This study represents the changes in alcohol-related behaviour between 1995 and 2004 among adolescents in northwest Russia from a semirural area. Over the period surveyed, alcohol consumption increased among both boys and girls. The proportion of abstainers decreased among both genders. Among boys, the age of initiation of alcohol consumption decreased and in 2004, over one-third had their first experience in 6th grade (12 years old) or earlier. Among girls, the age of initiation increased slightly. Introduction to alcohol in the company with friends increased among both genders. The frequency of drinking increased among both genders with doubling in weekly consumption. Beer consumption dominates among both genders. Among boys, it is higher and did not change much since 1995. Among girls, it increased remarkably by 2004. The number of girls experiencing drunkenness after consumption of alcohol increased after 2004.
A corresponding increase in the prevalence of alcohol consumption among both genders between 1993 and 2002 has also been reported in the Baltic countries. Alcohol intoxication in age of 13 or younger increased there as well [17
]. The similar picture emerges from the WHO Health Behaviour among School Children Survey study conducted in Eastern European countries (Bulgaria, Croatia, Slovenia, The Slovak Republic, and Ukraine). There, the occurrence of first alcohol and intoxication experiences at age of 13 or earlier has increased as well. In the same study, Russia was represented only by St. Petersburg—the second largest city in Russia, where the occurrence of first alcohol and intoxication experiences increased as well [18
]. In another study—the European School Survey Project on Alcohol and Other Drugs, where older age group from Moscow was presented, corresponding findings were obtained [14
]. Conversely, in Japan a decrease in drinking prevalence among adolescents has been observed between 1996 and 2004 [19
]. Also, in Finland, the amount of abstainers has increased among 12–18 year olds since 1997 [20
Shared past commonalities in socioeconomic environment may have caused similarities between the alcohol-related behaviour of Russian and Easter-European youth, especially former Soviet-Baltic countries and Ukraine. In these countries, there has also been an increase in availability and selection of alcoholic beverages and they are also relatively cheap. Contrary, in Finland and Japan, strengthening of alcohol policies started to be implemented a long time ago and they are constantly monitored for adjustments [19
]. From 1973 to 1987, Finland experienced similar increase in adolescent drunkenness due to increase in overall alcohol consumption and alcohol availability together with liberalisation of alcohol policy in general [21
Over the study period, the frequency of drinking among boys in Pitkäranta is almost double that of girls. However, between 1995 and 2004, the weekly alcohol consumption doubled among both genders. Also frequency of drinking among girls is still lower than that among boys, long-term consequences of existing increase should be considered. This might anticipate diminishing of gender differences in alcohol consumption is among Russian youth following a pattern observed in Canada and other countries participating in HBSC survey, by which there is near parity in the prevalence of alcohol consumption almost equal between the genders [15
]. Since women are more vulnerable to health hazards caused by excessive drinking, future alcohol problems among women are likely to increase in the future, as it has been observed in Finland [22
Parental alcohol consumption was not explored in our study, but in Pitkäranta. In Pitkäranta a tolerant attitude towards drinking in a child's close environment, such as by family and friends, may play a major role in increasing interest towards alcohol among youth in Pitkäränta, where the mean alcohol consumption has significantly increased among adults, especially among men between 1992 and 2002 [9
]. It would be interesting to study whether in Russia the youth alcohol consumption culture corresponds to that of adults or whether it exists as a protest against societal norms. In the absence of clear studies to date, the extent to which early drinking initiation among Russian youth influences later drinking habits together with variations in alcohol drinking frequency and amount remains uncertain.
Cultural and group components play an important role in determining drinking patterns [23
]. Among Pitkäranta's adolescents, peers play increased role. The introduction to alcohol increased among Pitkäranta's adolescents. This may reflect on changes in the macroenvironment, such as the greater availability of alcohol, access to it among youth [25
], increased purchasing power, and weaknesses in implementing of antialcohol policy [26
In Russia, the sale of alcohol to minors (under the age of 18 years) is banned, but there is no culture of comprehensively checking the buyers' age. Moreover the alcohol in Russia is both relatively cheap compared to other European countries and is widely available twenty-four hours a day in most places. Also purchasing power has increased since 1990 [9
In our study, beer consumption showed remarkable increase among girls. Beer is reported to be the main alcoholic beverage consumed among adolescents worldwide [15
]. Alcopops and other similar beverages have occupied their own market niche among both genders of Pitkäranta's adolescents. To date the alcohol concentration in such drinks in Russia can be upto 9%. Increasing popularity of alcopops among young people has been reported from other countries, especially among female adolescents [19
The prevalence of drunkenness among girls has increased almost to the boys' levels. However, it would be too early to assume that a modern drinking culture is taking over the traditional one in Russia since prospective studies are not available. It is possible that gender differences in drinking rates may diminish in Russia in the future.
Overall, the observed changes in alcohol behaviour among young people in Pitkäranta correlate with those reported in Moscow also in older age groups and those among youth from other posttransition European countries [16
]. Taking into account the effects of globalization and existing anti-alcohol legislation, it is, to some extent, possible to predict that future alcohol consumption trends among Russian youth will follow the direction of other Eastern European countries.
The main possible factors behind negative changes in alcohol behaviour among Russian youth are weakly enforced, age limits on alcohol sales, low alcohol prices compared to other European countries together with affordable prices in relative to income [9
], twenty-four hour alcohol availability, the inefficiency of preventive programs, the low level of alcohol harm-related literacy, and the existing familial drinking culture. Also, there are newer factors, such as new low-alcohol products that are introduced with aggressive marketing strategies, which raise alcohol consumption among adolescents. Recent increase in price affects only spirits thus further increase in consumption of other alcohol beverages could be expected. Due to observed changes in alcohol-related behaviour among youth and the growing alcohol sales, an increase in number of accidents, prevalence of sexually transmitted diseases, and unplanned pregnancies among adolescents could be expected. In the long term, the further increase in the burden of alcohol-related disease among adults could be expected in Russia.