Russians may toast with the words “Na zdorovie” — “to your health” — but a new study finds that many Russian men are often literally drinking themselves to death.

Russian men who drink three bottles of vodka a week double their risk of dying over the next 20 years, the study shows. It helps explain why Russian men have one of the lowest life expectancies in the world — 64 compared to 76 for U.S. men.

“Vodka (or other strong alcoholic drink) is a major cause of death in Russia,” the team of Russian and British researchers report in the Lancet medical journal.

But controls meant to limit drinking seem to be helping, they added. “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,” British cancer expert Richard Peto of the University of Oxford, who worked on the study, said in a statement.

David Zaridze of the Russian Cancer Research Center in Moscow and colleagues interviewed 200,000 people in three Siberian cities, Barnaul, Byisk, and Tomsk, over 10 years from 1999 to 2008. These cities reflect the average Russian population, they said. They asked them about drinking habits and health, and then looked to see who died and when.

The clearest pattern was among male smokers, who also happened to be the heaviest drinkers. They cleared out anyone who already had some disease when interviewed, and came up with 57,000 men. Men aged 35 to 54 who drank less than a bottle of vodka a week had a 16 percent percent chance of dying of anything over the next 20 years. But this rose to 20 percent for men who drank one to three bottles a week and to 35 percent for those who admitted drinking three or more bottles a week.

Most men did drink a bottle or less a week, but 2,842 said they drank three or more bottles every week. “Since 2005, Russian consumption of spirits and male mortality before age 55 years both decreased by about a third but are still substantial,” the researchers noted.

Heavy drinking can cause cancer, heart disease, stroke, liver failure and other diseases, and drinkers are more likely to die in acccidents or to be murdered. And people who drink and smoke together raise their disease risk even more.

The researchers checked to see if maybe drinking just a little was good for health — other studies in other countries show a few drinks a week can be good for you — but there wasn’t enough data to say if this was true in Russia.

Binge-drinking is a problem in the United States, also, although not as bad.

The Centers for Disease Control and Prevention estimates that 38 million Americans binge drink, defined as quaffing four or more alcoholic beverages in a single bout.

Source: NBC news