New studies find that about a million people in Russia die each year from alcohol and tobacco related illnesses. And in several recent years, more than half of all Russian deaths between the ages of 15 and 54 were caused by alcohol.
In Russia, deaths outnumber births these days.
The World Health Organization says a Russian man can expect to live to just under 60. In the United States, male life expectancy is 75. United Nations figures show Russia's population is declining by half a percent a year.
A study published in the British medical journal, The Lancet, finds alcohol and tobacco consumption account for Russia's higher death rate compared to western Europe.
Andrei Demin is from the non-governmental Public Health Association in Moscow. He says, "This is the major factor of demographic crisis in the country, which is threatening the future of the country in fact."
Demin says the average Russian adult drinks 50 bottles of vodka a year. He blames the high consumption rate on easy access to cheap alcohol and tobacco.
At these kiosks in Moscow, cigarettes cost 30 US cents a pack, and beer is less than a dollar - cheaper than water.
Russian President Dmitry Medvedev has described the health crisis as a national security threat.
But Andrei Demin blames Prime Minister Vladimir Putin for failing to raise taxes on tobacco and alcohol. "When he was president he was the first one to put that so high on the political agenda. In the year 2000 he said that demographic decline is problem number one for this country," Demin says,"but in fact nothing has changed a lot since that time."
Russia's health minister, Tatiana Golikova, says a tax hike on alcohol and tobacco must be implemented gradually. "Increasing taxes for a sensitive product has to take into the account the social consequences, and such an increase must be done by stages. We are going to keep pushing that decision, but it won't happen momentarily," she said.
Soviet leader Mikhail Gorbachev's popularity dropped when he imposed drinking regulations in the 1980s.
The present government has instead launched an advertising campaign calling on Russians to take care of themselves, and reminding them of the risks associated with heavy smoking and drinking.