An international group of scientists looked at a single city in the Urals to establish the effects of the drinking in Russia. Izhevsk was chosen for being a typical industrial city where life is much the same as elsewhere and where death rates match the Russian average.
Underlying the work was the question of why life expectancy in Russia is so low: in 2004 it was 59 years for men and 72 for women. Due to the low life expectancy and birthrate, the population in Russia is falling by 700,000 a year.
Alcohol has always been an important factor in death and disease in Russia, borne out by fluctuations in the death rates linked to changes in lifestyle and politics, says a report on the study, in the Lancet medical journal.
"President Gorbachev's anti-alcohol campaign in the mid-1980s was associated with an immediate rise in life expectancy, whereas increased alcohol consumption has been linked to rising mortality in the early 1990s during the transition from communism. Deaths related to alcohol, such as acute alcohol poisoning and liver cirrhosis, showed the greatest fluctuations, with similar trends for other causes plausibly linked to alcohol consumption."
A study published last year found that Russians, and inhabitants of other former parts of the Soviet Union, drank more than anybody else in the world - an estimated 15.2 litres of pure alcohol per capita each year for over-15s. They also drank more dangerously and were prone to binges, known as zapoi, meaning two or more days of continuous drunkenness.
David Leon, of the London School of Hygiene and Tropical Medicine, and colleagues examined records and interviewed the families of 1,750 men who had died in Izhevsk from 2003-05. The men were compared with 1,750 who were still alive. They found that problem drinkers and those who drank alcohol not intended for consumption were six times more likely to have died young than those who did not have a drinking problem. The chances of an early death were particularly high for those who got their alcohol from eau de cologne and other unorthodox sources - they were nine times more likely to die.
The authors say that men impoverished after losing a job through drinking may be forced to resort to drinking household products containing pure alcohol. Among those who were still alive, 47% who drank such products were jobless compared with 13% who stuck to vodka and beer.
Overall, 43% of deaths of men aged 25 to 54 were caused by alcohol, a figure that could be extrapolated to all of Russia because of the typical nature of Izhevsk. An estimate in 2002 put the death toll at 27%. The authors say their higher figures could be due to taking into account drinking of household products with very high levels of alcohol, as well as binges.
"Almost half of all deaths in working-age men in a typical Russian city may be accounted for by hazardous drinking," they write. "Our analyses provide indirect support for the contention that the sharp fluctuations seen in Russian mortality in the early 1990s could be related to hazardous drinking as indicated by consumption of non-beverage alcohol."
A separate commentary points out that people who get their alcohol from household products often live in poor housing and have bad diets, which could contribute to their chances of an early demise. It adds that illegally produced alcoholic beverages are also widely consumed.
The Kremlin is acutely aware of the epic scale of alcoholism. Ministers call it a "national tragedy". Although President Vladimir Putin has presided over a period of spectacular economic growth since 2000, he has so far not persuaded Russians to drink less.
The government has recently cracked down on rogue distillers. Yesterday the federal tax service suspended the licence of several factories producing "alcohol and ethyl alcohol products", saying they had not complied with a law requiring data on how much alcohol each bottle holds.
Russian alcoholics - drinking perfume, aftershave and cheap local alcohol - face great dangers. In winter, newspapers are invariably full of stories of drunks who have died after falling through icy ponds or collapsing in the snow.
According to 2005 figures, Russia has about 2,348,567 registered alcoholics, and alcohol is being linked to 72% of murders and 42% of suicides. The World Health Organisation rates the country as one of the most alcoholic in the world.
'Ultimately it's a disease of the soul'
Case study: Saviley Vlasov, 35, was a heavy drinker after leaving the army in his mid-20s. Now recovering, he works as a courier in Moscow
I started drinking when I was 14. I was a shy teenager, but after a night of drinking I became sociable. I got a new nickname, new friends and even a girlfriend. I started drinking heavily when I left the Russian army at the age of 25. It was 1992.
Every time I touched a drop of alcohol I couldn't stop drinking. I was helpless. I had just one purpose: to find alcohol. It was my only goal.
I would drink until I could no longer stand up. My relatives gave me money. I would normally drink for two or three days continuously. After that I'd collapse. Then I'd lie down for a week. Then I'd start drinking again.
This went on for several years. I'd look for money, steal it, borrow it, or get it from other drinkers. I mostly drank very cheap vodka. It's easily available in Russia, it tastes like industrial spirit.
On one occasion I set myself alight. I almost died. I woke up, and I didn't know where I was or how I got there. On another occasion I nearly fell out of the window of my Moscow flat.
I didn't have a girlfriend. I just drank alone at home and watched TV. My relatives thought I was a madman. They were waiting for me to go mad and put me in a hospital.
My entire universe became distorted. I started to measure someone only by alcohol - whether they were someone I could share 50g of vodka with. At my father's suggestion I went to Alcoholics Anonymous. But only once. Afterwards I carried on drinking, for two years.
Eventually I ran out of drinking companions and stopped. I've now been dry for eight years.
I'm not sure why alcoholism is such a big problem here in Russia. It happens elsewhere too. But ultimately it's a disease of the soul. Men and women drink in Russia because they don't have any spiritual goals. They have nothing to live for.
During my darkest moments, the whole meaning of my existence was to get alcohol. That was it. It was an unending struggle. Those years are still a blur to me.