One reason Russia's government doesn't do more to combat alcoholism is that the state is addicted to the bottle in its own way.
"Vodka has always been an example of government greed and hypocrisy," President Boris Yeltsin said last year in a national radio address."The authorities have always said that drinking is bad for you. But at the same time it was vodka, in fact, that allowed the government to make ends meet."
Taxes on alcohol have been a significant contribution to Russia's federal budget for many years. In Soviet times, they were said to constitute more than 25 percent of state revenues.
In the post-Soviet period, many liquor businesses are trying to stay one step ahead of the tax inspector. But levies on wine and spirits are still an important source of income, Yeltsin said.
"When the people spend their money on vodka, it should go to the treasury, not to swindlers," Yeltsin said, urging his countrymen to drink legally taxed liquor. "We will give (the tax money) to pensioners, soldiers, doctors, and teachers. It will help build the economy."
But such appeals fall largely on deaf ears - and strained wallets. Government officials estimate the state loses as much as $360 million a month from evasion of alcohol taxes, or more than four times the amount Yeltsin said it takes in each month from such taxes.
The government also has tried to turn consumers away from bootleg booze by repeatedly warning it can be deadly.
But Vladimir Treml, a Duke University demographer who has studied Russian alcohol use, says the warnings are aimed less at protecting citizens' health than filling treasury coffers.
"They try to perpetuate the perception that tainted alcohol is a serious problem," he says. "But the real problem is that they depend on it, too."