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Researchers tracked about 151,000 adult men in the Russian cities of Barnaul, Byisk and Tomsk from 1999 to 2010. They interviewed them about their drinking habits and, when about 8,000 later died, followed up to monitor their causes of death.
The risk of dying before age 55 for those who said they drank three or more half-liter bottles of vodka a week was a shocking 35 percent.
Overall, a quarter of Russian men die before reaching 55, compared with 7 percent of men in the United Kingdom and less than 1 percent in the United States. The life expectancy for men in Russia is 64 years — placing it among the lowest 50 countries in the world in that category.
It's not clear how many Russian men drink three bottles or more a week. Lead researcher Sir Richard Peto of Oxford University said the average Russian adult drinks 20 liters of vodka per year while the average Briton drinks about three liters of spirits.
"Russians clearly drink a lot, but it's this pattern of getting really smashed on vodka and then continuing to drink that is dangerous," Peto said.
"The rate of men dying prematurely in Russia is totally out of line with the rest of Europe," he said. "There's also a heavy drinking culture in Finland and Poland but they still have nothing like Russia's risk of death."
Alcohol has long been a top killer in Russia and vodka is often the drink of choice, available cheaply and often homemade in small villages. Previous studies have estimated that more than 40 percent of working-age men in Russia die because they drink too much, including using alcohol that is not meant to be consumed like that in colognes and antiseptics.
Drinking is so engrained in Russian culture there's a word that describes a drinking binge that lasts several days: "zapoi."
Peto said there was some evidence of a similar effect in Russian women who also drank heavily but there was not enough data to draw a broad conclusion.
The study was paid for by the U.K. Medical Research Council and others. It was published online Thursday in the journal Lancet.
Other experts said the Russian preference for hard liquor was particularly dangerous.
"If you're drinking vodka, you get a lot more ethanol in that than if you were drinking something like lager," said David Leon, a professor of epidemiology at the London School of Hygiene and Tropical Medicine, who has also studied the impact of alcohol in Russia but was not part of the Lancet study.
He said changing drinking patterns in Russia to combat the problem was possible but that it would take a significant cultural adjustments.
"It's not considered out-of-order to drink until you can't function in Russia," Leon said. "It just seems to be part of being a guy in Russia that you are expected to drink heavily."
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