and announced in May of 1985, only two months after Gorbachev became the General Secretary, it was his first major innovation and clearly high on his priority list. Some two years later it can be said that the anti-drinking campaign has so far affected the lives and pocketbooks of people, the state budget and local finances, regional income distribution, and generally the life in the country to a much greater degree than his other innovations and reforms. The popularity of the new General Secretary, increases in labor productivity, in economic efficiency and, thus, the ultimate success or failure of "perestroika" depend to an important degree on the results of the anti-drinking campaign. By any international or historical standard, the Soviet Union was by mid-1980s facing an alcohol problem of truly crisis propor- tions. Between 1955 and 1984, consumption of alcohol rose 2.5 *Professor, Department of Economics, Duke University. times, reaching a level of more than 16 liters of absolute alcohol per year per person 15 years old and older.(2) Drinking and alcohol abuse by women and minors was growing particularly rapidly. But this is not the whole story, through, as per capita consumption statistics alone do not fully reflect the negative consequences of drinking. The overall magnitude of adverse health effects in a country depends not only on the total amount of alcohol consumed but on a number of other factors such as the distribution of drinkers by quantities of alcohol consumed, types of beverages used (e.g., distilled spirits, wine, or beer), and the mode of drinking. Thus countries such as France, Portugal, or Italy have recorded per capita figures as high as 18-20 liters without experiencing the adverse health effects that have been observed in the USSR. The reason is that a very high share of total alcohol in these countries is consumed in the form of wine with low alcohol content. In the USSR, on the other hand, vodka and other strong beverages account for 62-63 percent (Treml 1986, p. 12) of total alcohol consumed, which results in higher levels of violence associated with drinking, more severe accidents, more fatal alcohol poisoning, and aggravation of cardiovascular and other somatic problems. The preference of Soviet drinkers for consuming large quantities of alcohol in a short period of time and without food intake is another factor that increases the overall adverse effect on population health. Demographers agree that heavy drinking has contributed significantly to increasing morbidity and mortality in the USSR. In the early 1980s, premature deaths directly and indirectly caused by alcohol accounted for about one-fifth of all deaths. Particularly alarming to the Soviet authorities, moreover, is the fact that these deaths were concentrated primarily among men of working ages. Life expectancy (at birth) of men dropped by a full five years from 67 years in 1964 to 62 by the end of the 1970s, recovering by one year to 63 in the early 1980s.(3) In some categories, alcohol related mortality in the USSR is completely out of the range of world experience. The number of deaths from acute alcohol poisoning, for example, rose to a staggering 51,000 by the late 1970s. This translates into some 19.5 deaths per 100,000 of population, as compared with a rate of 0.3 for 19 countries for which data are available (Treml 1982a, pp. 487-505). Other statistics illustrating the extent of alcohol abuse in the country are equally alarming. In the early 1980s, drunken drivers were responsible for 13,000-14,000 vehicular traffic deaths and 60,000 serious traffic injuries, while some 800,000 drivers were arrested for driving while intoxicated. The rate of arrests per million vehicle-miles was about 10 times higher than in the U.S. In the late 1970s, some 15 million drunks were arrested and placed in sobering-up stations annually (Treml 1985, pp. 58-59). Heavy drinking and alcohol abuse were major contributing fac- tors in the growth of violent and property crime, divorce, spread of venereal disease, congenital birth defects, mental illness, suicide, and other social anomalies. Drinking in the work place (common since the 1960s), reporting to work under different degrees of intoxication or with a hangover, and the growing number of workers suffering from alcoholism has adversely affected labor productivity in the country. Anecdotal evidence abounds, but unfortunately we do not have enough statistical data for a reliable analysis of the impact of alcohol in the productive sphere. In the early 1970s, two prominent Soviet statisticians reported that, according to their estimates, alcohol abuse in the country reduced labor productivity by some 10 percent (Strumilin and Sonin 1974, p. 38). In the absence of data and documentation we cannot verify or update this estimate, but if we were to accept it as correct a similar measure for the mid-1980s could easily have reached 15-17 percent. The overall picture conceals important regional and ethnic differences. In order to simplify the situation, we can divide the Soviet population into three distinct groups. The Slavs, Russians, Ukrainians, and Belorussians, have by far the highest per capita use of absolute alcohol, and this alcohol is consumed mainly in the form of strong beverages, i.e., vodka and homemade moonshine, and fortified grape and fruit wines. Per capita consumption of state- produced beverages in the three Baltic republics is higher than among the Slavs, but their aversion to samogon makes the overall consumption lower; more beer and less strong beverages also distinguishes them from the Slavs. Moldavians, Armenians, and Georgians, that is, the populations of wine-growing republics, consume less alcohol per capita than the Slavs, with wine of lower alcohol content being the main beverage. Muslims populating Soviet Central Asia consume on a per capita basis about 40 percent of the USSR average consumption. The differences in per capita consumption, beverage-mix, and in native traditions result in sub- stantially different adverse health and social effects of alcohol, as can be seen from the following comparisons for the late 1970s (Zaigraev 1983, p. 96): Number of Disturbances of Republics alcoholics public order (per capita) (per capita)* USSR average 100.0 100.0 RSFSR 111.6 138.2 Baltic 95.0 95.4 Central Asia 53.6 50.2 Transcaucasia 27.5 9.6 * Arrests and confinements in sobering-up stations Death and birth rates, morbidity and other health indicators show similar differences. Alcohol abuse and heavy drinking is thus essentially concentrated in Slavic republics which has important implications for the nationality policies of the Soviet state. The financial aspects of alcohol consumption in the USSR must be mentioned here because of their implications for policy. Because of the high quantity of beverages consumed and their high prices, in the mid-1980s Soviet households spent about 15 percent of their total money income on alcoholic beverages, a very high ratio by historical or international comparison.(4) Income from excise (turnover) taxes and taxes on profits of the alcohol industry and foreign trade in alcoholic beverages generated between 12 and 14 percent of total state budgetary revenues, which is an unusually high share for a modern industrial state (Treml 1986, pp. A46-50). This summary of the situation with regard to alcohol on the eve of Gorbachev's anti-drinking campaign would be incomplete with- out mention of the flourishing underground alcohol market created by high state prices of beverages and numerous restrictions on con- sumption. In the early 1980s the illegal home production of moon- shine or samogon was estimated at over 2 billion liters and ac- counted for close to 30 percent of the total consumption of absolute alcohol. Home producers also made grape and fruit wines, beer, and a variety of bogus vodka from stolen technical alcohol. Restrictions on hours and locations of sales of alcoholic beverages in the state trade network resulted in the emergence of a large black market. Middlemen, such as taxi drivers and employees of state liquor stores, would buy vodka at state prices during legal hours and resell it at a hefty premium during off hours or in places where such sales were prohibited. A variety of other methods of cheating the customers and the state emerged (Treml 1986a). 2. THE RECORD OF ANTI-DRINKING POLICIES BEFORE GORBACHEV A legitimate question to be asked at this point is why the Soviet authorities allowed the situation to develop in the way that it did for so long. Khrushchev was the first Soviet leader to explicitly recognize the existence of alcoholism and alcohol abuse in the country in announcing a major anti-drinking campaign in 1958 (Spravochnik . . . 1959, pp. 404-408). Several more campaigns of different durations and intensity were launched in later years. All campaigns had essentially the same character. They would start with condemnation of drinking, calls for temperance, and announcement of government plans to reduce production of alcoholic beverages. Their main focus would consist in raising prices of alcoholic beverages, expanding the penalties for drinking and alcohol abuse, and imposing restrictions on sales of beverages such as placing certain areas off limits for drinking or serving, or restricting the hours for the sale of alcohol. An interesting feature of the anti-alcohol policies of the state was the low priority placed on medical aspects of the problem, i.e., treatment, post-treatment counselling, and rehabilitation of people with alcohol dependence. While there had always been excellent physicians treating alcoholics, and advanced research on alcoholism was pursued in some institutes, the public health organizations of the USSR clearly did not view alcoholism as their responsibility. This position is not surprising as it simply reflected the attitude of the central authorities. For example, in the 8,000 word declaration of policy of the 1958 anti-drinking campaign the health issues and the role of the Ministry of Health were not even mentioned among directives addressed to dozens of state organizations and agencies (Spravochnik . . . 1959, pp. 405- 408). The 1972 anti-drinking campaign did recognize the need of medical intervention but in superficial terms. In fact, the Ministry of Internal Affairs had, and still has, a much wider responsibility in the struggle against drinking (Resheniia, 1974, pp. 91-94). The MVD operates thousands of so-called "medical sobering-up stations" and "labor-medical camps", prison-like institutions for unreformed heavy drinkers. It plays a major role in collecting and analyzing data alcohol consumption in the country and in designing measures to control alcohol abuse. The emphasis on punitive measures stem from the basic attitude of the central authorities towards drinking and alcoholism. Alcohol dependence is not considered a disease but a manifestation of moral weakness and character degradation. This attitude is slowly changing, and some medical specialists and others in authority begin to recognize alcoholism as a disease, but so far these people are in a minority (Roman and Gebert 1979). Thus the goals and the main concern of policymakers always was with law and order and with the elimination of the adverse effects of drinking on work ethics and productivity. As the data summarized above testify, the periodic anti- drinking campaigns of the last 30 years had no effect, and heavy drinking and alcohol abuse and their negative effects on health and the quality of life in the USSR continued to increase. Probably one of the most important factors affecting this phenomenon is that, contrary to all explicit declarations of the government, production and import of alcoholic beverages continued to increase throughout this period. Between 1958, i.e., the year of Khrushchev's first antidrinking campaign, and 1984, production of vodka doubled and production of wine increased six-fold (Treml 1982, p. 5; Narkhoz 1985, p.254). In the same period, net imports grew from less than 0.05 to 0.6 liters of absolute alcohol per person. It should be added that during these years the alcohol content of wines was boosted. by increasing fortification. In some years production or imports of specific beverages were down, but almost without exception these cuts were not related to policy decisions but to temporary shortages of raw materials available to the industry, such as grain or potatoes for alcohol, or grapes for wine making and, in the case of imports, to increases in world market prices. The only possible explanation of this obvious inconsistency between policy declaration and practice lies with the huge revenues generated by liquor trade, which ultimately carried the day with policymakers. Considerations of short term fiscal expediency thus always dominated at the expense of the long term potential benefits to be derived from temperance. As Gorbachev assumed the leadership in early 1985, the alcohol problem was thus clearly out of control, and the record of state anti-drinking policies was dismal. 3. GORBACHEV'S CAMPAIGN The new General Secretary's anti-drinking campaign was launched in May 1985, with the announcement of several far reaching measures intended to reduce drinking and alcohol abuse by restricting and controlling consumption of alcoholic beverages and by expanding and increasing penalties for drinking (Pravda, May 17, 1985, p. 1 and Stolbov, ed. 1985). Under the first we should mention raising the minimum legal age for drinking to 21, restricting the hours of sale of alcohol from 2 to 7 p.m., cutting down the number of outlets selling alcohol, directing a gradual reduction in the production of vodka and a complete phasing out of fruit wines by 1988. New penalties were introduced and existing penalties were increased (often doubled and tripled) for drinking on the job, being drunk in public, drunken driving, allowing subordinates to drink on the job, violations of regulations in liquor trade, and for home production, sale, or consumption of samogon. Three months after the start of the campaign, prices of alcoholic beverages were raised by 15-25 percent and were raised again by 20-25 percent one year later. In this regard the new campaign did not offer anything that had not been done or promised in previous campaigns: as before Gorbachev's anti-drinking program consisted in raising prices and in introducing increased penalties and new restrictions. There have been, however, some new and positive elements. The rhetoric that characterized earlier campaigns was replaced by a more somber tone, and the failure of earlier policies were implicitly recognized. One particularly interesting new element was the tacit recognition that the boredom of everyday life and the absence of adequate relaxation, rest, and entertainment facilities was one of the main reasons for heavy drinking. The authorities announced several steps designed to improve the situation, such as the expansion of athletic facilities and increased production of home tools and crafts. A major expansion of soft drink and fruit juice production was promised both as a replacement for alcoholic beverages in pubic eating outlets and as a way of absorbing the anticipated growth of cash not spent on alcohol. Another novel element was the increasing flow of published in- formation concerning alcohol. There had in the past been no dearth of published articles and monographs describing the dangers of drinking. For a long time, however, an almost total blackout had been imposed on the publication of general information on production and consumption of alcoholic beverages and on summary information on the extent of alcohol abuse, such as statistics on arrests on drunks, alcohol related mortality, and the like. Reflecting Gorbachev's call for "glasnost'," or openness, the official sources began publishing statistics on alcohol that had not been available since the mid-1950s. In contrast to the past, the May 1985 campaign did not fizzle out in a few months and the new restrictions and policies are being enforced with vigor. Central authorities continue to monitor the progress of the campaign, with successes and failures periodically reported in the media. Party members lose their cards and officials are fired for excessive drinking, while those caught drinking on the job are arrested.(5) The MVD police apparatus has been mobilized in an all-out attack on alcohol abuse. The police have engaged in sweeping searches and, confiscations of samogon, stepped up arrests of drunks in the streets and in work places, expanded checks for drunken driving and for violations of regulations in liquor trade. They keep order in long and unruly liquor store lines, stop minors from buying alcohol, and watch for liquor speculators. Production of alcoholic beverages has being relentlessly cut, vodka and wine factories are being closed down, grapevines are being destroyed. In one year production of vodka was cut b 'y 33 percent; of grape wine, by 32 percent; of fruit wine, by 68 percent; and of cognac, by 44 percent (Korolev 1986, p.3). Cuts of similar magnitude continued in 1986 and 1987. More than half of all stores were ordered to close their liquor departments and many restaurants stopped serving alcohol. Consumption of state-produced alcoholic beverages declined dramatically, as can be seen from the following statistics: (6) Absolute alcohol per person 15 Years old and older, liters 1980.......................................... 11.5 1984.......................................... 11.2 1985............................................9.9 1986............................................5.8 A special survey of 5,000 families undertaken at the end of 1985 indicated that 12 percent of the respondents stopped drinking com- pletely, 36 percent reduced their consumption, and 52 percent con- tinued drinking at the same level (Kogai and Kokorina 1986, p. 14). Unfortunately, very little information about the survey and its reliability is known, but rough estimates based on the article describing it suggest that those who reduced their drinking had cut their intake of alcohol by about 23 percent. The drastic cuts in production and sales of alcoholic beverages produced significant revenue losses for the state budget. In the six months after the start of the campaign the losses probably amounted to more than 6 billion rubles (7) and this happened despite the hefty price boosts posted in August of 1985. The poor state of financial planning of the anti-drinking campaign was particularly evident in 1986. The budgetary plan for 1986 provided for tax revenues of 102.6 billion rubles. The plan was drawn up in late 1985 and thus should have reflected financial consequences of reduced alcohol sales (Dementsev 1986, p. 6). In July, 1986, Gorbachev said that sales of alcohol were down 35 percent and because of this the budget lost 5 billion rubles but the authorities were prepared to deal with the loss (Pravda, July 27, 1986, p. 3). Five days later, however, the prices of alcoholic beverages were raised by 20-25 percent (Pravda, August 1, 1986, p. 3). These prices increases could not have been justified by the need to discourage drinking because alcohol sales were already decreasing, so the only explanation seems to lie with fiscal considerations. Despite the planning and the price boost the actual tax revenues in 1986 were 92.2. billion rubles, indicating an unanticipated loss of 10.4 billion rubles (Gostev 1986, p. 3). To place this value in a proper perspective, it might be mentioned that total budgetary expenditures on health in 1985 were 17.6 billion rubles (Narkhoz 1984, p. 559).(8) The anti-drinking cam- paign is thus having a major destabilizing effect on state finances. Unlike his predecessors, however, Gorbachev has not allowed fiscal constraints to interfere with his campaign, at least not so far. The figures shown above indicate that, in the first full year following the beginning of the campaign, the average consumption of alcohol compared with that of 1984 was reduced by half. According to numerous Soviet media reports, these rather impressive results have produced equally impressive improvements in a number of social indicators associated with alcohol abuse. We cannot draw a comprehensive picture of these improvements because the available statistics are presented as percentages, refer to poorly defined categories, and often are not consistent with one another. The data summarized below were culled from a variety of Soviet sources and refer either to the June 1985-June 1986 period or to the first six months of 1986 compared with the pre-campaign period. Thus, the campaign produced the following results: Percent Crime generally down 20-25 Traffic accidents caused by drunken drivers down 20-22 Traffic injuries and deaths down 20-22 Fatal accidents caused by drinking Percent In the work place down 20 In the home down 8 Loss of time caused by absenteeism in industry down 33 Loss of time caused by absenteeism in construction down 40 In addition, different reports have indicated decreases in mortali- ty from cardiovascular problems associated with alcohol; in di- vorces caused by drinking of one of the spouses; in cases of rape, hooliganism and other forms of street crime.(9) Generally speaking, in 1985 and 1986 the economy performed somewhat better than in the early 1980s, but we do not have suffi- ciently detailed data to relate the increases in labor productivity and other economic improvements to the anti-drinking campaign. It should be noted, however, that Gorbachev and other key leaders so far have not attributed major economic improvements to the campaign.(10) 4. RESULTS: AN INTERIM ASSESSMENT It is too early to offer an overall evaluation of Gorbachev's antidrinking campaign since we can look only on the evidence of direct short term results, some of which may not be lasting and some of which may be subject to varying interpretations. The ultimate test of the success of the program introduced in May, 1985, will lie in long term changes. In the meantime it is only possible to comment on certain aspects of the results that have been reported. For a number of reasons, the benefits of the remarkable 50 percent drop in the per capita consumption of state-produced alcoholic beverages should be interpreted with caution. In the first place, it should be noted that some of the beneficial results of reduced consumption of alcohol are probably exaggerated by officials eager to please higher authorities.(11) The main point to be kept in mind is that heavy drinking and alcohol abuse are highly complex and multidimensional phenomena which cannot be eliminated or even significantly modified in a span of a couple of years by a program of relatively crude punitive measures, restrictions, and propaganda. The experience of many countries, including Russia, strongly suggests that the observable modification of drinking behavior achieved by such measures results in an emergence of unexpected negative effects in other spheres of social life. Accordingly, such undeniably positive results of the campaign as the reduction in per capita consumption of alcohol or the reduced accident statistics should not only be evaluated in themselves but also balanced against unfavorable side effects of the campaign. It is quite clear, for example, that stiffer penalties and increased controls have reduced drinking in the workplace and, consequently, the level of industrial accidents. It should be noted, however that these pressures have also resulted in increased labor mobility as workers fired from or fined at one job move on the another (Trud, December 4, 1985, p. 2). Reinforced police patrol and stiffer penalties have reduced the level of disorder caused by drunks in the streets and of certain types of crime. Numerous reports indicate, however, that drinkers have-moved from the streets into the homes, resulting in more wife and child abuse and more property destruction (Nedelia, No. 16, 1985, p. 5; Trud, March 19, 1986, p. 2, June 10, 1986, p. 2, October 13, 1986, p. 2; Pravda, July 7, 1986, p. 7; Vlasov 1987, p. 2). According to some reports, even such an apparently beneficial change as the cut in alcohol-related accidents and traumas has some negative side effects. To avoid the newly introduced penalties, some drinkers who suffered accidents now delay seeking medical assistance until they have sobered up. In some cases the delay in treatment aggravates the condition of the patient (Trud, May 11, 1986, p. 2). One of the most important factors which will affect the outcome of the campaign is the samogon, market. The stepped-up police attack on samogon resulted in a 2.6 in- crease in the number of arrests of samogon makers, in confiscation or voluntary surrender of 900,000 pieces of distillation equipment and of 2.6 million liters of the brew (Vlasov 1987, p. 2) Despite all these efforts the available evidence indicates that home production of alcohol has grown (Pravda, June 10, 1986, p. 2; Trud, July 25, 1986, p. 2; Izvestiia, September 10, 1986, p. 3). Deep cuts in output and new restrictions on sales of state produced beverages created favorable conditions for an expansion of the underground market. The two price boosts pushed the price of vodka to 18.50 rubles per liter-a clearly excessively high price considering the average pay of about 1.25 rubles per hour. The higher price of state produced vodka made it possible for the black market to boost the price of samogon and also provided the drinkers with an additional incentive to distill samogon for home use. Estimating the increase in illegal home production of alcohol is very difficult, and the following figures are offered here as first approximations only. In 1986, sales of sugar, the main input into samogon-making, increased by 10 percent (Pravda, January 15, 1987, p. 3). Major cuts in state procurement of grapes and fruit left rural areas with plentiful supplies which could not be easily marketed because of perennial shortages of transport, warehouse space and refrigeration facilities. Thus, rural areas had the necessary raw materials for home wine-making. According to the Deputy Minister of the MVD illegal sales of alcohol, presumably samogon, increased by 42 percent in the first ten months of 1986 while home production of wine tripled (Zabotin 1986). Depending on assumptions, this statement could mean that per person 15 years old and older consumption (which we equate with production) of samogon increased by 1.3 to 1.8 and of homemade wine by 0.75 to 1 liter of absolute alcohol. (12) These are only rough estimates but it seems reasonable to conclude that the reduction in consumption of state produced alcoholic beverages was covered to a large extent by increased drinking of samogon and of other home-made beverages. In fact, some Soviet specialists say that the reduction of state produced beverages was fully compensated by samogon (Trud, April 21, 1987, p. 4; Kom- munist, No. 11, 1987, p. 37). The most desperate drinkers were switching to alcohol surro- gates such as aftershave lotions, colognes, and technical fluids containing alcohol. Runs on lotions and alcohol-based medicine have become so common that stores restricted sales to two bottles per customer, reduced the hours of sale, or had to call in police to control unruly buyers (Izvestiia, January 31, 1986, p. 3; (Literaturnaia gazeta, November 12, 1986, p. 12). More harmful was the increased drinking of stolen technical alcohol, antifreeze, methanol, and other toxic fluids. Not surprisingly, the number of fatal alcohol poisonings is growing. Thus we read of five deaths from methanol in one factory (Izvestiia, September 12, 1985, p. 4), or about a case in which 32 people were poisoned and 15 died from drinking antifreeze (Literaturnaia, gazeta, September 17, 1986); 200 people died in 90 cases of group poisoning (Vlasov 1987, p. 2). The underground market also helped the Soviet consumer to cir- cumvent the restrictions on sales of state-produced beverages, with ubiquitous middlemen (often taxi drivers) buying cases of vodka and then reselling them at a premium during off hours, in restricted areas, or to minors (Nedelia, No. 44, 1985, p. 71; Izvestiia, Janu- ary 10, 1986, p. 3; Trud, September 5, 1986, p. 2). Another important and possibly an interrelated problem is the use of narcotics in the USSR. There had been many similarities in the state policy towards alcohol and drug abuse. As with alcohol the official line was that the use of narcotics in the USSR is minimal and the medical authorities felt justified in neglecting the problem. (13) Responding to Gorbachev's demands for glasnost', the veil of silence was lifted, and the media now report that the use of narcotics in the country is widespread and rapidly growing. What is of particular concern to authorities is that higher prices and restrictions placed on sales of alcoholic beverages have induced some drinkers to switch from alcohol to narcotics. The relationship between alcohol and narcotics is very complex, and the Western experience does not indicate a strong substitutability between the two substances. The Soviet authorities, however, claim that the increased use of narcotics is, at least in part, the result of the antidrinking campaign (Moskovoi 1986, p. 3; Komin 1986, p. 3; Potapov 1986. p. 11). Most of the benefits of reduced drinking and alcohol abuse summarized above are real but they must be balanced against the un- desirable effects such as increased production of homemade alcohol, switching to narcotics, and other phenomena described above. These represent real economic and social costs which were not anticipated in the hastily drawn program of the campaign but which are now becoming more visible. What are the prospects for the future? There is no doubt that, generally speaking, a carefully prepared and monitored anti-drinking program that provides for a gradual reduction in production of alcoholic beverages, restrictions on their distribution, strict rules controlling drinking, and a continuing educational and propaganda efforts will bear fruit in a long run. There are, however, several reasons to question the overall effectiveness of Gorbachev's campaign and the ability of the authorities to maintain its momentum. One aspect of the campaign must be discussed at this point. For years Soviet specialists have been debating the question of the acceptable level of drinking. Most of the professionals, i.e., sociologists, psychiatrists, and journalists specializing in medical issues, felt that the goal of total abstinence or an introduction of a "dry law" in the Soviet Union was unrealistic. They suggested that most ill effects of alcohol abuse in the country would be eliminated if the drinkers were to learn how to drink in moderation and in a civilized manner, spreading alcohol intake over time and combining it with food. The opponents took the rather dogmatic position that any quantity of alcohol consumed under any circumstances is harmful to the society and the individual and that the goal of the state policy should be total abstinence. The Central Committee resolution set the tone for the whole campaign by rejecting the "civilized, moderate drinking" and the media made total abstinence the main theme of the propaganda "blitz". The notion of moderate drinking is being ridiculed in an article after article and its earlier supporters are being harshly criticized. Gorbachev's insistence on openness notwithstanding, the genuinely free discussion of this issue ceased. Proponents of moderate drinking such as Boris and Mikhail Levins, E.A. Babaian, and Z. Balaian who had been expressing alarm over the alcoholism for years and who made major contributions to the understanding of the alcohol problem, have been silenced. As a matter of fact, the attack on the moderate drinking position is becoming more and more of a witch-hunt. In this connection the name of a Leningrad surgeon, Fedor Uglov, should be noted. Uglov was long known as an outspoken critic of drinking but because of his extreme views, his naive approach to this highly complex problem and the lack of professional expertise he was virtually ignored by serious specialists. Uglov has today emerged as the main spokesman for the total-abstinence position and is advocating his views and attacking the now silent opponents in a style reminiscent of Lysenko. Most specialists would probably agree that this strategy, particularly when combined with crude punitive measures, is wrong and that the only long term solution to the alcohol problem in a country such as the USSR, with deeply rooted traditions of drinking, is a slow educational process leading to moderation and temperance. The tacit acknowledgement, made in the initial announcement of the campaign, that the boredom and drabness of everyday Soviet life contributes to the spread of drinking was a sign of progress in a society which has long denied the existence of social conditions leading to drinking. The increased production of hobby kits, auto- mobile spare parts and expansion of athletic fields ordered by the authorities is by far not a comprehensive solution. The state would have to address the needs for adequate housing and of the whole infrastructure of entertainment, leisure, and rest facilities. Development of such programs would take years and would be costly and, judging from current economic plans, this is not where Gorbachev's priorities lie. The fiscal problems have not been resolved. The fiscal folly of a significant dependence of the state on liquor revenues is now obvious. The budget is losing revenues while increasing cash holdings and savings of the people contribute to the hidden inflation and adversely affect labor incentives. Only a most comprehensive tax, wage, and price reform could resolve these issues and so far there has been no evidence that one is being considered. In the frenzy of the campaign's condemnation of drunkards and exposing of the evil of alcohol, the public health issues have been somewhat neglected. The basic attitude of central authorities did not change much; alcoholism is seen as a moral weakness, and the state's responsibility is seen in insuring the law and order in the streets and in the workplace and not in financing of an expansion of treatment facilities. The newly created network of narcological clinics is in part funded by enterprises and organizations and in part by paying patients but not by the state budget. It would appear to a Western observer that the anti-drinking program cannot be successful in the long run without a major commitment of public health support for counselling, psychiatric treatment, post- treatment assistance and rehabilitation. Illegal home production of alcohol is and will remain the main threat to the success of the campaign. Past Soviet experience shows that it is virtually impossible to eliminate samogon. The technique of production is very simple and does not require elaborate equipment, and the raw materials such as sugar, flour, grain, potatoes, or fruit are widely available and inexpensive relative to state-produced alcohol. And, unlike their American counterparts, Soviet samogon makers are small scale producers without large stills, which makes police detection difficult. About the only feasible method of elimination of samogon is to make it unprofitable by fixing prices of state produced alcohol at a sufficiently low level, a method that is unlikely to be adopted. In recent months the Minister of Internal Affairs, A. Vlasov, has been reporting the frustrations experienced by the police in their struggle with increasing illegal production noting that mere increases in penalties cannot be equated with effective anti- alcohol measures (1987, p. 2). The whole campaign was clearly designed in haste without con- sidering all possible consequences and with naive expectations of immediate and dramatic improvements in labor discipline and in disappearance of adverse effects of drinking. So far, Gorbachev displayed a remarkable degree of zeal in maintaining the momentum of the campaign in the face of what must be a considerable opposi- tion. In this regard he displays much more confidence in his power and more perseverance than his predecessors. In all probability, though, the real economic and social costs will continue to rise while the potential benefits, which are still quite uncertain, will not be felt for years. It is possible that facing these problems Gorbachev will be forced to modify the anti-drinking program by introducing more modest goals. ENDNOTES 1 For some of the recent studies see Keller and Efron 1974, Segal 1976, Connor 1979, and Field and Powell 1981; and best Soviet source Lisitsyn and Kopyt 1983. Part of the research for this study was done for the project on the quality of life in the USSR directed by Dr. Murray Feshbach of Georgetown University. The author is grateful to him and to Maurice Friedberg, Gregory Grossman, Aron Katsenelinboigen, and David Powell for their comments on earlier drafts. The responsibility for errors is, of course, the author's. 2 In the absence of Soviet statistics on alcohol in the past the author had made and published several series of estimates on production and consumption of alcohol (Treml 1982, 1986). Depart- ing from the past practice the 1985 statistical handbook published several sets of data on alcohol (Narkhoz 1985, p. 254, 471, and 609). For three years for which both Soviet and the author's per capita data are available the difference is only 0.1 percent suggesting that the estimates are fairly accurate. Accordingly, Soviet newly available data will be used in this paper whenever possible. For years for which Soviet data are not available, the earlier author's estimates will be used. The figure of 16 liters of absolute alcohol used in the test was based on the Soviet data for 1984 and adjusted upward to reflect consumption of homemade alcohol estimated at 4.3-4.4 liters of samogon and 0.5 liters of homemade wine (Treml 1986, p. A26 and A34). The author's samogon estimates are very rough. However, a recent Soviet article reported that samogon makers used up more than one million tons of sugar annually (Bazhenov 1985, p. 11) , a figure which is broadly consistent with the author's estimates. 3. See Feshbach 1982, pp. 33-35, 1?85, pp. 43-45, and Treml 1986, Pp. A54-62. The alarming drop in life expectancy estimated by Feshbach and others through 1984 is now confirmed as Narkhoz resumed after a gap of 15 years publishing life expectancy statistics (1985, P. 547). The newly released data show an increase in life expectancy of one year in the 1985-1986 period and also a drop in the crude death rate from 10.6 deaths per 100,000 in 1985 to 9.7 in 1986 (Pravda January 15, 1987, P. 3) attributing these changes mainly to the success in the anti-drinking campaign. 4 A roughly comparable ratio for the US was 1.8 percent. 5 We do not know the overall number of arrests or dismissals but judging from a sample of reports it must be large. For example, in two months 700 people (half of them officials) were arrested for drinking on the job in Estonia (Sotsialisticheskaya zakonnost, No.10, 1986, p. 34; 455 party officials were reprimanded and 74 were expelled in Vinnitsa oblast' (Pravda, September 24, 1985); in the Ul'ianovsk oblast'183 were expelled from the party for drunkenness (Trud, February 20, 1986, p. 2);330 teachers from 47 technical schools were penalized for drinking (Uchitel'skaia gazeta, September 25, 1986, p. 2). 6 The data for 1980, 1984, and 1985 are from Narkhoz 1985, p. 609, recomputed to reflect population of 15 years and older. The figure for 1986 is from SSSR v tsifrakh, 1986, p. 267. 7 Estimated roughly as the difference between tax revenues of 103.1 billion rubles which were planned before the start of the campaign (Finansy SSSR, No. 1 1985, p. 5) and the actual collections of 97.7 billion rubles (Narkhoz 1985, p. 6). Losses from reduced taxes on profits of the alcohol industry and of the retail trade network cannot be estimated. 8 One of the reasons for the unanticipated losses was the naive belief of the authorities that increased sales of fruit juices, soft drinks, and other consumer goods produced from "hidden inner reserves" would somehow cover some or most losses in sales. 9 An example of inconsistencies among reports can be seen in the following. According to MVD statistics reported on Moscow television on June 26, 1986,crime among minors was down 30 percent (JPRS-USR-86-042, August 25, 1986, p. 49). However, according to a report in Izvestiia on September 10, 1986 there was no appreciably change in crime committed by minors. Sources for the statistics summarized above are: Trezvost' i kul'tura, 8, 1986, p.2, and 9,1986, p.4; Pravda July 27, 1986, p. 3; Izvestia, October 12, 1986, p. 2; Moscow TASS in English, December 26, 1986; Beijing Xinhua reporting from Moscow, December 3, 1986, FBIS. 10 Statistics showing economic improvements in 1985 and 1986 contain a number of puzzling inconsistencies and it is quite possible that they are being manipulated to present Gorbachev's leadership in a more favorable light. This was first brought to my attention by Prof Gertrude Schroeder. See also Vanus 1986 and Hanson 1986. 11 For a sample of reports exposing inflated results of the campaign see Trud, August 16, 1985, p. 5 and August 14, 1986, p. 2; Vozdushnyi transport, April 8, 1986, p. 4. 12 Consumption of samogon in 1983 was estimated by the author as 4.2 liters of absolute alcohol per person (Treml 1986, P. A34). In the 1980s consumption was increasing at about 5.6% per year and we will estimate l@84 consumption on the basis of this rate as 4.4 liters. It is impossible even to guess how the samogon market changed in the second half of 1985. Police became more active and the penalties were increased and this may mean that the production was cut. On the other hand, the shift in demand and higher prices of vodka may have induced higher production. We will use a range of 4.0 to 4.4 liters per person for the whole of 1985. The 42% increase referred to above would then mean that per capita consumption in 1986 grew to between 5.7 and 6.2 liters of absolute alcohol. Estimation of home production of wine was done in a similar fashion. 13 "One of the better known journalists writing on medical themes, Balaian, said in a recent article (1986 P. 13) that for a long time newspapers would not accept reports on drug use because the topic was prohibited. He also cites a methodological recommendation issued by the Ministry of Health stating that in the USSR "use of narcotics does not pose a serious problem".