Vodka is killing a disproportionate number of young men in Russia, a study has found.
Research by Oxford University shows one quarter of all Russian men die before the age of 55, compared to just 7% in the UK, with the main cause put down to alcohol and cigarettes.
Researchers monitored 151,000 men in the Russian cities of Barnaul, Byisk and Tomsk from 1999-2010.
They interviewed them about their drinking habits and studied the cause of death in 8,000 of the subjects.
Men who drink three or more litres of vodka a week have a 35% chance of dying before they reach their 55th birthday, the research found.
Life expectancy for men in Russia is 64 years, ranking it among the lowest 50 countries in the world.
Prof Sir Richard Peto, of the clinical trial service unit at the University of Oxford, said vodka was the root cause of many deaths.
"Russian death rates have fluctuated wildly over the past 30 years as alcohol restrictions and social stability varied under Presidents Gorbachev, Yeltsin, and Putin, and the main thing driving these wild fluctuations in death was vodka."
Death rates among adults under 55 in the UK have been declining steadily since 1980, mainly because so many people have stopped smoking. But death rates in Russia have fluctuated sharply, approximately in line with alcohol consumption.
Prof David Zaridze of the Russian Cancer Research Centre in Moscow said controls on alcohol had proved effective in the past.
He said: "The significant decline in Russian mortality rates following the introduction of moderate alcohol controls in 2006 demonstrates the reversibility of the health crisis from hazardous drinking."