Alcohol and suicide in eastern Europe

INTRODUCTION AND AIMS: The aim of this paper was to estimate how suicide rates in seven eastern European countries are affected by changes in population drinking and to put the results into a comparative perspective. DESIGN AND METHODS: The analysis included data on annual suicide mortality rates and per capita consumption for the post-war period from: Russia, Belarus, Poland, Hungary, Bulgaria, the former Czechoslovakia and the former German Democratic Republic (GDR). Overall and gender-specific models were estimated using the Box-Jenkins technique for time-series analysis. The estimates were pooled into two groups, i.e. spirits countries (Russia, Belarus and Poland) and non-spirits countries (Hungary, Bulgaria, former Czechoslovakia and former GDR). RESULTS: All countries obtained positive alcohol effect estimates. The effects on the overall population were largest in the spirits countries, where a 1-litre increase in per capita consumption was associated with an increase in overall suicide rates of 5.7-7.5%. The effects were somewhat smaller in the non-spirits countries, 2.7-4.7%. The estimates for males were larger, but showed the same national variations as the overall population estimates. The female estimates were generally smaller than for men and did not differ between the two country groups. DISCUSSION AND CONCLUSIONS: The results suggest that per capita consumption matters for suicide mortality in these eastern European countries, but that the strength of the relationship is contingent upon the drinking culture, so that it tends to be stronger in countries with detrimental drinking patterns.