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Peter Anderson

Thomas F. Babor

Sally Casswell

Roberta Ferrence

Norman Giesbrecht

Christine Godfrey

Harold D. Holder

Paul Lemmens

Klaus Mäkelä

Lorraine T. Midanik

Thor Norström

Esa Osterberg

Anders Romelsjö

Robin Room

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7. be30nacnocTb o61neCTBa H noTpe6neHHe anxOronA B0C06bIX yCJIOBHAX

Ô. PaCnpOCTpaHeHHe HH(f.lOpMaLjHH o6 anKOrone:

B03Z[ei3cTBHe Ha nOTpe6neHHe anKOrOnA H HaCOL[HanbHbIN KnHMBT 241

9. I4H,IjHBH,E(yanbH0 OpHeHTHpOBaHHble HHTepBeHnHH, KaK

KOMHOHeHT OTBeTHOIi nOnHTHKH 06LIZecTBeHHOrO

3JjpaBOOXpaHeHHA OTHOCHTenbHO anKOrOJIA

153

175

217

10. 110JIHTHLIeCKHe BbIBO,IjbI

IZpHnO)KeHHe. BO3M0>iCHOCTH AJIA HCCne,IjOBaHHii

271

293

311

IÎp@,gbICTOpNSi CO3,gâHNSi 3TON KHHrN

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yiieHblX 143 9 cTpaH, KOTOpble pa6OTâJIn BMecTe, KOnnerHaJIbHO BTemeHiie iiHTeHCHBHOrO JZByXJIeTHerO nepHOJ[a. O(liiilji3aJIbHO npOCKTAI'Ij 06yCnOBJIeH KOHTpaKTOM C EBpOneiiCKiiM 6lopo BCeMHpHOiiOpraHH3alnili 3JjpaBOOXpaHeHHSI. TeKCT nponlen CTagIiiO

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BapHaHTbI, 06cyXcneH1-iSi Bceli rpynnoA, npoMexcyTOgHOK pa6oTblmanor' peJ[aKTOpCKOH rpynnbl H OrpOMHOIï COBMecTHOii pa6OTbI.Pe3ynbTaTOM 3TOii COBMeCTHOii pa6OTbI SIBIiJICSI TeKCT, KOTOpbIN

npeACTaBJISIeT COrJIaCOBaHHylO TOT-IKy 3peHliSl BceX aBTOpOB, KOTOpble

CJjeJIanH CBOii BKJIaA B 3Ty pa6oTy cxopee KaK HHJ[nBliJjyâJlbHbleyT-IeHble, t-IeM KaK npenCTaBI-iTenii KaKIiX-JIii60 OpraHH3ainHli.

ABTOpbI H HX peraJIHH

Griffith Edwards, D.M., HccneAosaTenbcKHi3 ueHTp aAAHKuHH,HauHOHanbHblii ueHTp aAAI,IKuHH, 14HCTnTyT ncHxHaTpHH,JIOHAOHCKHIi yHHBepCHTeT, BenHKO6pHTaHHA.

Peter Anderson, M.Sc., M.R.C.G.P., M.F.P.H.M., KoxcynbTaHT,EBponericKHil naafi AefIcTBHiI no 6opb6e e noTpe6neHHeM anxorOnA,Esponeûcxoe perHOHanbxoe 61opo B03, KoneHrareH, eLlaHHA.

Thomas F. Babor, Ph. D., M.P.H., AHpeKTOp no Hayxe,1CCneAOBaTenbCKHi-i ueHTp nO ânKOrOnIO, KOHHeKTHKyTCKHrl

yHI-iBepciiTeT, CHIA.

Sally Casswell, Ph. D., AHpeKTOp HccneAosaTenbcxoro oTAenaAnKOronb H o6fuecTBeHHoe 3ApasooxpaxeHHe, PyHa Hra, BaHaHra,Xayopa MH Te IIHKaxa (ocTpoBa HOBON 3enaHAHH, npHM.

nepeBoAHHKa), OKneHAcKHii yxl-IBepcnTeT, HoBax 3enaHAHA.

Roberta Ferrence, Ph. D., cTapluHH HarHblH COTpyAHHK, (DoHAHCCneAOBaHHii aAAHKuHK, OHTapNo, KaHaAa.

Norman Giesbrecht, Ph. D., crapHlHH HayvHblH coTpyAHHK, (I)oHAHccneAoBaHHA aAAHKuHH, OHTapHo, KanaAa.

Christine _Godfrey, cT luapHi3 HccneAosaTenb, IeHTp 3KOHOMHKH3AOpOBbA l'I, OpKCKHN yHHBepCHTeT, BenHKO6pHTaHH51.

Harold D. Holder, Ph. D., AHpeKTop H CTapiHHH Hay9HblÎicOTpyAHHK, l'1CCneAOBaTenbCKHN Hemp HpO(iHnaKTHKH, bepKnH,CHIA.

Paul H.M.M. Lemmens, Ph. D., HccneAoBaTenb, JIHM6yprcKHAyHHBepcHTeT, MaacTpNxT, HHAepnaHAbl (H C HeAasxero BpeMeHH -HCCneAOBaTenb B rpynne HCCneAOBaHHSI anKOrO1151, liepKnH,KanH4 lopHHA).

Klaus Mäkelä, Ph. D., AmpexTOp no HaynHblM HccneAoBaHHSIM,CIDHHCKHH (1)OH,EI n0 I'13yLIeHi3I0 npo6neM anKoronii3Ma, XenbCHHKH,

CDHHnAHJZHA.

Lorraine T. Midanik, Ph. D., acCHCTeHT npocf)eccopa, YHHBepcHTeTKanVICpOpHHH B bepKnH, KanH4)opH115I H cTapLUHH HaynHbliicOTpyJjHHK, rpynna HccneJIosaxHA anKOrOJIA, KanHIIIOpHiiNCKHN

HHCTHTyT MeJAHL[HHCKHX HCCneJZOBaHHFi, CHIA.

Thor Norström, Ph.D., nportieccop CouHOnorHH, CTOKronbMCKHHyHHBepCHTeT, CTOKrOnbM, II.IBeL[IiA.

Esa Österberg, M. Sc., HccneJjoBaTenb, IHCTHTyT COLjHanbHbIXHccne,goBaHHI3 H3yneHHsl anxoronA, XenbCHHKH, HHnAHJ>HSI.

Anders Romelsjö, M.D., HccneuosaTenb, KaponHHcKHH HHCTHTyT,CaHA6H6epr, IlIseuHSi.

Robin Room, Ph. D., BLtue-npe3HJZeHT no HCCJIeJyOBaHHAM H

pa3sHTHIO, cDoH,a HccneJZosaHFiii aJIJ1HKLjHIi, OHTapLio, KaxaAa.

Jussi Simpura, Ph. D., Hccne,gosaTenb, I'IHCTHTyT COUHanbHbIXHCCneJ[OBaHHii H3y4eHHSI anKOrOJIA, XenbCHHKH, CDHHJIAHJjHA.

Ole-Jorgen Skog, Ph. D., J>;HpeKTOp no HayKe, HaLIHOHanbHbll-iHHCTHTyT no HaynHblM HCCneJZOBaHHAM B o6nacTH aJIxoronH3Ma HHapKOTHKOB, OCJIO, HopBerHA.

1

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CnOCO6CTBOBanH noTpe6neHHIO anKOrOnA, HanpHMep, Tpe3BeHHH-

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B nOAAep)KKy 3TOT0 OCHOBHOTO nOJIO)KeHHA B 3TOKi KHNre, mar3a WarOM, 6yAeT nposeAeHo NccneAosaHNe TOTO, KaK o6mHpxbie,npOBOANMble Ha Me)KAyHapOAHOrI OCHOBe HCCne,IjOBaHNA H OnbITNCIIOnb3OBaHNA pa3nN4HbIX Mep MOT CerOzjHA BnNATb HacpopMHposaHHe peWeHNrI. K KOHCjy 3TOH KHNTN 414TaTenb11O3HaKOMNTC51 C TeM, MTO Ha ,IjaHHblrI MOMeHT O61eKTHBHO 113BeCTHO

O TOM, KaKNe MepbI, B KaKNX O6CTOATenbCTBaX 6y,gyT 60nee NnNMeHee nOne3Hbl AnA 0611114X i31111 Cne11N(1/N4HbIX uenerl nOnNTNKH,COpNeHTNpOBaHHOri Ha COKpaIueHlKe anKOTOnbHOTO 6peMeHN. AaHHOe

N3n0)KeHNe TaK)Ke NMeeT L[enblO HCnpaBNTb HeBepHOe npejlcTaBneHNeo6 anKOrOne, KOTOpOe B npO1IInOM 4aCTO NMenO CnHWKOMnpNyKpaWeHHbIN XapaKTep. TaKNMN n0)KHbIMH npe,gnOnO)KeHNAMN,HanpHMep, ABnSInNCb: y6e)KUIeHNe, MTO 0611.jNrI ypOBeHb N CTNnbnoTpe6neHNA anxoronA HaceneHNeM He HMeloT HN4ero o61uero cpaCnpOCTpaHeHNeM H citeporl AeNCTBNA anKOTOnbHbIX npo6neM;npeAnoJ10)KeHNe, MTO 3noynOTpe6nAIOIuHe anxoroneM maki HeNMe1OT HN4ero 061uer0 C OCHOBHOr1 MaCCON nb10n1er0 HaCeneHNA Hn03TOMy Ha HNX HeB03MO)KHO rIOBnHATb nyTeM npNnO)KeHNA06bI4HbIX yCNnNri; y6exuleHNe, 4T0 IIOTpe6neHNe aJIKOrOnA MO)KeTHe6narOnpHATHO IIOBJKNATb TOnbKO Ha He60nbmyl0 4aCTb HâceneHNA;CJ1HWKOM CHnbHaA KOH11CHTpauNA BHHMaHNA Ha XpOHNMeCKNX3a60neBaHNAX, K KOTOpbIM npHBenO nbAHCTBO BMeCTe C nOJIHbIMnpeHe6pe)KeHNeM K OrpOMHbIM OTpNIlaTenbHblM nOCneACTBNAM

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3

npo6neM, CB513aHHbIX C noTpe6neHHeM anxoronn B BHAe OnHCaHHn6a3osoro pacnono)KeHHSI 6OneBbIx ToLIeic liyAyT oLlepLlexblHeKOTOpble 06LI.jHe H OCHOBHble nepcneKTHBbI, B paMKaX KOTOpbIX BnocneAylotuHx rnasax 6y,ayT npOBOAHTbCn COOTBeTCTByIOLI(He

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4

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npo6neM.

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CHa6xCeHHA anKOroneM, XOTA aJIKOTOnb 4aCT0 nOpOxCnan o6nlHpHblenpo6neMbl H BO BpeMA npenbinylijHX pexcNMOB (Simpura andTigerstedt 1992). OTMeHa TapNC13HbIX 6apbepoB B npenenaxEBponeNcKoro coo6LL[eCTBa H yBenN4eHHe KOnH4ecTBa 4neHOBCoo6luecTBa Talcxce, cxopee Bcero, ocna6NT KOHTpOnb HaanKOTOnbHOM pblHKe B 3ananHOii EBpone. B CKaHnNHaBNH NCeBepHON AMepNKe TaKHe McXaHH3MbI pbIHO4HOTO KOHTpOnA, KaKMOHOHOnHN Ha anKOTOnb, 6bInN OTMeHeHbI HAM CTanH McHeeCTpOTNMH. Pa3BHBaIOIuHFICA MNp, TeM BpeMeHeM, npOnOnxcaeTnOnBepraTbCA orpOMHOMy naBneHHIO CO CTOpOHbI COL(No-KynbTypHbIX

H pbIHO4HbIX CNn, KOTOpOe, CKOpee BCero, 060CTpAT H yBenN4aTypoBeHb CBA3aHHbIX C anKOrOneM npo6neM (Maula et al. 1990).ToprOBble COTnaLIIeHHA, npecnenyA KOMMep4eCKHe HHTepecbI,CnNIHKOM 4aCTO NTHOpHpyiOT MenNLIHHCKHe H COLINanbHblenOCnenCTBHA.

CnenyloLuaA H BeCbMa onpenenexxaA npH4NHa nposeneHHAo630pa H CHHTe3a COCTOHT B TOM, 4TO Ha CerOnHALLIHHii neHbCylljeCTByeT 6onee LLIHpoxaA H 3aNHTepeCOBaHHaA B nony4eHHH,06CyxC,ineHHH H npHMCHeHHH nOCTNxceHHii HayKH nOnHTN4eCKaAaynNTOpNA. XOTA BO MHOrHX BenOMCTBaX HaL(HOHâJIbHbIX H McCTHbIX

npaBHTenbCTB, a TaKxce Ha MexCnyHapOnHOM yposxe no CNX nopCyIueCTByeT HeKOTOpOe OTpHLjaHNe H npeHe6pexCeHHe naHHbIMH

5

npo6neMaMH, BC2 NCe pacTeT nOHHMaHNe He06XOAHMOCTH pa3pa6OTKH

H nepeCMOTpa anKOronbHON nOJ1HTHKH B CBeTe 06beKTHBHbIX AâHHbIX(Mäkelä et al. 1981; Single et al. 1981; Klingemann et al. 1992).Heo6xo,gHMO npH3HaTb ponb B03 He TOMbKO B TemeHHe HeaasHeronepHOAa ee AeATenbHOCTH, HO H B TeLieHHe 6onee ,i[nHTenbHoronepHo,ga pa60Tbl no aHanH3y H OpraHH3aL(HH H3y4eHHA B3aNMOCB513HnpHpoAbl anKOrOMbHON 3aBHCHMOCTH H anKOrOMbHbIX npo6neM(Edwards et al. 1977); no pa3BHTHEO H pacnpocTpaxeHHlo McTO1IHKne'leHHA (Grant and Hodgson 1991), no npoBeAeHHloMewayHapo,IHibIX COBMecTHbIx HCCneAOBaHHN n0 ne'leHHlo (Moser1980; Babor and Grant 1992); no noAAepN<Ke (1)opMHposaHHAnonHTHKH H 3aLIwTe 3,Ij0p0BbA (Bruun et al. 1975; Rootman andMoser 1984; Farrell 1985; Grant 1985; Moser 1985; Walsh and Grant1985; Porter et al. 1986; World Health Organisation 1993).06Hapo.uoBaHHe EsponeHCKHM 61opo B03 EBponeHcxoro nnaHajjeNCTBHN no 6opb6e c noTpe6neHHeM anKOronA AsnSIeTCA BaNCHbIMnpHMepoM nonbITKH yCTaHOBneHHA OCHOBHbIX HanpaBneHH41perHOHanbHOi nOJIHTHKH (World Health Organisation 1992).

HaKOHeIJ<, nepecMoTp HyNCHO CAenaTb He TOnbKO nOTOMy, LITOHe06XOA4MO paCCMOTpeTb, LITO HOBOrO CTâMO 143BeCTHO, HO TaKNCe 143-

3a npeHMyujecTB, KOTOpble BbITeKaIOT H3 OnpeAeneHHA npo6enoB B3HaHHH. ECnH HyNCHO 41,o611TbCA AanbHeNLUero nporpecca, TO AâHHble

np06enbl AOMNCHbI 6bITb o6HapyNCeHb1 H HCnpaBneHbl CneAylow,HMnOKOneHHeM HCCneAOBaHH11.

MbI CCbinanHCb BbILIle Ha BbinyljjeHHbIN B 1975 roAy AoKnaA"11o11HTHKa KOHTpOMA HaA anKOroneM" (Bruun et al. 1975). 3TOT TpyAABMAeTCA TOLiKOH OTC4eTa AllA HaLUerO o63opa, HO HCCneAOBaHHACOOTBeTCTBy1OI1J,erO nOMHTHLIeCKOro OnbITa HaCTOnbKO 3HaLIHTenbH0nporpeccl-IposanH 3a nocneAHHe ABa,IjLjaTb neT, LITO 661.110 6b1

HeBepHbIM nOCTpoHTb AaHHy10 KHHry KaK BTOpOe 143AäHHe HMHnepeH3AâHHe 3TOrO TpyAa. BMeCTO Toro, 4TO6b1 orpaHHMHBaTb Ce651npeAblAyujeN CTpyKTypOFi, MbI penlHnH OnHpaTbCA Ha npolunblÿBapHaHT, HO B 3Ha'-IHTenbHON CTeneHH nOAONTH K 3aAa4e no-HOBOMy.

6

1.3 KPYf" 11PO611EMHbIX BOIIPOCOB: f1PU1POAA 1,1PA3HOO6PA314E CBf13AHHbIX C A11KO1-011EM f1PO611EM

1.3.1 f1pNpO,ga IlpH4HHHON CB51311

Opa3b1 "anKOronbHble np06neMbl" HnH "CBA3aHHble C anKOrOneMnp06neMb1" COJjep)ICaT npennOJIO)ICeHHe O npH4HHHOM C.B513H. B 3THX,

Ha nepBbIN B3rn5J>;, npOCTbIX CJIOBOCOLIeTaHIiAX CKpbITa, TeM HeMcHee, OnpeJjeneHHaA CJIO)KHOCTb. rIpH4HHHaA CBA3b B JjaHHOiï06naCTH peJjKO HnH HHKOrJ_ja He HMeeT eJ1;HHCTBeHHbIX HnH npOCTbIX

KOpHeFi, 60nee 4acT0 MbI HMeeM jjen0 C npHLIHHHOH 3aBHCHMOCT1,I0,KyJja 6onbLIIe BOBne4eHb1 HHZjHBHjjyanbHble pa3nei4A H COLjHanbHbleyCnOBHA KaK OTJjaneHHble, TaK H HenOCpeJjCTBeHHble B03jZ,el%ICTBHA; a

TaK)ICe BH,Ij, npojjOnDICHTenbHOCTb H HHTeHCHBHOCTb nOTpe6neHHA

anKOrOJIIi, a He npOCTO (paKT ero nornonjeHHA.

KpoMe TOrO, npH4HHHaA CBA3b B J(aHHOM cny4ae LIacTO yCJIOB-HaA; JjaHH6II%I ypOBCHb HnH BHJj noTpe6neHHA anKOrOJIA MO)KeTnpHBeCTH K npO6neMe B 3aBHCHMOCTH OT TOrO, KTO nbeT cnHpTHoe,ero paLjHOHa nHTaHHA, rJje 3T0 npOHCXOJjHT, KTO H KaKHM o6pa3oMpearNpyeT Ha BbInHBKH H TaK Jjanee. lipHiiHHHaA CB513b B Z(aHHOMcny4ae He ABJISIeTCA npeJjMeTOM HbiOTOHOBCKON (1)H3HKH, H

HeonpeJjeneHHOCTb ABnAeTCA 4aCTb1O Kâ)KnOrO ypaBHeHHA. B IjenAX

ACHOCTH jjaHHOrO H3n0)KeHHA, TeM He McHee, 6yJjeT 11One3H0 BKpaTL[e

npOaHanH3HpOBaTb 3Ha4eHHe nOHATHA "CBA3aHHOCTb" BO itipa3e"CB513aHHble C anKOrOneM".

1. Eblmb npuuuuoü ocmpblx unu xponutecxux nocnedcmeuü.OCTpbie np06neMbl Tpe6yloT nornon.jeHHA 3Ha4HTenbHOi7 AO3bI

anKOronA H, BO3MO)KHO, B OCO6bIX yCJIOBHAX HnH O6CTOATenbCTBaX,

HO He Tpe6ylOT nOCTOAHHOrO nOTpe6neHHA. HpHMepOM TaKOI%I OCTpOÎ-i

npo6neMbl MO)KeT 6bITb nepenOM, Cny4HBIIIHI%ICA BO BpeMA naJ);eHHA B

COCTOAHHH OnbAHeHHA. XpOHH4eCKHe npo6neMbl, C JjpyrOH CTOpOHbI,

nOJjpa3yMeBaK)T nOCTOAHHbII4 ypOBeHb nOTpe6neHHA. uHppO3 ne4eHHABnAeTCA TH11H4HOI%I npo6neMoH, OTHOCAIIZeNCA K nocneAHeüKaTerOpHH. TaK)ICe MO)KHO nOHATb, 4TO MO)KeT Hâ3bIBaTbCA "OCTpoi%I

HnH XpOHH4eCKOi%I np06neM01%I". ,LnHTenbHOe nOTpe6neHHe anKOrOnA

MO)KeT npHBeCTH, HanpHMep, K LjHppO3y, HO Ha OnpeJjeneHHOM 3TanenpOH3ONJjeT CHnbHOe KpOBOTe4eHHe H3 nHLLjeBOjja: OCTpble

np06neMbl MOryT HMeTb XpOHH4eCKyI0 OCHOBy.

7

2. O6ycnoelzeuubze Ka/cum eudom nompe6neuuR? B TO spew!, KaKnBa venoseKa MoryT noTpe6nATb OHO H TO )Ke KonNL{eCTBO aJlKOronAB TegeHNe HenenN, MecALia, HIM rOna, TOT N3 HNX, KTO nbeT B6onblLlNx go3ax, 6onee sepoATHO NcnblTaeT onpe,i),eneHHble BNAbInpo6neM, Hem TOT, KTO TO)Ke CaMOe KOnNLieCTBO noTpe6nAeMOroanKOTOnA pa3AenNT Ha McHbIDNe, HO e)KeAHesxble ,1:( 0361.

3. %loeedetrue e cocmoRHUU onbRxexuR. To, KaKNM o6pa3oM neeCe6A LienoBeK B COCTOAHHN OnbAHeHNA, BepoATHO, COCTaBNT

cnenyloLl[NN Ba)KHbI41 CpaKTOp np06neM, 0006eHH0 B COILNanbHOÎ-Icckpe (MacAndrew and Edgerton 1969; Mäkelä 1978).

4. Cmamb npuLzuuoû dnR ebznuezuezo unu aim zozo-mo àpyzozo.

AJIKOrOnb MO)KeT, HaIIpNMep, I1HBCTM K OnbAHeHN1O BOANTenA, HOnbAHbIN Iiloctlep MO)KeT 3TM y6NTb neLllexona. CyucecTByeT MHOrOânKOrOnbHbIX npo6neM, KOTOpble OTpa)KaiOTCA naCCNBHO: CeMbA,pa60TOnaTen14 NJIN 06LILeCTBO pacnnaLlNBaiOTCA 3a 3TO. 3TNnOCnenCTBNA LiaCTO OTHOCAT K "npO6neMaM ASIA OKpy)KaIOLIjNX".

5. Cmamb npuL[uuou peaKtfuu o6ufecnzea. HeKOTOpble anKOrOnbHblenpO6neMbl (HanpNMep, paK nNIL(eBOna) He Tpe6yloT peaKuNN

O61IjeCTBa B CBA3N C NX BO3HNKHOBeHNeM. Apyrue, TaKNe KaK noTepSl

pa60Tbl, TIOpeMHOe 3aKn10LIeHNe, 3a6oTa O neTAX HRH pa3opBaHHblri6paK ABnAIOTCA np06neMaMN, KOTOpble Bb13bIBaIOT NJIN BnNAIOT

CBONM nOABneHNeM Ha HeCpOpManbHylO NSIN (l)OpMâJIbHyIO peaKL),NiO

O6ll[eCTBa.

6. AllKOZOnb Will uanunzoK? B 6OnbLLINHCTBe cnyvaeB BelljeCTBOM,KOTOpOe CLiNTaeTCA npNLINHOÎ-i anKOrOnbHbIX npo6neM, ABnAeTCA3TNJIOBbIN CnNpT, COAep)KNTCA nN OH B nNBe, BNHe NnN KpenKNXCIINpTHbIX HanNTKaX. CyILIeCTByeT, TM He McHee, pAn npNMepOB, BKOTOpbIX OnpeAenëHHble TNnb1 HanNTKOB CBA3bIBa1OTCA C onpene-

neHHbIMN naTOnOrNAMN. HanpNMep, nOTpe6neHNe nNBa MO)KeT 6b1Tb

CBA3aHO C BO3HNKHOBeHNeM paKa TOJICTON KNIIIKN. r1pNMeCN, TaKNe

KaK McTNJIOBbIN CnNpT, MOryT B HeKOTOpbIX cnyLlaslx flPHBCTM KCepbe3HbIM OCJIO)KHeHNAM HRH (iaTanbHOMy NCXOny.

1.3.2 TNllbl CB513aHHbIX C allKOroJ1@M Ilpo6n@M

OCO3HasaA nOCTOAHHy1O HeO6XOnNMOCTb nOMHNTb O

CJIO)KHOCTAX, CB51 3aHHbIX C nOHATNeM "npNL(NHHaA CBA3b", B 3TOMpa3Aene Mbl KpaTKO OnNIneM TNnbl npo6neM, K KOTOpbIM MO)KeT

flPHBCTM nOTpe6neHNe ânKOronA.11enblO ABSIAeTCA He npNBeAeHNe

8

3HLtHKnOneRH4ecKOrO CnHCKa BCeX BO3MO)KHbIX KpynHo- HnH MenKO-

Hane4aTâHHbIX CTaTeii, a OnHCâHHe Kpyra npO6neMHbIX BOnpOCOBKHHTH. B KâKOr%I-TO CTeneHH BO3MO)ICHO OnpeRenHTb OTHOCHTenbHy1O

4aCTOTy BO3HHKHOBeHHSI pa3nH4HbIX THnOB npo6neM, HO 3TaOTHOCHTenbHOCTb 6yReT BapbHpOBaTbCSI B 3aBHCHMOCTH OT BpeMeHN,

CTpaHbE HRH B npeReRax pa311H4H6IX CJIOeB C0o6HWeCTBa. K TOMynK)6a51 nOnblTKa paCIIORO)KNrb OLIeHb pa3Hble npO6neM6I COrnacHOCTp0TOE4 HepapxHH OTHOCHTen6HOFi BaNKHOCTH 6bina 6m HenpoRyK-

THBHOE3 1,13-3a 1-1pOH3BOnbHOCTH B35ITbIX KpHTepHeB H npHRâHHOI'O HM

Beca. 3TH KpHTepHH MOFyT, HanpHMep, BKJIEOLIaTb B ce6si 60nb HcTpaRäHHe HRH BnHSIHHe Ha KaLIeCTBO )1CH3HH; OCTpOTy HRHXpoHH4HOCTb; nOTepAHHbie rORbl )1CH3HH; BpeR, npH4HH5leMblii

,gpyrHM; 3aTpaTbl COLIHanbHbIX CnyxC6 H Cny)IC6 3,IZpaBOOXpaHeHHSI HRH

60nee LIIHpOKHe aCneKTbl 3KOHOMH4eCKHX 3aTpaT.

Ann npo6neM, KOTOpble HCnbITblBaeT OTj[enbHblii nblOLLjMI

4eROBeK, yR06Ho B351Tb HeCKOR6K0 HCKyCCTBeHHyIO KnaCCHIfHKaLiHEO,

iiTO6bI paCrIORO)iCHTb H3n0)KeHHe nOR OTRen13H6IMH 3arOROBKaMH,

COOTBeTCTByiOIIIHMH 41113144eCKON, nCHXOROrH4eCKOFI H COL(HanbHOkE

CCpepaM. 3Toro paCIIORO)KeHHSI Mbl 6yReM npH,C[ep)KHBaTbcSl HH)Ke, a3TM nOCReRyeT naparp4, rRe paccMaTpHBaloTCSI npo6neMbl,BO3HHKaEO111He nepeR ApyrHMH REORbMH B pe3ynbTaTe nOBeReHHSInbEoll(er0 4enOBeKa. YKa3aTenAMH OTHOCHTen6HOli BenH4HHbI

pâ3nH4HbIX npo6neM 6yRyT Cny)KHTb TORbKO TaKHe KaTerOpHH KaK"06bI4HO" HRH "4acT0".

O6palua5lcb, B nepBylO o4epe,gb, K noR3aronoBKy CiH3H4ecKHxnpo6neM, H, B Ka4eCTBe nonpaeKH K Co,gep)KaHHEO y4e6HHKOB,KOTOpble BbIReRSIIOT TORbKO KnaCCH4eCKHe 1l)H3H4eCKHe naTOROrHH,

CB5I3aHH6Ie C aJiKOroneM, BaxCHO noR4epKHyTb BenH4HHy H

pa3Hoo6pa3He OCTpbIX BpeRHbIX nocneRcTBH11 noTpe6neHH5IanKOrOnSI, TaKHX KaK TpaBMbl B pe3ynbTaTe ROpO)KHO-TpaHCnopTHbIX

HRH RpyrHX npoHclneCTBHM, BO3HHKa1OI1114X no BHHe anKOrOnSl,TpaBMbl B RpaKâXX, OCTpble MCRHLtHHCKHe OCRO)KHeHH5I (HanpHMep,

OCTpblli naHKpeaTHT HRH anK0r0RbH6II%I renaTHT) H TaK Ranee(Alcohol Health and Research World 1993; Klingemann et al. 1993).ARKOrOnb TaK)Ke MO)KeT npHBeCTH K CMepTH H3-3a CnHLIIKOM6onbLIIOE%[ RO3bI (Poikolainen 1977). OcTpble OCRO)KHeHHSt MOryT BHeKOTOpbIX cTpaHaX HRH perHOHaX COCTaBRSITb 60nbHlylo 4aCTbO6merO KOnH4eCTBa BpeRHbIX C13H3H4eCKHX nOCneRCTBHÎI

noTpe6neHHH anxoronSE. IIoR4epKHyB 3TOT nyHKT, Hy)KHO CKa3aTb,

9

'ITO TaK)Ke 6e3 COMHeHHA BepHO H TO, 'rTO CIIHpTHOe MO)KeT npHBeCTH

K nOBpC)ICJJeHHtO no'ITH Ka)KJjOf3 TKaHH H CHCTeMbI opraHH3Ma Cnocnej[yiOII(eFi JJnHTenbHOfl HeTpyJJOCII0006HOCTbrO HRH XpOHH'IecKHM

3a60neBaHHeM, BHe3anHOfl eMepTbIO H 60nbIIIHMH 3aTpaTaMH cny)K63ApaBOOXpaHeHHA (Lieber 1982). K HeraTHBHbIM BRHAHHAM TaKOrOTHna OTHOCATCA: OCJIO)KHeHHA HâHOCAIL[He BpeJJ HepBH014 CHCTMC HnpHBOJJALL(He K pa3nH'IHbIM THnaM HapyLLIeHHN MO3rOBOH

AeATenbxocTH H nepwtlepHiixblM HBPHTM (Victor et al. 1989);BbICOKOe KpOBAHOe J1,aBneHHe, CepJJe'IHble 3a60neBaHHA H HHCynbT(Saunders et al. 1981; Preedy and Richardson 1994); ocno)KHeHHA B6pioIIlHOIi nonocTH, TaKHC KaK XpOHH4eCKHfi naxxpeaTHT (Shermanand Williams 1994, Benjamin et al. 1977); pax poTosofi nonocTH HropTaHH, rnoTKH, nHII(esoJla, )xenyJjKa, ne'ieHH, npAMOii KHIIlKH Hxcexcxofi rpyJ1H (International Agency for Research on Cancer 1988).Cei%I4ac npOHCxOJjHT MeJJneHHOe HaxonneHHe 4:laKTos, roBOpAILjHx oTOM, 'ITO âJIKOrOnbHble np06neMbl MOryT TaK)Ke npoABnATbCA BOMHOrHX JipyrHX (DOpMaX: Ko)KHble 3a60neBaHHA (Higgins et al. 1992),31-IJJOKpHHHble HapyuleHHA (Marks 1981; Van Thiel and Gavaler1990), HapyLLIeHHA KpoBH (Lieber 1982), 3a6onesaHHA MblunJ (Peterset al. 1985), 3a6onesaHHA KOCTH (Spencer et al. 1986), Hapyn.IeHHAHMMyHHO1%I CHCTeMbI (Dunne 1989) - BOT nHÜlb HeKOTOpbie gonon-HHTenbHble HapyIIICHHSi 143 CnHCKa, KOTOpblfr npOJjonACaeTyBenH'iHBaTbCA.

LITO KaCaeTCA nCHXOnorNYecKHX nOCneJJCTBHN, anKOr'Onb pe3KoHapylllaeT MHOrHe acneKTbi nCHXOMOTOpHbIX H n03HâsaTenbHblX HCpyHKI(Hfl. HapyuleHHe 3MOL(HOHâJIbHOTO KOHTpOJIA MO)KeT npHSeCTH

K npOABneHHIO )KeCTOKOCTH no OTHOnIeHHK) K J(pyrHM (Martin 1992).AJIKOrOnb HMeeT cyLgecTSeHHOe OTHOIUeHHe K HaHeCeHHIoyMbllIIneHHbIX nOBpeNCJJeHHr%I ce6e H cosepuleHHio caMOy6HfrcTB(Murphy and Wetzel 1990; Hawton et al. 1989). HepeJJKHMnocneJJcTBHeM JJnHTenbHOro 3noynoTpe6neHH2 anxoroneM ABnAeTCAKpaTKOSpeMexHaA noTepA naMATH H, pe)Ke, 6onee onpeJjenexxaAKapTHHa cna6oyMHA (Lishman et al. 1987). ATIA 60nbHHl[ 3HaKOMbI,XOTA McHee H3BeCTHbI cpeJJH Hâ.ceneHHA, TaKHe CHHJJpOMbI, KaK 6enaAropA'IKa, aJIKOTOnbHble raJInK)LJHHaLJHH, npHCTynbl a6CTHHeHL(HH(Isbell et al. 1955; Schuckit 1985). AnKOronbaaA 3aBHCHMOCTbABRAeTCA OCHOBHbIM nCHXO6HOJIOrH'recKHM OCJIO)KHeHHeM, KOTOpOe

MO)KeT 6bITb CneJJCTBHeM 'Ipe3MepHOro ynoTpe6ReHHA anKOrORA,npHBOJJALqerO 3aTCM K COXpaHeHHIO 3n0ynOTpe6neHHA anKorOneM C

10

nOCne,ayEOLLIHM pHCKOM BO3HHKHOBeHHSI COOTBeTCTByEOLLiHX npO6neM

(Vaillant 1983).

COL[HanbHble npo6neMbl, S1BnSIlOLI[HeCSI pe3ynbTaTOM nOTpe6neHH2

anKOTOnSI, BeCbMa MHOT04HCneHHbI. CIO,L1a BXO,T15IT HeyZ[a4H Ha pa6oTe,

nporynbl, yBOnbHeHHe, 6e3pa6oTHga H HCC4aCTHble Cny4aH Hapa6o4eM MecTe (Pratt and Tucker 1989; Stallones and Kraus 1993).BbInHBKa MonKeT npHBeCTH K JjonraM, )KHnHLLjHbIM np06neMaM, HnH, B

KpaHHeM cny4ae, K HHLneTe (Baumhol 1987; National Institute onAlcohol Abuse and Alcoholism 1989). B3aHMOCB5I3b MexcayanxoroneM H npecTynneHHSiMH o4exb CRO)KHa, H BonpocnpH4HHHOCTH J);On)KeH 3,E1eCb paCCMaTpHBaTbCSI C 00060I%I

OCT0p0)KHOCTb10, HO anKOronb, npslMO HJIH KOCBeHHO, BOBRe4ëH Bpâ3nH4Hble THnbI npaBOHapyLLIeHHE4, BKnEOLIaSI HaCHnbCTBeHHble

npecTynneHHSI (Pemanen 1991) H, KOHe4H0, BoxcaeHHe aBToMo6Hnsl BHeTpe3BOM COCTOSIHHH (CM. rnaBy 7).

IIp06neMbl, KOTOpble 1-1bIOLLal1i 4enOBeK CO3,4aeT Ansl ApyrHxnK)I(e17, 06bI4H0 BKnlOtialOT npslMOe B03AeFiCTBHe Ha Cynpyra H AeTei%I

B nnaHe nCHXH4eCKOl%I HJIH (pH3Hi-IeCKO'n TpaBMbl (Martin 1992), aTaKNCe OCJIO)KHSIeT MX 06pa30BaTenbHyie, COIjHânbHyiO H CpHHaHCOByiO

AeATenbHOCTb (Sher 1991). 3JJecb TaK)Ke 4aCTO MO)KeT npHCyTCTBOBaTb3neMeHT npH4HHeHHSI HeyJj06CTB, Bpega HnH 3aTpaT J>nx BCeX 4neHOB06LLlecTBa - HanpHMep, )KepTBbi nbSIHbIX BO,gHTeneN HRH HaCHnbCT-BeHHbIX npeCTynneHHN HIM TOBapHIu no pa6oTe, CTaBLLIHN

y4aCTHHKOM npOH3BOJjCTBeHHOÎ-i asapHH, BO3HHKllIeÎI no BHHe

anKOTOnSI. PI, B 3aKnE04eHHe, B J>,aHHOM pa3,gene "npo6neMbl Jxns[OKpy)KaIO1.ImX" Hy)KHO OTMeTHTb TOT OrpOMHbIEi naCCHB wI51

06n(eCTBa, KOTOpbIIi HaKannHBaeTCA B pe3ynbTaTe CyMMHpOBaHHSIBceX 3aTpaT: Ha COIjHanbHyEO 3an1HTy, Cny)K6bI 3JIpaBOOXpaHeHHSI,

cTpaXOBaHHe, CHCTeMbI Ha6nEOJ);eHHSE 3a Co6nEOJjeHHeM 3aKOHa HHCHORHeHHSI HaKa3aHHN, KOTOpble CB5I3aHbI C nbSIHCTBOM, a TaK)Ke3aTpaTbi, KOTOpble SIBRSIEOTCSI pe3ynbTaTOM CHH)KeHH31 npOH3BOJ);H-

TenbHOCTH TpyAa (Rice 1993). rIo3xce B 3TOï-1 rnase 3TOT BonpocnOJ);HHMaeTCSI BHOBb.

MO)KHO 6bIR0 6b1 B nOCneJjylOHjHX naparpaltaX paccMOTpeTb 3T0BCë Ha 60nee aeTanbHOM ypOBHe, HO TaK)Ke HennOXO OTCTynHTb HB31-n5lHyTb Ha MaTepHan C 601Iee 0611161 TO4KH 3peHH51. B H3R0)KeHHH,

KOTOpOe CTeCHeHO Hay4HbIMH ClCsOpManbHOCTSIMH, He 6yJa;eT HeBepHbIM

HanOMHHTb ce6e, 4TO nOJj a6CTpaKTHbIM nepe4HCneHHeM CKpbITblpa3nH4Hble CTeneHH H B14):1bI 60ne3HeÎ7, HeC4aCTHEi, nOTepb, 6onH,

11

nHLUeHHt-i, caMoyHHxceHllA, pa3pyluenHA ceMbH, HaneceHHA pannpyrl-1M H pa3pyuleH41. MHorHe cTpanaHl-lA eutë 6e4lopMeHHb1 NTOn6KO O6O3HaLIH11iiCb.

1.3.3 KoHueHrpauNA npo6neM B npe,genaxHenocpe,gcTBeHHOro Onblra oTAenbHoN nN4HOCTNNMI BO BpeMeHN

gaHHble OnpOCOB BbI51BH1114 HCKOTOpbIX n104erl, KOT0p6Ie

yTSepxcnanH, 1ITO B TeileHNe 12 MeCALteB no HHTepBb1O OHHCT0J1KHynliCb TOnbKO C 04H0N, H3OJI14pOBaHHOIi npo6neMoH,CB513aHHOI4 C ânKOrOneM, B TO BpeMA KaK pyre COO6LLtalOT, 9TO 3a3T0 we BpeMA OH14 CTOJIKHyniiCb C HeCKOn6KHMi1 H11 14 MHO>KCCTBOM

TaKI-lx npo6neM (Clark and Hilton 1991). Pe3yJIbTaTbl onpoca cpenHBCeX Bo3paCTOB HaCeneHHA nOKa3bIBaFoT, LITO nnA 60nbLner' iIaCTHn0406H6IX npo6neM TaKOIi OnbIT CKOpee OTHOCHTC5I K enHHIiIHbIMnp06neMaM H11l1 npOABneHi-tAM, H1114, BO3M0>KHO, K 2 HIM 3 npo6neMaM,

LIeM K COBMeCTHOMy npOABneHHiO MHOrHX npo6neM B TeLleniienaHHOro nepLtOna BpeMeHH. He y BCeX, KTO 1iCn6lTblBân LtenblÎ-i pAnnpo6neM B Te4eHtie 12-MCCALlHoro nepHOna, OHH 6y4yT B03HHKaTb BnocneAyioLgHe 12 MecALtes (Room 1977).

Onpochi Bce xce, OJ.IHaKO, OnpenenAtoT HexoTOpoe KOnHHecTB0pecnoHneHTOB, KOTOpble CTOJIKHynHCb C MHO>KeCTBOM npo6neM BTelleHlie OnpeneneHHOPO peTpOCneKTHBHOrO nepllona. Wyllie andCasswell (1993), HanpHMep, npeACTaBnAIOT naHHble npoBeneHHOrO B1988 r. B HoBal 3enaHAHH Ha14HOHanbn01-0 onpoca o noTpe6neHlaHanKOrOnA. OH11 BbIABiinH rpynny MOJ1OnbIX My>KilHH, KOTOpble MHOFO

nblOT, CTanKliBatOTCA C MHO>KeCTBOM npo6neM Ii o6ecnOKOeHbI 3THM.

CylitecTByeT rpynna nbloLLtYIX ntoneN, KOTOpb1e nonroe BpeMAnponon>KaIOT CTanKHBaTbCA CO MHO>KeCTBOM nHLIHbIX npo6neM,CB513aHHbIX C B6IHI3BKOFI, B TO>Ke BpeMA, BO3MO>KHO, npHHHHAAMnoxceCTSO npo6neM npyrHM 11 10451M (Robins and Regier 1991).CKopee Bcero, 6onbulaA 4acTb TaKHX nbIOLItNX ntoneti cTpanaeTanKOronbHON 3aBHCHMOCTb10 H, TaKHM o6pa3oM, BCe 6o11bine li

6Onbllle nonanaeT B noByWKy TpynHOHCKOpeHHMON npHBbILIKFI

3noynoTpe6neHNA anKOroneM, KoTOpaA H3 rona B moil nponon>KaeTnopo>KnaTb npo6neMy 3a npo6neMori (Edwards 1989).

ECnH KOHLteHTpaLtHA npo6neM - 3TO ABneHHe, KOTOpOe MO>KeT6bITb BbIABneHO no pe3ynbTaTaM OnpocoB, OHO TaK>Ke 3HaKOMOpa6oTHtiKaM COLtlianbHOro 06eCneLIeHHA H KJ1HHtiK. AIN ceMbH,

12

KOTOpaa 6opeTC5I, 1-1b1TaSICb npeOAOneTb XpOHHMeCKYIO anKOrOnbHYIO

3aBHCiiMOCTb, (paKT, iITO np06neMbl He npHXOAAT B OAHHOMKy,SIBnSIeTCSI OtieBH,gHbIM. FOCyAapCTBeHHaa nOJIHTHKa JjOn)KHa, TâKHM

o6pa3oM, 6bITb aApecosaxa ABYM peaJIbHOCTSIM: eAHHHMHOMy,

peAKOMy B03HHKHOBeHHiO OT,genbHbIX npo6neM H (paKTy KOHI.(eH-Tpalji4H HRH IIOCTOSIHHOro nOSIBneHHa npo6neM.

1.4 YCTAHOBJ1EHHbIE PE3YJ1bTATbI O PACIIPOCTPA-HEHHOCTN VI CTOVIMOCTVI CB5I3AHHbIX C AJ1KO1"OJ1EMI1PO6J1EM: HEKOTOPbIE ME)K,gYHAPO,gHbIE,gAHHbIE

B 3TOM pa3Aene MbI nOnblTaeMCa yCTaHOBHTb KapTHHy CTOH-MOCTH, B IIIHpOKOM CMbICne 3TOT0 CJIOBa, aJIKOrOnbHbIX np06neM Ana

061ueCTBa. He,LiaBHI3e o630pbi, o6pHcosblBalolgHe MexcAyxapoAHylonepcneKTHBy n0 AaHHOMy BOnpOcy, MO)KHO HaFiTH B Giesbrecht et al.(1989) H Helzer and Canino (1992). TeM He Mexee, COOT-

BeTCTBY1011lHe BCeCTOpOHH14e MHpOBb1e AaHHble, Ha KOTOpble MO)KHO

6bI1I0 6b1 OnFipaTbCSI, OTCyTCTByIOT. B OCo6eHHOCTi3 Onjyn(aeTCaHeXBaTKa AOCTOBepHOIi IiH(tlOpMaljliH 143 pa3BNBaIOU.(lixcx cTpaH, 133BOCTO4HOli EBpOnbt, 143 peCny6nHK 6blBlnerO CCCP. CpaBHeHHepa3n14MHbIX CTpaH 3aTpy,gHeHO 143-3a pa3HHIjb1 B OnpeAeneHHaX,oT6ope MaTepHanoB 14 B MeTOAi1Ke c6opa AaHHbIX. BpeMeHaMH, n0pâ3nHMHbIM npHMHHâM BO3HHKaeT CKJIOHHOCTb K Hej[OOneHKe.CyLI[eCTByeT, OZjHaKO, Taxxce OnaCHOCTb pa3AysaHHa npo6neMb1.IIpHMeHaeMble B onpocax OnpeAeneHl3a "anKOronH3Ma" HHOrAa BeCbMaHeT01-11-IbI, B pe3ynbTâTe nocne,IjyloujHe OIjeHKH pacnpOCTpaHeHHaBbIrnaASIT Hey6eAFiTenbH0. 3aTpaTb1 MOryT 6bITb npeyBenHMeHbI(Helen and Pittman 1993; US Secretary of Health and HumanServices 1994). IIpHt114HHbIï-1 B1U1aA anKOrOna no OTHOIUeHH10 Kn106oÎ4 AaHHOÎ3 naTOnorHH HnH CO6bIT141O LIaCTO Tpy,aHO onpe,genHTbTOMHO.

B CB5I314 C 3THMH, a TaK)FCe ApYr11MH npHMHHaMH, MbI XOTHMnpe,I(OCTepeMb npOTHB Mpe3MepHO YBepeHHbIX HHTepnpeTanHI%I

n1060TO OTJjenbHOCO OTpbIBKa 143 TO1i KapTHHbI, KOTOpaa OHHCbIBaeTCa

HH)Ke. ITpHBO,aHMble IjH(tipb[ MaCTO JlyMUle paCCMaTpHBaTb Kai(

OpHeHTHpOBOMHble, MeM KaK HOJIHOCTb10 HaAe)KHble. B TO )Ke BpeMa,HeCMOTpa Ha ee He3aBepuIeHHOCTb, npOSlBnaeTCa KapTHHa, KOTOpaanOATBep)KAaeT npeAnOJlO)KeHHe, LITO Ana MHOTHX cTpaH anKOTOnbCO3AaeT KpynHble H pa3HOO6pa3Hble np06neMbl, Tpe6yK)ujHe 3aTpaT.

13

Heo6xoAHMa ropa3Ao ny'IHIaA 6a3a MexcAynapoAHblx AaxHbix, HoOnHpaACb Ha yxce HMeIOIIjHeCSI (PaKTb1, 661110 6b1 TpyAHO yTBep>KAaTb,

'ITO npo6neMHble BOnpOCbl AaHHoii KHHrH TpHBHâJI6HbI.

1.4.1 LbNppo3: pa317N4Hb1@ ypOBHN CM@pTHOCTN Bpa3J1N4HbIX CTpaHaX

CMepTHOCTb B pe3ynbTaTe IjHppo3a ABnAeTCA Cne,IICTBHeM

3noynOTpe6neHHA anKorOneM (Smart and Mann 1992), HO Hen6351paCCMaTpHBaTb eë C nORHOÎd yBepeHHOCTbiO KaK nOKa3aTen6 BCeXTHHOB anKO1-0116H6IX npo6neM. bOnee TOTO, Heo6XOAHMo nOMHHTb,'-ITO A01151 o6HjeH ItH(i)pbI CMepTHOCTH B pe3ynbTaTe mHppo3a, rJjenpH'IHHOÎI ero BO3HHKHOBeHHA 66111 anKOronb, H IjNpp03a,BO3HHKIHerO no ApyrOii npH'iHHe, MO)KeT BapbHpOBaTbCA OT CTpaH61 K

cTpaHe. CMepTHOCTb B pe3ynbTaTe IjHppo3a, TeM He McHee, ABJIAeTCAInFipOKO HCnOnb3yeMbIM BHAOM CTaTHCTH'IeCKHX AaHHbIX, aCpaBHeHHA 11O3BOJIAIOT OnpeAenHTb CTeneHb pa3nHVHH MexcAy

CTpaHaMH B ypOBHe npH'-IHHAeMOrO anKOroneM BpeAa. CynjeCTByeTMHOTO cTpaH, rAe perynApH61N c6op HaAë)KHbIX AaHHbIX 0CMepTHOCTH B pe3ynbTaTe gHppo3a HnH RI06bIX Apyrl,ix npH'iHHCMepTH He ocynjecTBRAeTCSI, 1-103TOMy MM He CMOrnH npHBeCTHCTaTHCTHKy no CMepTHOCTH B pe3ynbTaTe IjHppo3a AJIA pecny611HK6blBnlero CCCP, 6011bHIHHCTBa A3HaTCK0r0 H THXOOKeaHCKOroperHOHOB, A(pHKH H OTHOCHTenbHO MHOTHX CTpaH JIaTHHCKOilAMepHKH. I'IMe10HjHeCA AaHH6Ie npeACTaBneHbl B TpëX OTAeJI6HbIXTa6RHIjaX 1.1, 1.2, 1.3. B Ka)KAOM Cny'Iae H ARA COXpaHeHHABO3MO)KHOCTH CpaBHHBaTb npOH3BeAeHa cTaHAapTH3aCjHA n0eBponeFicKONI 6a3e HaCeneHHA. Mbl KpaTKO HpOKOMMeHTHpyeMKa)iCAyIO 1-13 3T1,IX Ta6RHLj B OTAenbHOCTH.

Ta6nnua 1.1 npeAcTaBnSIeT pacnono)KeHHbie B nopAAKey6bIBaHHA AaHHb1e n0 CMepTHOCTH B pe3y116TaTe LjHpp03a H3 24 CTpaH

EsponericKoro perHoxa B03. Heo6xoA14M0 nOMHHTb O BO3MO)KHOMBRHAHHH HaI1HOHanbH6IX pa3HOBHAHOCTe11 npoljeAyp61 ocBHAe-

TCnbCTBOBaHHA CMepTH. ypOBHH o6HjeH CMepTHOCTH BapbHpyIOTCA OT

HaHB6ICIIIerO 54.8 (BeHrpHA) AO CaMoro HH3KOT0 2.9 (I'IpnaHAHA). HeTOnbKO 3TH ABe Kpa17HHe H03HI1HH, HO H CaMO pacnpeAeneHHe BIjenoM, rOBOpHT O LIpe3Bb1'IaÎdHOi1 CTeneHH pa3nHLIHN MexcAy

CTpaHaMH. HOpSiAOK pacnonoxceHHA CTpaH OT BbICOKOTO ypOBHA AOHH3KOTO He MO)KeT 067551CHATbC51 B11HAHHeM TOR6KO oAHOTO 4)aKTopa:

cTpaHbl, rAe pacnpoCTpaHeHO noTpe6neHHe ruina HnH BHHa, MoryT

14

Ta6n4ua 1.1. Espana: Kornl4ecTBO cMepTen B pe3ynbTaTeuvlpp03a Ha 100 000 HaCeneHV1A, CTaH,C;apTN3al.l,V1A BO3paCTa HaeBponeHCKOe HâCeneHVle, pacnon0)KeHV1e or BbICWerO noKa3a-TenA K HV13WeMy. CTaTNCTN4eCKV1e AaHHble npe,f>,CTaBneHblB03, ?KeHeBa.

CTpaHa rO,g O6ü{HN CTaH,gapTN3HpOBaHHaA CMepTHOCTb

ypOBeHb MyNC4HHb1 N(eHülHHblM/NC COOTHO-

WeHHe

BeHrpllsa 1991 54.8 79.7 32.6 2.4

PyMbIH113:1 1991 38.1 47.5 28.8 1.6

repMaHllsa (MP) 1991 33.7 49.7 19.4 2.5

ABCrpllsa 1992 28.2 41.2 16.4 2.5

Vlrantlsa 1990 26.8 31.7 18.0 1.8

nopryranllsa 1993 26.9 39.3 15.1 2.5

4exocnoeaKHSa 1991 25.1 38.1 13.4 2.8

repMaHUSa, (cDPr) 1991 22.2 30.4 14.6 2.1

V1cnaHllsa 1989 21.0 30.0 12.9 2.3

J11OKceM6ypr 1991 18.7 21.9 15.4 1.4

6bIBw. 10rocnaBllsa 1990 18.4 27.7 10.2 2.7

OpaHullsa 1991 17.0 23.3 10.6 2.2

6onrapllsa 1991 15.0 22.0 7.8 2.8

flonbwa 1991 13.9 19.1 9.2 2.1

6enbrHA 1987 11.9 14.4 9.5 1.5

m11HnAHANA 1992 10.7 15.3 4.2 3.6

WBeHuapllsa 1991 9.5 12.9 6.1 2.1

ManbTa 1991 9.0 14.0 3.9 3.6

rpeuvw 1990 8.9 12.1 5.8 2.1

V13pallnb 1989 8.7 10.3 7.0 2.5

WBey119 1990 6.8 8.8 4.7 1.9

Ben11KO6pNraHlnA 1991 6.1 6.9 5.3 1.3

H11AepnaHAb1 1991 5.1 6.3 3.9 1.6

Hopei-on 1991 4.4 5.4 3.3 1.6

VlpnaHAllsa 1990 2.9 3.1 2.7 1.1

15

HMeTb BbICOKi7rl ypOBeHb; CaMble BbiCOKHe nOKa3aTenH Ha6nfO,gaK)TCA

KaK y CTpaH 143 BOCTOLIHOii, TaK H 143 3ana,lZHOii EBpOnbl; ,qse CaMbIXHH3KHX uHCtipbI npHXOAATCA Ha npOTeCTaHTCxyK) (HopBerHA) 14 HaKaTOnHLIeCKyiO CTpaHy (14pnaHAHA). COOTH011IeHHe My)KLIHHbI/

)KeHIL[HHbI KOne6nIOTCA OT 3.6 (OHHnAH,TjHA H TaK)Ke ManbTa) AO 1.1

(HpnaHAHA). He cyulecTSyeT CHCTeMHoro, HayL1HO AOcTOBepHOroaHanH3a, 6e3 COMHeHHA, MHOT0HHCneHHbIX 061ACHeHH1%[ npHIiHH3T01'O pa36poca HauHOHanbHblX ,IZaHHbIX O CMepTHOCTH, H MbInpeAnaraeM ,tIaHHble TaKHMH, KaK OHH eCTb.

CTaTHCTHHeCKHe ,gaHHble o6eHx AMepHK H CTpaH KapH6cxoroperHoxa (Ta6nHua 1.2) BHOBb nOKa3bIBaIOT 6onbmHe pa3nHHH51Me)K,gy cTpaHaMH, He XBaTaeT AaHHbIX 143 MHOrHX rocyAapcTS, HCTâHAapTH3auHA Ha 6a3e eBponeiiCKOrO HaCeneHHA MO)KeT 6bITbMcHee HeM yAOBneTB0p14Ten1)H0N AnA HeKOTOpbIX npHBeAeHHbIX BTa6nHue cTpaH. CTpaHbl .T1aTHHCKOI7 AMepHKH npHBOAAT 6oneeBbICOKHe AâHHb1e o6 ypOBHe CMepTHOCTH B pe3ynbTaTe LjNppo3a, HeMCHIA H KaHaAa, B TO BpeMA KaK Ase CTpaHbl KapH6CKOT0 perHoHa,r,qe eCTb COOTBeTCTByiOLuHe AaHHble, HaXOAATCA B HH)KHeli HaCTHTa6nHL1bI (TpHHHAa):1 H To6aro, Ky6a). COOTHOIIIeHHe My)10HHH6I/)KeHI1IHHb1 KOne6neTCA OT 4.0 (1.1y3pT0-PHKO) Ao 1.2 (Ky6a).

B 3aKniOHeHHe 3TOIi CepHH Ta6nHua 1.3 npeACTaBHT AaHHble oCMepTHOCTH B TpëX CneAyiOluHX CTpaHaX: AnOHHA, ABCTpanHA 14HOBaA 3enaHAHA, BHOBb C pâ36p000M uN(Dp no 06LueI%I CMepTHOCTH HcoOTHOU1eHHI0 11OJ10B rAe-TO B npeAenax cpe,gxero ypoBHA.

L1TO )Ke Hy)KHO CAenaTb C 3THM14 O6UIHpHbIMH, HO BCë eiuëHeAOCTaTOHHO nOJIHbIMH AaHHbIMH HaLjHOHânbHbIX CTaTHCTHK n0CMepTHOCTH B pe3ynbTaTe uHppo3a. yBepeHHoe 06Luee yTSep)FUjeHHeAOn)KHO COCTOATb B TOM, HTO eCnH B3ATb B KaHeCTBe noKa3aTenAypOBeHb CMepTHOCTH OT uHppo3a, pâ3nHHHb1e CTpaHbl HCnbiTb1Ba1OTnOpa3HTenbHO pa3HbIN ypOBeHb OTpHL(aTenbHblX HOCneACTBHi3

nOTpe6neHHA anKOronA. Pa3HHL[a MeNCAy BeHrpHeM H 1'1pnaHAHeiïABJIAOTCA nOHTH 20-KpaTHON, HO MbI MO)KeM npeAnOJIo)KHTb, HTOCpeAHHH rpaxCAaHHH ni060Fi CTpaHbl B paBHOM CTeneHH OAHHaKOBO HeOCO3HaeT 3THX 4ClaKTOB.

16

Ta6nHL4a 1.2. AMepInKln In cTpaHbl Kapin6cKoro perHoHa:KOnN4eCTB0 CMepTeVt B pe3ynbTaTe L{lnppo3a Ha 100 000HaCeneHV1A, CTaHAapTN3aLlVIA B03paCTa eBpOrIeV1CKOroHaCeneHNA, pacflOnONCeHHe OT BbICWerO IlOKa3aTenA K

H1n3WeMy. CTaTNCTw-IeCKlne ,gaHHble Ilpe,gCTaBneHbl B03,iKeHeBa.

CTpaHa Fog O6LLptNypOBeHb

CTaH,gapTN3NpOBaHHaACMepTHOCTb

My)K4HHbI )KeHLl{NHblM/H(

COOTH.

McKCHKa 1990 48.6 72.5 21.8 3.3

4HnH 1989 46.2 67.5 26.5 2.5

flyspro PHKO 1990 29.7 47.2 13.5 4.0

3KBa,qop 1988 21.7 28.7 14.1 2.0

Kocra PHKa 1989 20.4 26.7 13.1 2.0

BeHecysna 1989 19.4 28.6 9.6 3.0

ApreHrHHa 1989 13.3 20.1 6.4 3.1

TpHHHqa,q H 1989 13.2 19.6 6.7 2.9To6aro

Ky6a 1990 12.4 13.3 11.3 1.2

flaHaMa 1987 11.6 14.2 7.7 1.8

CWA 1990 11.6 15.2 8.0 1.9

Ypyraal7 1990 11.5 17.5 6.8 2.6

KaHaqa 1990 9.3 12.7 5.8 2.2

L-ITO KaCaeTCA COOTHOWeHHA My>K4411ibli)KeHLL[HHbI, 6onbWl-lepa3nH4HA Me>Kgy CTpaHaMH CBHZ[eTenbCTBylOT O TOM, 4TO CTpaHblpa3nH4alOTCA He TOnbKO no o6LueMy KOnH4eCTBy CBA3aHHbIX CnoTpe6neHHeM anxoronA npO6neM, HO no LiX pacnpe,iZeneHiilo MemutyCnOAMH HaceneHHA. Ha6nlo,IjaeMble pall-LW-MA B nonoBblXCOOTHOWeHHAX HaCTON414Bo nojjCKa3bIBalOT, 4TO Heo6XO,llNMO HCKaTbCOL[HanbHble, KynbTypHble, 3KOHOM144eCKHe Id HCTOpH4eCKHe

17

Ta6nHua 1.3 FInoHVIA, ABcrpanrlA vl HoBa9 3enaH,gHR:KOnV14eCTBO CMepTeVl B pe3ynbTaTe uvlppo3a Ha 100 000HaceneHV1A, CTaH,gapTVl3amV1A B03paCTa Ha eBponeVlCKoeHaceneHVle, pacnono)KeHme or BbICWVIX noKa3arene0 K

HV13WViM. ,qaHHble npe,gOCTaBneHbl B03, WeHeBa.

CrpaHa Fog O6WHl1ypoeeHb

CTaHAapTH3HpOBâHHaACMepTHOCTb

My)K4HHbI )KeHüAHHbiM/)IC

COOTH.

SinoHt7sl 1991 13.4 17.7 9.1 1.9

ABCTpantnA 1988 8.1 11.7 4.2 2.8

HoBasl 1989 3.7 5.2 2.4 2.23enaH,gtnsa

06135ICHeHH51 pa3HHL(bI B ypOBHAX CMepTHOCTH MexcAy My)K4HHaMH H

)KeHLqHHaMH, a He npOCTO 6140n0r144eCKHe np144HHb1 y513BHMOCT14. B06ll[eM, 3TH Ta6n1411bI CaMH HO ce6e ABHO 11oKa3blBaIOT, 4TO, BHe3aBHCHMOCTH OT CTpaHbl, K011H4eCTBO CB5,13aHHbIX C ânKOTOneM

HaL[HOHanbHblx np06neM He 5IBnAeTCA sceo6U.jHM H HeH36e)KHbIMIbaKTOM. 3T0 He "AâHHOCTb".

1.4.2 PacnpocrpaHeHHocTb anKOronbHblx npo6neM HanKOronbHOH 3aBHCHMOCTH B 06u{eN nnacce HaceneHHA

CaMble nOnHble HCCneAOBaHHA no 3TOMy BOnpOCy npOBOAHnHCb

B CILIA. Hej1,aBHee BcecTOpoHHee 3nmkeMHonorH4ecxoe H3y4eHHe,npose,IjeHHOe B 3TON cTpaHe, BKnI04aeT B Ce6A "3nHAeMHonorH4ecxoeN3y4eHHe HCTOKOB", KOTOpOe 6pan0 ,gaHHble B WITH Bb16paHHbIXreorpaciH4ecKHx 3oxax (Robins and Regier 1991). B 3TOM H3y4eHNHnpHMeHAnHCb AHarHocTH4ecKHe KpHTepHH DSM-III (AmericanPsychiatric Association 1980), H 6bIn0 BbIACHeHO, 4TO B Te4eHHe BCeH)KH3HH np06neMbl, CB513aHHble CO "3noynOTpe6neHHeM anKOrOneM","anKOTOnbHON 3aBHCHMOCTbI0", HnH H TeM H ApyrHM, BO3HHKânH y23,8% Myxc4HH, 4,5% )KCHLI1HH H 13,8% B O61i(eM, B TO spew' KaK B

Te4eHHe oAHOrO rOAa np06neMbl B03HHKanH COOTBCTCTBeHHO y11,9% My)K4HH, 2,2% )KeHIAHH H 6,8% B 06meM. Bo BCeMHpHOMMaCLHTa6e anKOTOnbHbIX npo6neM, CHIA MONCHO Hâ3BaTb CTpaHOFI

18

cpenHero ypoBHA (cM. Ta6nH1ry 1.2). CAenaxxaA B naxxoMHCCnenOBâHHH OueHKa 4aCTOTbI B03HHKHOBeHHA anKOI'OnbHbIXnpO6neM B Te4eHHe BCe1%I )KH3HH npeAcTasnSIeT OCO6bIFi HHTepeC,pa3pymaA npencTasneHHe, 4TO BO3HHKHOBeHHe KpynHblX nH4HbIXanKOrOnbHbIX np06neM - peAKHti1 cny4ali. gOnoJIHHTenbHble AaHHbleaHanH3a HauHOHanbHOrO onpoca CHIA no 3,gpaBOOXpaHeHHK) 1988 r.(B.F. Grant et al. 1992), xorna 6bino onpomeHo 6onbmoe KOnH4eCTBOHaceneHNA no BOnpOCaM HanH4HSI y HIiX "anKOCOnbHOr%I

3aBHCHMOCTH" H "3noyn0Tpe6neHH51 anKOroneM", HCIIOnb3yAKpHTepHH DSM-III-R (American Psychiatric Association 1987),nOKa3anH, 4To arm BO3HHKmHX B Te4eHHe OAHOro rona npo6neM3aBHCHMOCTH H 3noynOTpe6neHHA, B351T61X BMecTe, cOOTHOmeHHe

My)K4HHbIbKeHII[HHbI COCTaBJIAeT 3 K 1 (13,4% K 4,4%). He MexeeHHTepeCHOM 6b1na BbIABneHHaA BO3paCTHâA rpanaL(HA: HanpHMep,pacnpOCTpaHeHHOCTb npo6neM OAHOro rOAa 6bina ,qnA My)K4HHBo3pacTa 18-29 neT - 23,5%; Bo3pacTa 30-44 neT - 14,3%; Bo3pacTa45-64 neT - 7,2%; Bo3pacTa 65 H Bblme - 2,8%. BbIBOjj, 4TO ypOBeHbpacnpocTpaHexxoCTH noA06HbIX npo6neM nagaeT C Bo3paCToM,no,lIaep)KaH B mHpoxoFi Macce aMepHxaxcxoN nHTepaTypbl noonpocaM (Cahalan et al. 1969; Cahalan and Room 1974; Clark andHilton 1991).

06paLLlaACb OT aMepHKaHCKOI'O OnbITa K OnbITy pâ3BHBaIOII(HXCAcTpaH, MO)KHO CKa3aTb, 4TO npOBeAeHHblli B KoJlyM6HHHaL[HOHanbHbIN AOMamHHN onpoc, rne AnA OnpeneneHHA HanH4H2npo6neM HCIIOnb30BânHCb aHKeTbI CAGE, co06LIlaeT o no4TH 20%HanH4HH ânKOrOJIH3Ma CpeAH My)ICCKON 4aCTH peCHOHAeHTOB H O 4%

pacnpocTpaxeHHH nono6Hblx npo6neM cpeAH xceHLgHH (Rodriguez etal. 1992).

HeKoTopble ;taHHble HeaaBHero onpoca B H0BO1i 3e1IaHAHHnpnEeAexbl B Ta6nHue 1.4, rAe BOCnpoH3BeJ'lexbl pe3ynbTaTbl H3,goxnaAa Wyllie and Casswell (1989). PacnpocTpaHeHHocTbanKOrOnbHbIX npo6neM naHa OTAenbHO AnA My)IC4HH H AJIA )KeHLI(HH.11TO AOnNCHO C4HTaTbC5I "Cepbë3H01%I" npo6neMOI3, 3T0, KOHe4H0,BonpoC Cy61,eKTHBHbIN, HO 10%-1-i ypOBeHb pacnpocTpaHeHHOCTHnpo6neM cpeAH My)K4HH, KOTOpbIN MbI BHAHM B AOKnaAe, KOHe4HO,He MO)KeT 6bITb pacL(eHeH KaK He3Ha4HTenbHbli4. KOrna 9% My)K4HH

c006II[aK)T, 4TO nbK)T C ppa, a y 5% My)K4HH TpACnHCb pyKH yTpOMnocné BbInHBKH, MO)KHO COCTaBHTb npencTasneHHe O BO3MO)KHOi3

19

Ta6nruua 1.4. PacnpocrpaHeHHocTb anKOronbHbix npo6neM,BO3HVIKWVIX B Te4eHVle npe,qblgyL.LlVIX 12 MeCAIieB, Bo3paCTOnpOWBHHbIX 14-65 neT, N3y4anacb rpynna HaCeneHVIFI HOBOVI3enaHAVIVI.

OulyulanH BnHAHHe BbInHTOfO HaKaHyHe anKOronA

OutyuWanH BnHAHHe anKoronA BO BpeMA pa6orbl,y466bl, AoMawHel pa6orbl

npocbinanHcb Ha cneAyloulHN AeHb H He MornesBCnOMHHTb, 4T0 AenanN BO BpeMA BbInHBKH

6bI110 CTbIAHO 3a Te nOCTynKH, KOTOpble COBepWHnH BnbAHOM COCTOAH1114

561110 BOBne4eHbl B Cepb23Hble CCOpbI nOcne BbInHBKH

VIHOrAa HanHBanHcb, KOrAa 6bInH cepbë3HblenpH4HHbI0CTaBaTbCA Tpe3BbIM

Ou1Yu4anH, 4T0 A0111KHbl COKpaTHTb nOTpe6neHHe HnH6pOC61Tb COBCeM, HO He MOrnH

BbInHBanH cpa3y, KaK TOnbKO npocbinanHcb yTpOM

O6Hapy»14n14, 4T0 HyN(!(aIOTCA B 6o11bWeM KOnH4eCTBeanKoronA 4TO6bl AoCTH4b Toro we 3CO(iDeKTaOnbAHeHHA, 4TO H paHbwe

OTCYTCTBOBanH Ha pa6Ore 143-3a BbInHBKH

YTpOM nOCne BbInHBKH TpACnHCb pyKH

n OnaAanH B ApaKY H3-3a BbInHBKH

nOnaAanH B aBTOM0614nbHyK) aBapHK) H3-3a TOM, 4T06bI11H B HeTpe3BOM COCTOAHHH

OCTaBanHCb B COCTOAHHH OnbAHeHHAHeCKOnbKO AHeN

Bpa4N roeopHnH, 4T0 BbmHBKa nnoxo BnHAeT Ha Bawe3AOpoBbe

npeAnafanocb yb1TH H3-3a BbInHBOK

n OnaAanH B Hec4aCTHble Cny4aH Ha pa60Te, y4ë6eHnH AoMa nocne BbInHBKH

Hcmouxux: Wyllie and Casswell 1989.

20

MykMHHbI14-65 ner

(K011-BO 799)

)KeHU.IHHbI14-65 neT

(K011-Bo 881)%

46 29

28 14

22 10

16 9

12 8

10 4

9 6

9 1

8 2

5 1

5 2

5 1

4 1

3 1

3 1

3 1

2 1

pacnpOCTpaHeHHOCTH aJIKOrOnbHON 3aBHCHMOCTH cpeAH My)K4HHAaHHOro HâceneHHA: KOrAa COOTBeTCTBeHHO 1% H 2% )ICeHLuHHOTBe'-Ia1OT Ha 3TH we ABa BonpOCa yTBepAHTenbHO, pa3HHua cpeAHnOJIOB CTaHOBHTCA 04eBHAHOii. 3TOT onpoc TaK)ICe nOKa3an, 4TO 32%My)K4HH H 6% )iCeHII[HH (o6LuaA uHCppa 18,9%) CTanKHBâJIHCb Cnp06neMaMH 3noynoTpe6neHHA HnH 3aBHCHMOCTH B Te4eHHe )K13H14.gamme OnpoCOS no,qo6HOro poAa, BHe 3aBHCHMOCTH OT CTpaHbI,HMex)T yCT04I1INBy10 TOHAeHuHIO yKa3b1BaTb Ha CneKTp, pa3HOO6pa3He

H pacnpoCTpaHeHHOCTb anKOrOnbHbIX np06neM cpeAH HaCeneHHA.

1.4.3 CnnepTHOCTb B pe3ynbTaTe noTpe6neHNSi anKoronA

KonlelecTBO cMepTeii B pe3ynbTaTe "anxoronH3Ma" HnH

"anKoronbHOro nCHXO3a", HnH B pe3ynbTaTe TaKHX LIacTO CBA3aHHbIXC anKOrOneM naTOJIorNFi KaK uHppo3, B CyMMe, BepOATHO, OTpa)ICaeTTOnbKO tiaCTb peanbHOTO KonHLIeCTBa cny4aeB, 'coma anKOronbABnAOTCA COCTâBJIAIOLueii npH4HHbI CMepTH. Bo MHOFHX Cny4aAXCMepTH OT eCTeCTBeHHbIX npH4HH, BKJIK)LIaA, HanpHMep, naHKpeaTHT,HHCynbT H pax pa3nH4HbIX opraHoB, anKOrOnb MO)KeT ABnATbCSIBâ)ICHbIM LliaKTOpOM, KOTOpbIN BHëC CBOii BKnaA; 4aCTO OH TaK)ICeMO)KeT HMeTb OTHOLneHHe K CMepTH, HaCTynHBLQeIï B pe3ynbTaTeasapHH, CâMOy6HiiCTSa HnH HacHnHA. l'1nnIOCTpanHA 1.1 BOCnpOH3Be-Aexa H3 HeAasxeii ny6nHxaIiHH npaBHTenbCTSa (1)paHUHH (Ministèredes Affaires Sociales et de la Solidarité 1993), ocxoBaxxoii HaAaHHbIX, n0ny4eHHbIX H3 INSERM (1993), H XOTA MbI AOn)ICHbI 6bITbOCTOpO)KH6IMH, KaK HHKOrAa C npeAnOJ10)KCHHAMH O npHiNHHONCBA3H, KOTOpaA CKp6ITa nOA uHLlipaMH 3TOii OCIHuHanbHON CTaTHCTHKH,

3Ta CXeMa nOKa3bIBaeT, KaK CrpynnHpoBâHHâA no pâ3nH4HbIMCBA3aHHbIM C ânKOrOneM npN4HHaM CMepTHOCTb BHOCHT CBOii BKnaA B

o6LueHauHOHanbHble L(NCppbI cMepTHOCTH.

1.4.4 AnKOronbHbie npo6nennbi cpe,gN nagNeHTOBncNXNaTpN4ecKNX KnNHNK

B Halipo6H, KeHHA, 21% nOBTOpHbIX nonaAaHHli B

nCHXNaTpH4eCKyIO KnHHHKy 6bInH AHarHOCTHpoBaH6I KaK

anKOronbHblFi nCHX03 (Badia 1985), B TO BpeMA KaK B I'epMaHHHnpOueHTHâA AonA noA06HbIX nauHeHTOB, CTpaAalonjHX OT

anKOrOnbHOii 3aBHCHMOCTH, 6bina onpeAeneHa B 30% (Feuerelin1989). B LLIBeuHH B 1983 F. (nocneAHHii roA, no KOTOpOMy eCTb

21

AaHHble) 53% My>KCLINH N 13% >KeHLWNH, BbINNCaHHbIX N3 nCNXHaTpH-

iieCKHX KJINHNK, NMeJIH 41HaFHO3 "aJIKOrOTIN3M" (Swedish Council forAlcohol and Other Drugs 1991), B TO spew! KaK B 6onbHNue BMoAcnn, B .TIOHAOHe COOTBeTCTBy1Onjee KOJINYeCTBO CTauHOHapHbIX N

aM6ynaTopnblx nauneHTOB COCTaBJIAeT OKOJIO 10% (Glass andJackson 1988).

VinnIOCTpauNSA 1.1 ElpOueHTHbIVI BKJ1a,0, pa3111,4yHbIX KaTerOpVIV1CBS13aHHOV1 C anKOfOneM CMepTHOCTVI B 70 000 e>KerO,O,HbIX

CMepTeN TaK0M pO,ga.

PaK33

Ty6epKyne3

cDpaHL(NA

HeonpeqeneHHbie8

CaMoy6Niicrea8,5

HcniouuuK: INSERM 1993

qopoJ+cHbie aeapHN9

1.4.5 14nKOfOnbH6le np06neMbl y nagINeHTOB KIINHNKo6u4ero npoctHnsl

Tenepb nepeNAëM OT gonN nOA06HbIX npo6neM B

nCHXNaTpHt-IeCKHX KJINHNKaX K 06bIi41-1bIM KnHHNKaM. gaHHblecDpaHuNN no 3TOMy BOnpOCy 110Kâ3bIBalOT BO3MO]KHOCTb

perNOHanbHblX pa3nNLIN1 B npeAenaX OAHOii cTpaxbl. B 6o11bH14ueO6LuerO npo4/NnA B Tyny3e 25% MpK9NH N 6% )ICeHa[NH nOnyLINJiNANarHO3 "anKOron143M", B TO BpeMSi KaK B KaHHaX n0A06Hblli AHarHO3

22

nORy4141I14 35% MyxC4HH H 9.6% xceHLgHH (Association National dePrevention de I'Alcoholisme 1992). Coo6uAaeTcA, 4TO B I'epMaHHH20% CTa1jHOHapHbIX 6OnbHbIX KnHHHK O6LuerO 11p04/14nA MBnMIOTCM

3aBHCHMbIMH OT anKOTOnB (John et al. 1994). B CHIA o6HapyxceHO,tiro 25% CTaIjHOHapHbIX 60nbHbIX HMeIOT np06neMbI, CBA3aHHble CanxoroneM (US Secretary of Health and Human Services 1990), sABCTpanHH cooTBeTCTSyIOUtaM uNctIpa nomHHMaeTCM AO 30% (Bell etal. 1988; Williams et al. 1978; Ryder et al. 1988). B AoxnaAe ocooTBeTCTByIOUiHX Hcene,t(osaHHMx B HHjÿepnaHZ[ax (Zitman 1984)3aKnIOtIaeT, iITO cpe,gHMM pacnpocTpanexxocTb "3noynoTpe6neHHManxoroneM" cpeAH nocTynaiOLuHx B 6oJIbH14I46I o6ulero npocpHnMnauHCHTOS COCTaBnMeT 20% ARA MyxC4HH H 6% ARA xceHLuHH.O6cneAOBaHHe, npOBeAeHHoe cpeAH naltHeHTOB KJIHHHKH o6LueronpocpHJIM B Kyana-JlyMnyp, ManaIi3HA, nOKa3anO, LITO no KpHTepHAMDSM-III-R 9,7% nauHeHTOB "3noynoTpe6nAloT anxoroneM" HRH"3aBHCHMbI OT aJIKOrOJIA" (Saroja and Kyaw 1993). Pe3ynbTaTbl AaHHoroHCcneAOBaHHA 11OKa3bIBaIOT KOne6aHHA B pacnpoCTpaHeHHOCTHanKOI'OnbHbIX np06neM, KOTOpble MOxcHO 06HapyxCHTb B nOArpynnaXMHOf OHamOHâJIbHOCO o6u[ecTBa: n0 KpHTepHAM DSM-III-R 6bIn14npOAHarHOCTHpOBaHbI nOROxCHTenbHO 22% nauHeHTOS HHAHHueB,9% KHTai%u(es 14 6% ManaHL(es (MycynbMaHe). B i-IHRH, cTpaHe, rAepacnpoCTpaHeHo BHHOnHTHe H BbICOK ypOBeHb uHpp03a (CM. Ta6nHuy1.2), y 4,5% nauHeHTOB, BbInHCaHHbIX H3 O611114X KJIHHHK, anKOTOnbHaM

np06neMa ABRAeTCA rnaBHOÎd, B TO BpeMM KaK y 38% nauHeHToBAHarH03 CBA3aH C nOTpe6ReHHeM anKOrOnA (de la Jara 1991).

1.4.6 BJ1mAHNe aJ1KOrOJlf1 Ha BO3HNKHOBeHNeHeC4aCTHbIX CJ1riaeB, He BKJ1104a51 ,GOpO)KHble aBapNN

I'IMeIOLuHeCA B HanH4HH AaHHble 143 pAAa CTpaH n0Ka3bIBaIOT,4T0 pä3nH4HOrO pOAa HeC4aCTHble Cny4aH MOryT B CyMMe COCTaBHTb3Ha4HTenbHy1O A0n1O CBM3aHHOi7 C aJIKOrOneM 3a6onesaeMOCTH HcMepTHOCTH. HeAaBHHN KaHaACKHIi Aotu[aA (CCSA/ARF 1993)npeAnonaraeT, 4TO anKOrOnb, BepoMTHO, BOBne4ëH B 40% CMepTeH OTBHe3a11HbIX na,geHHFi, 30% cMepTeH OT noxcapoB H 30% cMepTeHyTOHyBLLIHX. O6uiHe CyMMapHble AaHHble aMepHKaHCKHX HCTO4HHKOB

Amu cReAyloLuHe undopbl: 28% cMepTeH OT naAeHHH, 47% CMepTeH OTnox<apos H 34% cMepTeH yTOHysIHHX (Cherpitel 1992). I4ccJIeAoBaHHA143 pâ3nH4HbIX CTpaH 11O3BORAIOT npeAnOROxCHTb, 4TO BbInHBKaBOBne4eHa B 26-54% 6bITOBbIX TpaBM H TpaBM, nOny4eHHbIX BOspew! oTAblxa (Honkanen 1993).

23

O63op NccneAoBaHNf-1 ponN anKOrOJIA KaK OAHON 143 npNLINHnocelueHNA nyHKTOB cxopoH noMO1uN (Cherpitel 1993), rne cBenenblAaHHble n0 ABCTpanNN, CDNHnAHANN, (DpaHIANN, MeKCHKe, ICnaHNM,BenNK06pNTaHMN, CHIA N BONCK CHIA B repMaHNN, nOKa3an n1NpOKyIO

aMnJlNTyay KOne6aHNF1 Me>KAy pa3nNT-IHbIMN TeppNTOpNAMN. 11Oi1TN BO

Bcex CnyzlaAX, KorAa eCTb nOAO6Hble AaHHble, y TpaBMMpOBaHHbIXnaL(MeHTOB Ha6n10AaeTCA 3HaiINTenbHO 6onee BbICOKaA

paCnpOCTpaHeHHOCTb nO3NTNBHOrO pe3ynbTaTa aHänN3a CAK(cOAep>ICaHMe anKOrOnA B KpOBN), T-IeM y HeTpaBMNpOBaHHbIX

nauNeHTOB, nOCeTNBIiIMX Te >Ke 11)(HKTbI B TeMeHMe TOrO xce BpeMeHN.

HanpMMep, Cherpitel N Rosovsky (1990) nposoANnN onpoc B 8 nyHrrraxCKOpOii nOMOIuN B MeXNKO N 06Hapy>KNJ1N, LITO 10% TpaBMMpOBaHHbIX

naliNeHTOB NMenN CAK 6onee 100 Mr/%, B TO BpeMA KaK TOnbKO y2% HeTpaBMNpOBaHHbIX nauNeHTOB Ha6niOnancA TOT >Ke ypOBeHbânKOrOnA B KpOBM.

1.4.7 AOpONCHO-TpaHCflOpTHbI@ I1pONCW@CTBNSi

BKnaA BOANTene17, HaX0A5Inj11XC51 B HeTpe3BOM COCTOAHi-i11 3a

pyneM, B BO3H14KHOBeHNe AOpo>KHbIX aBapNH - Bonpoc, KOTOpbINnOCTOAHHO npNBneKaeT npNCTanbHOe BHNMaHNe BO BCeM wipe, N BOMHOrNX cTpaHaX cyli[eCTByIOT AaHHble no COAep>KaHN10 anKOrOnA BKI>OBN BOANTeneN, BOBne4eHHbIX B aBapNN CO CMepTenbHblM NHeCMepTenbHbIM MCXOAOM. B KaHaAe B 1990 roAy cpeAN CMepTenbHOTpaBMNpOBaHHbIX BOnNTeneN 9,8% NMenN 1103NTNBHbIN CAK HN>Ke80 Mr/%, 9,1%-CAK 81-150 Mr/% N 27,3% CAK 6onee 150 Mr/%(CCSA/ARF 1993). B CILIA nonaraloT, 1-ITO B 1990 ronynpN6n113NTenbHO B 50% TaKNx asapNN BOBne4ëH aJIKOrOnb (NationalHighway Traffic Safety Administration 1992). IlpoBeneHHoe BocDpaHuNN B 1984 Tony HauNOxanbHOe NCCne,goBaHNe noxa3an0, LITOnpM6nM3NTenbHO B 40% aBapNH CO CMepTenbHblM NCXOAOM LIenOBeK,

OTBeTCTBeHHbIN 3a eë BO3HMKHOBeHNe, NMen ypOBeHb anKOronA BKpOBN 60.116111e, 4eM 80 Mr/%, B TO BpeMA KaK B repMaHNN CjiNTaIOT,IrrO anKOrOnb BOBnellëH B 19% nop0>KHO-TpaHCnopTHbIX npONCN1eCTBNIiCO CMepTenbHblM NCXOAOM (Bühringer and Simon 1992). BBenNKO6p14TaHNN B 1990 rony 800 venoBex norN6no B AOpo>KHbIXKaTaCTpo(iaX, rne BOANTenb 6bIn B COCTOAHNN OnbAHeHNA N 20 100genOBeK 6bInN TpaBMNpOBaHbI B 11OAO6HbIX aBapNAx (UKDepartament of Transport 1991). gaxxbie no LIIBeuNN

pacCMaTpNBaIOT COOTHON1eHNe anKOrOnbHOFi OnbAHeHNA N

Cepbë3HOCTN aBapNH: nonaralOT, 4TO B aBapNAX CO CMepTenbHblM

24

HCXOAOM, anKOrOnb 6bIn BOBne4ëH B 7,1%-11,5% CnyLlaeB, HO TOnbKO

B 6,2%-8,7% cnyLIaeB Cepbë3HbIX TpaBM H B 3,7%-5,6% cny4aeBMeHee cepbe3HblX HHAHBHAyanbHblX TpaBM (Swedish Council forInformation on Alcohol and Other Drugs 1991). B pa3BHBaloluHxcAcTpaHaX HHCl)OpMaLjHH no AaHH6IM BOnpOcaM nOKa ManO.

C0061uaeTCA, TITO B LIHn1i anKOPOnb BOBne4ëH B 50% AOpO)KHbIXasapHil (de la Jara 1991). B pa6oTe 113 flanya (HosaA I'BnHesl)o6HapyxceHo, 4To nonoBHHa o6cneAosaxxoro KOnH4ecTBa wocpepos,norH6LUiix B AOpO)KHbIX asapHSlx, HMena coAepxcaHHe anxoron51 BKpoBH (CAK) 6onee 80 Mr/% (Sinha et al. 1981). 3TH awropbl Ta10Kecoo6LuaioT, tao 90% norH6mHx neluexoAos HMenH CAK 6onee 80 Mr/%H 55% yposeHb 6onee 150 Mr/%.

1.4.8 BnasIH17e anKoronsl Ha cosepweHHe caMoy6HNcTBH y641i1CTB

Pe3y1IbTaT6I HCCneAOBâHHN no 3THM BOnpOCaM Hy)KAafOTCAOnATb xce B OCTOpO>KHOM HCTOJIKOBaHHH, H CJIOBO "BOBne4eHHe"CKpbIBaeT nOA C060i%I peanbHble TpyAHOCTH npH4HHHOFi

HHTepnpeTauHH. HeAaBH13e HCCneAOBaHHA n0 anKoroni0 H y6H11CTBâM

(Pernanen 1991) nOKa3anH 3Ha4HTenbHble KOne6aHFiA B 3aBHCHMOCTHOT Kpyra 06CneAyeMbIX, CTpaHbl H BpeMeHH. KaHaACKylO OL[eHKy(CCSA/ARF 1993) - 30% caMoy6nFICT6 H 60% y6Hï-ICTB cosepina-IOTCA nOA BnHAHHeM anKOTOJIA - cneAyeT paCueHHBaTb KaK

npN6nH3NTenbHylO, HO AOCTaTO4HO 060CHOBaHHyIO B COOTBeTCTBHH C

ApyrHMH pe3ynbTaTaMH HCcneAOBaHHH. gaHHble no LIHnH

npeAnonaraiOT BO3AeÎ.1cTBHe BbInHBKH B 38,6% cnyLlae6 CaMOy6HFicTBH 48,6% cny4aeB y6H1iCTB (de la Jara 1991). B CCCP 6onee 60%y6HiiCTB HJIH pa36oNHbIX HanaAeHHI%I, 3aKOH4HBLLIHXCA TA)ICenbIMH

TeneCHbIMH nOBpe)iCAeHHAMH, 6b1nH cOBepLIIeHb1 nIOAbMH B

COCTOAHHH OnbAHeHHA (KOIÜKHHa H Ap. 1994).

1.4.9 CBS13aHHble c anKoronenn coLvanbHble aaTpaTbi

B nio6ori cTpai-ie noAc4eT Bcex o6yCJIOBJlexxblx anxoroneM3aTpaT, KyAa BKn1O4aIOTC51 TaKHe ceKTopa KaK 3ApaBOOxpaHeHHe,couHanbxoe o6ecne4eHHe, noTepH Ha npoH3BOAcTBe, 3aTpaTbl,CB5I3aHHble C AopO]KHo-TpaHCnOpTH6iM npOHCLneCTBHAMH, 3aTpaTbI no

C06n10AeHHiO 3aKOHOB H HCHOJIHeHHiO HaKa3aHHii npeACTaBnAIOTTpyAHyio npo6neMy, H K ny6nHKyeMbiM LjH(ivaM Hy)KHO OTHOCHTbCA C

60nb11.10N CTeneHblO OCTOpO)KHOCTH. 3aTpaTbl no 3aHATOCTH Kâ)ICyTCA

0006eHH0 COMHHTenbHblMH. O11eHKH 6bInH npeAJIO)ICeHbI TaKHMH

25

cTpaHaMH, xax bpa.3HnHA (Brazillian Association of Studies onAlcohol and Other Drugs 1990), BenHK06pHTaHHH (Maynard et al.1988), AscTpanHA (Collins and Lapsley 1992), Kaxa.ria (Adrian 1988)H SInOHHA (Nakamura et al. 1993). ,TIaxxble, npeACTaBnexHble B 3THXaHanH3aX, HHTepecHbl, HO npHBeAëHHble noKa3aTenH AOnDICHbI

BKnK)*-IaTb TOnbKO OnpeAenëHHble 3neMeHTbI, KOTOpble 06bItIHOBXOAAT B COCTaB O6LI(HX uHCtip, n03TOMy He CTOHT npHBOAHTb 3TH

AaHHble nOAHOCTbiO. BMeCTo 3TOrO MbI npeAnaraeM Ta6nHgy 1.5 -AaHHble HeAaBHeIi OueHKH e)ICeroAHbIX 3aTpaT CHIA n0OnpeAeneHHbIM CTaTbAM (Rice 1993): npOMbIIIIneHHble 3aTpaTbI BAaHHOM CnytIae 6bInH HCKnI04eHbl. O6MHe 3KOHOMHtieCKHe 3aTpaTblno "3noynOTpe6neHHIO anKOrOneM" AnA CHIA 3a 1990 roAoueHHBaIOTCA B 6onee item 100 MnH. Aonnapos, 80% 3THX 3aTpaTnpHXOAHTCA Ha netleHHe, 3a60neBaeMOCTb H CMepTHOCTb. K1KylO 6bInpH6binb HH npHHOCHnO o61geCTBy nOTpe6neHHe anK000nA, scer,gaCyLQeCTByIOT Ba)KHble CTaTbH, KOTOpble AOn)ICHbI 6bITb nOCTaBneHbl BnaCCHB B 3TOM 6anaHCe. r1bITaT6C5I CTpOHTb 6anaHC Ae6eT-KpeAHTTOnbKO C TO9KH 3peHHA 3KOHOMH4eCKHX n0AC9eTOB He HMeeTHHKaKOrO CMbICna - Henb32 COOTHeCTH, cKa)KeM, tIenOBeKa, KOTopbH%I

BbIXOAHT nbAHblfl H3 6apa H y6HBaeT npoXOoICero, H Hanor, KOTOpbIN CHero B351H 3a BbInHBKy, HnH, npHBOAA Apyroil npHMep,n0)KH3HeHHyIO BbinnaTy n0C06HA n0 06ecneLteHHIO BCeM AeTAM,HCnbITaBIiIHM B 3apOAbIL1IeBOM pa3BHTHH aJIKOrOnbHbIn CHHApOMnnoAa, C npH6binblO Ka3HatleHcTSa OT HanOrOB, KOTOpble nnaTAT 3aBbInHBKy HX MaTepH. C COLIHâTIbHOIi H ttenoBetteCKOI%I TOtiKH 3peHHA3TH nOACYeTbI He MOI'yT 6bITb c6anaHCHpOBaHbI. gym ueneLlHacTOAn(er0 H3nO)KeHHA AaHHble, npeACTaBneHHble B Ta6nHue 1.5,npHBeAeHbl, t3TO6bI npOCTO nOAttepKHyTb, tiTO Aa)Ke He npHHHMaA BOBHHMaHHe BCio CyMMy CTpaAaHHN, anKOCOnbHbte npO6neMbl CTOAT3HatiHTenbHblX 3aTpaT, KOTOpble npaBHTenbcTSa AOn)ICHbI ytIHTbIBaTb.

1.5 OBLL114E 11 K11FOr-IEBbIE IlEPCIIEKTNBbI

CyllyecTSyloT onpeAenëHHble O6u(He nonO)ICeHHA, KoTOpbtene)KaT B OCHOBe MHOrHX nocneAytoluHx pa3AenoB 3TOIi KHHrH, HCeHttac 6yAeT nOne3HO CdoOpMynHpOBaTb HX H npHBeCTH B KpaTKOtiCbopMe.

26

1.5.1 ÎÎeperl4Hasl npociHnaKTHKa anKOronbHblxnp06neM NMeeT 4pe3BbI4aNHyla BaN(HOCTb ,4171061.1{eCTBeHHorO 3,gpaBOOXpaHeHr1A B O61geM CrIeKTpeanKOTOnbHON nO11MTNKN

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0611jeCTBO HaH60JIee 3C14eKTHBHO MO)KeT npeAOTBpaTHTb nOABJIeHHe

aJIKOI'OJIbHbIX npO6JIeM.

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IIpH 3TOM OHO He HMeeT TO1-1HOrO Hay4HOr0 3Ha4eHHA. B ueJIAX

ACHOCTH AaHHOrO H3JI0)KeHHA Mbt npeAn04HTaeM HCHOJ1b3OBaTb AByX-

OCeByiO KoHuenuHlO "npo6JleM, CBA3aHHbIX C aJIKOrOneM" H

"aJIKOrOJIbxal 3aBHCHMOCTH" (Edwards et al. 1977). 3THIl)OpMyJIHpOBKH MOryT nOMO4b COeAHHHTb np06JleMHble BOnpOCbl06HjecTBeHHorO 3ApaBOOXpaHeHHA H KJIHHHuHCTOB.

1.5.3 AnKOronb nopowgaeT npo6neMbl, HO TaIUKe ,gaëTnpertMyweCTBa

3Ta KHHra pacCMaTpHBaeT o6ycnoBJleHHble anKOroneMMeAHuHHCKHe H COuHâJIbHble npo6rleMbl, a TaKXCe OTBeTHyiO

nOJIHTHKy HO ABHHbIM BOnpOCaM. To, 4TO aJIKOTOJIb ABJIAeTCA

HCTOLIHHKOM yAOBOJIbCTBHA H pbIH04Hb1M TOBapOM, AOJDiCHO 6bITb

npH3HaH0, a BepOATHble npeHMyHjecTBa ASIA 340pOB1351, KaCaiOii[HeCA

BO3MO)KHO1-O 3aHHITHO1-O 3C-4eKTa âSIKOTOJIA npH KOpOHapHON

6one3HH cepAua, 6yAyT o6cyxCAaTbcA no3)Ke.

1.5.4 cDyHKI{NN pNCKa

CerOAHA 3T0 ABJIAeTCA Ba)KHOii KOHuenuHeii AJIA 061I.jeCTBeHHOTO

3ApaBOOXpaHeHHA (Rose 1992). BMeCTO TOrO, 4TO6b1 3aABTb BonpoC,CKa)ICeM, ABSIAeTCA JIH paANauHA npH4HHOii JieiiKeMHH, npO6JleMa6yAeT paCCMaTpHBaTbCSI TaK: KaKaA CTeneHb pHCKa COOTBeTCTByeTKaKOMy ypOBHIO H npOAOJ1)KHTeJIbHOCTH B03AeliCTBHA paAHauHH.

gOJDICHa 6bITb onpeAeSleHa KpHBâA, OnHCbIBafOHjaA COOTBeTCTByIOlId10

27

Ta6nNl{a 1.5. 3KOHOMN4eCKV1e 3aTpaTbl CWA no anKOfOnbHbIMnpo6neMaM 3a 1990 ro,q.

Ton 3aTpaT CyMMa B MnH.npoyeHTHoe

pacnpe,qeneHHe

B yenoM

npAMble 3aTpaTbl

104.918 100.0

CneyNanN3NpoaaHHble opraHN3ayoN 3.690 3.5

6OnbH111..tbl ,ßnA KpaTKOBpeMeHHOrOnpe6blBaHNA

4.882 4.7

BpavH npo npeAnpHArHAx 255 0.2

,qpyrHe npo<peccNoHanbHbie ycnyrN 350 0.3

AOMa nOCTOAHHON OneKO 1.165 1.1

3arparbl Ha noRAepN<Ky 840 0.8

HenpAMble 3arparbl

1.3a6oneBaeMocrb 38.965 37.1

Herocnorano3opoBaHHoe HaceneHOe 38.728 36.9

rocnoTano3opoBaHHoe HaceneHOe 237 0.2

2.CMeprHocrb 35.770 34.1

l7povue 3ampamb!

npAMble

npecrynneHOA

16.777

6.178

16.0

5.9

AopoN<Hble aaapoH 3.911 3.9

Pa3pyweHHA OT noN<apa 673 0.6

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Oco6ble 3a6oneearluA

AnKOronbHblH cHHapoM nno,ga 2.222 2.1

11OA.C4CT 3aTpaT 1990 roAa HpOBO,i[HJICA no COL[HO3KOHOMH4eCKHM

nOKa3aTeJIAM, npHMeHeHHbIx K OLLeHKaM 1985 rOAa H aL[anTHpOBaHHbIX no D.P. Riceet aI. (1990). OueHKH 3aTpaT nepec4oTaH6I no R.D. Rice (1993).

28

(tlyHKUHK) pHCKa. B 3TOri KHFire nOAXOA (PyHKUHH pHCKa 6yAeTnpHMeHSITbCSI AJISI OnHCâHHSI B3aHMOCB5I3H Mexuay, C OAHOri CTOpOHbI,

KOnHLIeCTBOM BbInHTOI'O H, C ApyrOrl CTOpOHbI, - KpyrOM (1)143HLICCKHX

H COUFIanbHbIX nOCneACTBHrI BbInHBKH.

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nOCTeneHHOM nOBbILIIeHHH nOTpe6neHHSI. Kai( 6y,geT nOKâ3aHOn03)Ke, 3TOT BHA aHanH3a MO)KeT npeAOCTâBHTb HOOpMaUHiO3HaLIHTenbHOii npaKTHLIeCKOr3 Ba)KHOCTH AnSI (bOpMHpOBaHHSI

aJIKOTOnbHOii nOJIHTHKH.

1.5.5 ÎÎp@OMCTB@HHOCTb

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Ha3aA, TO BnepeA, TO 143 AaHHON npO6JIeMbI. TaKHM 06pa.3oM, TO, LITOCOCTaBJISIeT "npo6neMy", 3TO 6onee BonpOC CABHrOB, OTTeHKOB HCTeneHeN, 4eM KaTerOpHN NnH a6COnlOTOB, HnH n1o6oro(PHKCHpOBaHHOTO COCTOSIHHSI, Ha3bIBaeMOTO "anKOTOnH3MOM". EcnH

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HnH AByMSI pa3nH1-IHbIMH LIaCTSIMH HaCeneHHSI.

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1.5.7 A11KO1'OJ1bHaA 3aBNCNMOCTb

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29

ABnAeTCA neranbHblM HanHTKOM, KOTOpbIN 3aKOHHO 11pOH3BORHTCA,

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30

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32

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BABOR T.F. AND GRANT M. (ed.) (1992) Project on Identificationand Management of Alcohol -Related Problems: Report on Phase II.Geneva: WHO

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HH,gepnaHp,bi 5.6 8.8 8.2

HoBaA 3enaH,gHA 7.6 9.6 7.8

HopBerNA 3.6 4.6 4.1

rlopTyranNA 9.9 11.0 9.8

VicnaHHA 11.6 13.6 10.8

WBeL{NA 5.8 5.7 5.5

WBeHuapHA 10.7 10.8 10.8

TypuHA 0.5 0.7 0.6

CWA 6.7 8.2 7.5

B TeveHHe AByx AecATHneTHI7 (1)paHLjHA, I4TaJIH5I H LIIBeLuHA

nepexcHBanH nOCTOAHHb1Ii CnaA. B nATHaAL[aTH CTpaHaX nOTpe6neHHe

npo,gonxcano pacTH B CeMHAeCATbIX ro,gax, HO CHHoKanOCb HRH

OCTaBanOCb cTa6HnbHbIM B BOCbMHAeCATbIX. TORbKO BgaHHH,CDHHJLHHAHH, BenHK06pHTaHHH, SInOHHH H .lIIOKceM6ypre nOTpe6neHHeBce ewe npoAonxcano BO3paCTaTb B BOCbMHAeCATbIX roAax.Pa3Hoo6pa3He TeHAeHIjHFi nOTpe6ReHHA B BOCbMHAeCATbIX rOAaX He

HcKRi04aeT BO3MONKHOCTH, IITO B TeveHHe 6onee ARHTeJIbHON

48

HCTOpHTieCKOii nepCneKTHBbI TeHZjeHuHSI C6nH)KeHH51 MO)KeT CTaTb

OTIeBHJ(HON. Ha CaMOM Jjene, O,I(HO 113 BO3MO)KHbIX HCTOJIKOBaHHN

3aKJIK)TIaeTCA B TOM, TITO nOCneBOeHHâA 3pa nOCTOAHHOrO pOCTanOTpe6neHHA B HHJjyCTpHanbHOM MHpe J(OCTHrna CBOeii nOBOpOTHOI%I

TOTIKH, HO C He60nbIIIOi3 pa3HHuei4 BO BpeMeHH ,I(JIA pa3HbIX CTpaH.

KaK yxce ynOMHHâJIOCb, nOCneBOeHHoe nOSbIIIIeHHe ypOBHAnoTpe6neHHA anKOTOJIA B HHJjyCTpHanbHblX CTpaHâX COnpOBO)iUjanOCb

Me)KHauHOHanbHbIM C6nH)KeHHeM o6IIjHX ypOBHei%I nOTpe6neHHSI.3TOT npouecc npoJjonxcanCA B CeMHJjeCATbIX H BOCbMHJ(eCATbIXroJjax. CTpaHbl, nepexcHSaBIIIHe sOCTaTOTiHO 3aMeTHOe CHH)ICeHHenOTpe6neHHA, HaTlanH C OTHOCHTenbHO BbICOKOTO ypOBHA

noTpe6neHHA, B TO BpeMA KaK CTpaHbl, nOKa3blsaiOIIjHe CâMblli60nbnl0ii nOJjbeM, npHHaJjne)KâJIH K rpynne CTpaH C HH3KHM ypOBHeMnOTpe6neHHA B ceMHJjeCATbIX rOJ(aX. Me)KHauHOHanbHble pa3nHTmA,TaKHM 06pa30M, npOJ(On)KanH yMeHbIIIaTbCA. CaMble nOCneJ(HHeH3MeHeHHA B nOnynSipHOCTH HanHTKOB 11OKa3aHbI Ha HJIJIIOCTpauHH 2.1.

Ha 3TOii J(HarpaMMe CTpaHbl, rJje sons rima COCTaBnAeT 6onee50%, paCIIOJIO)KeHbI B BepXHeM yrny TpeyronbHHKa. CTpaHbI, BKOTOpbIX npeo6naJjaloT BHHO H xpenxHe CIIHpTHble HanHTKH,

paCI7OJIO)KeHbI COOTBeTCTBeHHO B HH)xHHX neBOM H npaBOM yrnaX. B

cepeJjHHe HaXOJjHTCA 30Ha, rJje HH OJ(HH H3 HanHTKOB He HMeeT J(onH

6onee 50 %. Ha TOTIKy OTCTieTa (1970) B Ka)x,qOM CnyTiae yKa3bIBâJIanereHJja, onpeJjenAioluaA cTpaHy, nHHHA yxa3blsaeT HanpasneHHe BCeMHJjeCATble - J(eBAHOCTble rO)jbl. HJInIOCTpauHA nOKa3bIBaeT, TITO B

TeTieHHe J(Byx nOCneJ(HHx JjeCATHneTHH npoJ(onxcanCA npoueccBO3paCTaHHA OJjHOpOJ(HOCTH. 3a HeCKOnbKHMH HCKJIIOTIeHHAMH,

nHHHH, H306pa)xa101uHe 143MeHeHH51, JjBHraIOTCA OT yrnOS, rjje OJjHHTHn HanHTKa npeo6naJjaeT HaJj JjpyrHMH. O6IIjee HanpasneHHeJ(BH)KeHHii, TeM He McHee, HanpaBneHO He K ueHTpy JjHarpaMMbl (rJ(e

OJIH BCex TpeX rpynn HanHTKOB 6bInH 6b1 paBHbIMH), a11pH6nH3HTenbH0, K TOTiKe, COOTBeTCTByiOII(ei%I TaKOMy COOTHOIIICHHiO

HanHTKOS: 50% - nHsO, 35% - BHHO, 15% - KpenxHe CnHpTHble HaIIHTKIi.

B TeTIeHHe HeJjaBHerO nepHOJja 6onee CTa6HJIbHOTO noTpe6neHHA3aMenjeHHe 6bIJI0 6onee 06bPiHbIM, TIeM JjO1I0JIHeHIie. B CTpaHax, rJjenpeo6naJjaeT sHHOnHTHe, H3MexeHHA Mo)KHO xapaKTepH3osaTb KaxBbPIHTaHHe, Talc xax cHH)xeHHe n0Tpe6neHHA sxxa TOnbxo TIaCTHTIHoKOMneHCHpOSaTIOCb nOBbI1IIeHHeM nOTpe6neHHSI nHSa H KpenKHXCnHpTHbIX HanHTKOB.

49

BHHO

IIHBo

100 " 00 50 100

ICpeHKHe CHHPTHble HaHHTKH

HJIJIIOCTpaI[HH 2.1. H3MeHeHH5I B HOnyJISIpHOCTH HaHHTKOB B

cTpaHaX DpraHH3aLAHH 3KOHOMH'3eCKOFO COTpyAHHtieCTBa H pa3BHTH5I

B nepHo,q 1970-1990 r. 3a HOJIHbIM 06bsICHeHHeM 06paLuaHTecb KTeKCTy. KaxcAasl JIiiHHSI COOTBeTCTByeT BeKTOpy H3MeHeHHFi B O,LHIO4I

cTpaue, Ha'-iaJIbHaSI TO,-IKa COOTBeTCTByeT nOJIO)iCeHHIO Ha 1970 r.CTpaHbI o603Ha4eHbI CneAyIOLuHMH cHMBOnaMH: ABCTpaJIHSi (AUS),ABCTpHSI (A), renbrHSl (B), KaHaAa (CND), ,DIaHHSI (DK), (1HHn51HAHSI(FIN), OpaxuHSl (F), I'epMaHHSI (D), BenHKo6pHTaHHx (GB) ,

I'IcnaHJ'<HSI (ICE), HpnaHAHSI (IRE), PITanHSI (I), SInOHHSI (JPN),JIloxceM6ypr (LUX), HHAepnaHAbl (NL), Hoaasl 3enaHAHSI (NZ),HopaerHSl (N), IlopTyranHSl (P), IICnaHHSI (E), lllBeuHx (S),LHBeHuapHSt (CH), TypuHSl(TUR) H CHIA (USA).

2.2.2 CTPaHbi LieHTpaJ1bHON H BOCTO4HOH EBp011bl

Bo MHOFHX CTpaHaX LjeHTpanbxOli H BocToLIHoN EBponblCOuHanbHble H 3KOHOMHLIeCKHe CABHFH OTpHuaTenbHO HOBnHSInH Ha

HaAe)ICHOCTb aJIKOFOnbHOii CTaTHCTHKH, a H3MeHeHHe HOnHTHLieCKHX

rpaHHu 3aTpyAHSIeT CpaBHeHHSI no BpeMeHHOIi HIKâJIe. B 6bIBLIIHX

50

COBeTCxxX pecrry6nHKax 3aperxcrpllposaxxoe noTpe6nelHle pe3KOynano BCneACTBHe aHTHanxoronbxoi%I KaMnaxHH 1985 rojja. HecMoTpSiHa pacnpocTpaxeHHe He3axoxxorO npoH3BOjjcTBa aJIKOrOnSi, o6LuHIcnaA TOprOBnH ânKOTOnbHbIMH HanHTKâMH He 6bin KOMneHCHpOBaHnOBbILIIeHHeM AOMaHIHerO npOH3BO,IjcTBa. Hocne 1987 ro,tta H

npeKpalueHHSI aHTHanKOTOnbHOïi nOnHTHKH, nOTpe6neHHe ânKOTOnSIHaiian0 B03paCTaTb. HeMHorO nO3xce COuHaJIbHble H 3KOHOMHLleCKHeH3MeHeHHSI pe3K0 nOBbICHnH JjOCTynHOCTb asticotons' B 60nbIIiHHCTBe

6bIBU1Hx CoBeTCKHx pecny6nxK (Lehto and Moskalewicz 1994), Ho6naro,3apSI pocTy LiacTHoro npejjnpHHHMaTenbcTBa, AOnSi o6lueronOTpe6neHHSI, dHKCHpyeMâSI OcHuHânbHbIMH HCTOLIHHKâMH, MO)KeT

6bITb Aaxce HH)iCe, LIeM B 1987 rOAy. YpOBHH pa3nHiIHbIX nOKa3aTenellaJIKOTOnbHbIX npo6neM, TeM He Mexee, HOBbIHIaIOTCSI B POCCHH,YKpaHHe H 3CTOHHH.

C 1990 rua nOnbCKaSI anKOTOnbHaSl CTaTHCTHKa AaeT AaHHbleTOnbKO no OTeiieCTBeHHbIM HanHTKaM, B TO BpeMSI KaK HMnOpTHbieHanHTKH OCTaIOTCSi HeyiiTeHHbIMH. gaHHble o63op0B no anKOTOnIOnoKa3bIBaK7r 50% nOBbIIIIeHHe noTpe6neHHSI anKOrOJISi MexcJry 1989 H1992 rOAOM. 3-Ta oueHKa nOJITBepxcjiaeTCSI cooTBeTCTBy10nlHM

noBbIIIIeHHeM KOnHileCTBa rocnHTanH3auHN C anxoronbxbIMH nCHXO-3aMH. B L1esICKOii pecny6nHKe, CnosaKHH H 1ionrapHH noTpe6neHHeaJlKoronx TaiOKe noablLUaeTCSI (Lehto and Moskalewicz 1994).

2.2.3 Pa3BHBatou{Hecsi crpaHbi

BOJIbIIIHHCTBO pa3BHBa10HiHxCSI cTpaH nepexcHBa10T CTOJIb

3HaiIHTenbHble HyxcAbI, LITO c6op perynxpxoi-1 CTaTHCTHKH Ansl HHXTpyAeH HnH HeB03M0xceH. HaAexcHble ABHHble no nOTpe6neHHIOanxoron3l peuxo HMeIOTCSI B HanHiIHH. B AoxnaAe Walsh H Grant(1985) HeT AâHHbIX n0 HenpOMblLnneHHOMy H3rOTOBneHHIO,

asticotons', neranbHOMy HnH HeneranbHOMy, HO aBTOpbI 3aKn10ilaiOT,LiTO "npOH3BOACTBO H nOTpe6neHHe nHBa, BHHa H KpenKHX CnHpTHbIX

HanHTKOB nOBbIIIIaeTCSI cIaKTHileCKH BO BCeX perHOHaX MHpa" 3aHCKJIiO9eHHCM CTpaH, rue pacnpOCTpaHeHO BHHOnHTHe: 1:13paHuHH,1'1TanHH, IIopTyranxH H HeKOTOpbIX CeBepo-acIpHKaxeKHXrOCyAapCTB. CyLueCTByiOT TaKxCe Aâ.HHbie, nOKa3bIBa10HjHe, LITO

noTpe6neHHe nHBa 3aMCTHO nOBbICHJIOCb C 1960 no 1980 roA BOMHOrHX CTpaHaX IleHTpanbHOli H FOxcHOrl AMepHKH, Acl)pHKH HA3HH. COOTBeTCTByIOIueii HHCpOpMauHH no BHHy H KpenKHMCnHpTHbIM HanHTKaM HeT (Kotteinen 1988; Maula et al. 1990).

51

Smart (1991) coo611jaeT, LITO MHorne pa3BHBatoHiHecSl cTpaxblnoxa3anH 6onbluoe nosbHileHHe noTpe6neHHSI anxoronsl rocy,gapcT-BeHHOro 11p0H3BOAcTBa H peanH3aüHH c 1970 no 1980 ron. TeM HeMexee, nOBbI1HeHHe noTpe6neHHSi BO BCeX BMecTe B351TbIX

ac1)13HKaHCKHX cTpaHaX 6b1J10 He3Hai-IHTenbHbIM, H TOnbKO B 1O)KHON

A(1/pHKe Ha6111oAanOCb He6onblIIoe nOBbIHIeHHe. 1-1oBbIHleHlte

noTpe6neHHx B A3HH, CeaepnoFl AMepHKe H EBpone 6binocyllteCTBeHHbIM. OCHOBbIBâSICb Ha HMetOLgexcSI HH4tlOpMaL[tiH, Bp51n Jill

MO)KHO CKa3aTb yBepeHHO LITO-Hu6y3b o6 anKOrOnbHbIX TeHAeH1[ti5fXpa3BHBatolgerocsl MHpa.

2.3 f1P14Bb14KA K f1OTPEBJIEHVIK) AJ1KOt"OJ1A 14V13MEHEH14A O6LLiEfO f1OTPEBJ1EH14A

143MexeHH5I B O61ueM noTpe6neHtut MoryT npoi7cxo3iiTbHeCKOnbKnMH CnOCO6aMH. HOBble moan MOryT BOBneKaTbC5I B

noTpe6neHlle H3 rpynn Ao 3TOr0 Bo3AepxcHBaBluHxcsl OT anKOrOJISI,}inH we MO)KeT HMeTb McCTO 06paTHbA npouecc npexpaLLteHHs1noTpe6neHliSl KaK cneACTBHe HOBbIHleHH5I 3a6oTbl O 3A0p0Bbe.1-1aCTOTa nOTpe6neHlist H KOniti-IeCTBO BbIHHBaeMOro 3a OAHH pa3ânKO1-On5I MOryT Ii3MeHtiTbC51 TaK, LITO, Hanpl-1Mep, BbInHBKa CTaHeTe)Ke3HeBHoI7, BMeCTO TOrO, 4TO6bI npOHCXOAtiTb n0 CHeljHanbHbIMnOBOnaM H BbIXOAHbIM. 14 HaKOHei(, npHpona ycnOBHH BbIHHBKFtMO)KeT H3MeHIiTbC5I, KaK 3T0 npOIiCXOAHT B CTpaHaX, rAepacnpOCTpaHeHO nOTpe6neHlie BHHa: BbIHHBKa 3a eAOii BCë 6OnbIHe3aMeLltaeTCSI BbIHHBKOÎ-t BO BpeMSi OTnbIXa C 3(1n1)eKTOM O11b51HeHIi5I B

KaLIeCTBe OCHOBHOrO 3neMeHTa (Pyörälä 1990). CHCTeMaTHiIeCKHilaHanH3 H3MeHeHHli nptiBbI4eK K nOTpe6neHIiIO anKOrOnSI B CB5I3H CH3MeHeHH51MH 06Hjer0 noTpe6neHHx Tpe6yeT CepHH CpaBHliTenbHbIXIiCCneAOBaHHi-t B TeT-IeHHe 60nee nnHTenbHbIX nepHOAOB BpeMeHFi.110A06Hble HCCneAOBaHHSt HanHHatOT npOBOAHTbCSi. KaK npHMep,MO)KHO npHBeCTH npOBeAeHHblli B CDHHnSIHAHH aHanH3 (Simpura1987), n0Ka3aBLIIIiN, iITO B nepHOA 11OBbI1HeHH5I nOTpe6neHHSI C 1968HO 1976 ron, CHa4ana HMeno McCTO nOBbI1HeHHe "taCTOTbI BbInHBOK, a

nO3)Ke nOHH)KeHHe B ypOBHe Tpe3BOCTH, LITO CKâ3anOCb Ha pOCTenOTpe6neHliSl. B 60nee n03n1-1HIi nepHOA CTa6HnbH0r0 nOTpe6neHH5I(C 1976 no 1984 ronbl) H3MeHeHHSt Tpe3BOCTH, iIaCTOTbI BbIHHBKH HnOTpe6n5IeMOrO 3a on1iH pa3 KOnHLIeCTBa OCTaBanHCb He6011b1HHMH.

52

2.4 POT. b BKJ1A,gA PA3J1144HbIX CJIOEB HACEJIEHVISI BV13MEHEHVIE OSLuEfO IIOTPE5J1EHVIA

14MeeTC5I nHIIIb He6onblIIoe KOnIiLIeCTBO RaxxbIx, n03BOnASOLLjHX

CpaBHHTb H3MeHCHHA noTpe6neHHA pa3nH11HbIX nOArpynn HaCeneHHSI.gaHHble 110 TeHAeHLjHAM, B OCHOBHOM, HMeK)TCSI TOnbKO nonoTpe6neHHIO anKOronH pa3nHLIHbIMH nonaMH. B 1980-x ronax)KeHCKBA AOnA B 06IIjeM noTpe6neHHH anKOronSl B HHAyCTpHanbHblXCTpaHaX 6bina CTa6HnbH0171, npH6nH3HTenbH0 25-30%. Pa,i[HKanbHbleH3MeHeHH31 jjOnH nOTpe6neHHA My)ICLIHH H)KeHII[HH 6bInH OTMeLIeHbI

TOnbKO B CBSI3H C 6011bIIIHMH pe(tiOpMaMH B nOnHTHKe KOHTpOnA H

npOAaxCH anKOTOnM, KOTOpble npOH30LnnH BOHHnMHnHH B 1968 roily(Simpura 1987). Tax KaK HaLIHHaIOT nOSIBnSITbCSI CpaBHHTenbHblej[aHHble 3a AJIHTenbHblli nepHOA no THnaM noTpe6neHHA anKoronSl(Fillmore et al. 1991), 60nee AeTanbHbll%I aHanH3 BKna,zia pa3nwIHbIxnoArpynn HacenexHA B H3MexeHH51 o6ü.tero nOTpe6neHHA anKOronSi,AOn)ICHO 6bITb, 6yAeT Bo3M0MCeH B 6n14)Kai%IIIIeM 6ynyLueM. B 06LueM,

CerOnHALLIHHii OnbIT nOKa3bIBaeT, tITO OTHOCHTenbHOe nOTpe6neHHe

pâ3nHLIHbIX CJIOeB, BepOATHO, AOCTaTOLIH0 CTa614JIbH0 Ha npOTA)ICeHHH

OTHOCHTenbH0 KOpOTKOrO nepHOna BpeMeHH, XOTA B TeLIeHHe 60neeAnHTenbHOrO nepHona MO)KeT npOH30IiTH 6onee paAHKanbHOe Hpa3H006pa3HOe nBH)ICeHHe.

2.5 MHO)KECTBO TEH,gEHL.1140

MexcnyxaponHaA KapTHHa TeH,IZneHLjHI%I COBOKynxorO

noTpe6nexHA anxoronA yxa3blBaeT Ha pa3HOO6pa3He Bcex THnoBH3MeHeHHii. Ha naHHbIFi MOMeHT MHp He nBHraeTCA TOnbKO B KaKOM-nH60 OAHOM HanpaBneHHH B nnaHe noTpe6neHHA anKOrOnA. BCTpaHaX, Tne TpanHLtHOHHO nbiOT BHHO, nOTpe6neHHe yMeHbLIIaeTCA,

H 3Ta TeHneHLjHM CHH)KeHHM Ha6nK)naeTCA B HeKOTOpbIX ApyrHxHH,IjyCTpHânbHblx CTpaHaX 3ananHOFi EBponbl. B TO )Ke spew' B HHbIXHHAyCTpNanbHblX cTpaHaX nOTpe6neHHe anKOronA npOAOn)ICaeT

yBenHLIHBaTbCA. B iiaCTHOCTH, MHOrHe CTpaHbI ueHTpanbHOI%I HBOCTOLIHON EBpOnbI CTanKHBaIOTCA cel3mac C TpeBO)KHbIM pOCTOMnoTpe6neHHM anKOronM H anKOTOnbHbIX npo6neM. B HCKOTOpbIX

perHOHaX pa3BHBalOIgHXCSI cTpaH noTpe6neHHe HanHTKOB

KOMMep9eCKOTO npOH3BOACTBa 3Ha'-IHTenbHO pacTeT, HO, XOTA

KOHTp0Jlb nOTpe6neHHA 6bin 6bI OtIeHb none3eH AnB HaLLHOHanbHOTO

53

nnaHHposaHKABOnpOCy HeT.O6bILiHO H,gyTnOTpe6neHHIO

3ApaBOOXpaHeHHA, HaJje)KHbIX ,iI,aHHbIX no 3TOMyBMeCTe C H3MeHeHHAMH B o6njeM noTpe6neHHHH3MeHeHH51 B Bb16ope HanHTKOB, B npHBblLiKaX KânKOPORA, H HHOP,Ija TaK)Ke nOABRAeTCA HOBOe

pa3Z(eneHHe nOTpe6neHHA Meway nOjjPpynnaMH HaCeneHHA. Bo BCëMwipe H no OTHOIIIeHHIO KO BCeM 3THM H3MepeHHAM CyIIZeCTByIOTnpFiMepbl pe3KHX nepenaAoB, MeJjneHHbIX H3MeHeHHii HRH

CTa6HnbHOPO COCTOAHHA. Mono CJjenaTb TORbKO OJjIiH yBepeHHbni06ujHii BbIBOjj TWA niO60Ii CTpaHbI: KaK MbI rice POBOpHRH paHblIIe,ypOBHH H THnbI nOTpe6neHHA He yCTaHaBnHBaIOTCA pa3 H HaBCePJja.J1oT (paKT HMeeT 60nbHI0e npHKnaAHOe 3HaLIeHHe ;ATM COL[HanbHOHnOnHTHKH H nOnHTHKH 3JjpaBOOXpaHeHHSi.

54

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FILLMORE K., HARTKA E., JOHNSTONE B.M., LEINO E.V.,MOTOYOSHI M. AND TEMPLE M.T. (1991) The collaborativealcohol -related longitudinal project: preliminary results from a meta -analysis of drinking behavior in multiple longitudinal studies. BritishJournal of Addiction 86, 1203 -1210.

KORTTEINEN T. (1988) Agricultural Alcohol and Social Changes inthe Third World. Helsinki: Finnish Foundation for Alcohol Studies,Publications No.38.

LEHTO J. AND MOSKALEWICZ J. (1994) Alcohol policy duringextensive socio- economic change. Copenhagen: WHO RegionalOffice for Europe.

MÄKELÄ K., ROOM R., SINGLE E., SULKUNEN P., WALSH B.,BUNCE R. et aI. 1981. Alcohol, Society and the State, Vol 1, Toronto:Addiction Research Foundation.

MAULA J., LINDBLAD M. AND TIGERSTEDT C. (eds.) (1990) Alcoholin Developing Countries. NAD Report 18. Helsinki: Nordic Councilfor Alcohol and Drug Research.

NEGRETE J.C. (1980) Sociocultural and economic change in relationto alcohol problems. In: Moser J. (ed.) Prevention of Alcohol -RelatedProblems, pp.159 -170. Toronto: Addiction Research Foundation.

PYÖRÄLÄ E. (1990) Trends in alcohol consumption in Spain,Portugal, France and Italy from the 1950s until the 1980s. BritishJournal of Addiction 85, 469 -477.

ROOM R. (1991) Cultural changes in drinking and trends in alcoholproblems indicators: recent US experience. In: Clark W.G. and HiltonM.E. (eds.) Alcohol in America, pp.149 -162. Albany N.Y.: SUNYPress.

SIMPURA J. (ed.) (1987) Finnish Drinking Habits. Results fromSurveys Held in 1968, 1976 and 1984. Helsinki: Finnish Foundationfor Alcohol Studies.

SMART R.G. (1991) World trends in alcohol consumption. WorldHealth Forum 12, 99 -103.

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SPRING J.A. AND BUSS D.H. (1977) Three centuries of alcohol inBritain. Nature 270, 567 -572.

SULKUNEN P. (1976) Drinking patterns and the level of alcoholconsumption: an international overview. In: Gibbins R.J., Israel Y.,Kalant H., Popham R.E., Schmidt W. and Smart R.G. (ed.) ResearchAdvances in Alcohol and Drug Problems. New York, pp.223 -281:John Wiley.

SULKUNEN P. (1983) Alcohol consumption and the transformation ofliving conditions. A comparative study, pp.247 -297 In: R.G. Smart,F.B. Glaser, Y.Israel, H. Kalant, R.E. Popham and W. Schmidt (eds.)Research Advances in Alcohol and Drug Problems, Vol. 7, NewYork: Plenum.

WALSH, B. AND GRANT, M.: Public health implications of alcoholproduction and trade. WHO offset publication No. 88. WHO:Geneva.

WILSON G.B. (1940) Alcohol and the Nation. London: Nicholson andWatson.

WORLD DRINK TRENDS 1992. Produktschap voor GedistilleerdeDranken, and NTC Publications, Henley -on- Thames.

56

3

`/i HriN B VIgyâJl b H Oe

IIOTpe6JleHV1e âJIKOI"OJ1fI ItCTelleHb pIiCKâ

B 3TOFi rnase 6y,geT paccMaTpxsaTbCSI Kpyr BonpocoB,KaCalOnjxXCSI xHJ114B14J1yanbHOTO nOTpe6neHxSi anKOTOnSi H CTeneHxpxCKa. B HaLIâne TaKOii J[xCKyCCxx He06XO,axMO 11p143HaTb xCOLiyBCTBeHHO OTHCCTIiCb K JAxneMMe peanbHOii )Kx3H14, KOTOpaSICTOHT nepe,a KaXCJjbIM nbioxixM LMenOBeKOM: anKOTOnb MO)KeT npxHeCTx

KaK yAOBOnbCTBxe, TaK H HeCaCTbe. Ho KaKOBa BepOSITHOCTb, HenOCpe,a-

CTBeHHâSI HnH OTaanëHHasl, TOrO, LITO, OnpeJjeneHHOe KOnHLIeCTBO xnH

cnoco6 noTpe6nexxsi npxBeJryT K 11O314THBHbIM xnx HeraTHBHbIMnOCne,I(CTBIüiM? ECnx 3T0 nxLiHbIii BOnpOC aJia OT,aenbHOrO LIenoBeKa,

TO COOTBeTCTByIOLL(xe OTBeTbI JjOnXCHbI 6bITb npx onpeAeneHHHrOCyJjapCTBeHHOii nOnxTxKx. HayLIHOe nOHHMaHxe xH,4HB14J(yanb-HOrO pxCKa, LLTO SIBnSIeTCSi OCHOBHOÎI TeMOiI 3TOIi TnaBbl, SIBnSIeTCSI

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J(HA HeJ(enH, BpeMeHH rOJ(a H 3Tana )I0H3HH: 6onee TOrO, 3THH3MeHeHHA MOryT HMeTb HeperynApHblii XapaKTep. BCeo61L(eeJ(nHTenbHOe H3rieHHe HaCeneHHA (Lazarus et al 1991; Temple andLeino 1989) 06HapyxcHnO 3HazIIiTenbHOC J(BH)Kexxe Mexçay KaTerOpHAMH

no nOTpe6neHHIo B TeLIeHHe ,i[JIHTenbHOl'O nepHoJ(a BpeMeHH. BoMHOrHX HHJ(yCTpHanbHblX CTpaHaX CnOpa,aH4ecKHe iipe3MepHbmBbInHBKH B MOJIOJ(OM BO3paCTe HMeIOT TeHJ(eHL(HiO 3aMeLL(aTbCA 6onee

pelynApHbIM nOTpe6neHHeM B CpeJ(HeM B03paCTe, C MCHbIIIHM

KOJIH4eCTBOM "nHKOB" noTpe6neHHA, H 3T0, B CBOIO Oiiepejÿb, HMeeTTeHJ(eHL(HiO 3aMeLLjaTbCA ropa3,zxo 6onee HH3KHM noTpe6nexxeM BnO)KHnbie rOJ(bI. YpOBeHb noTpe6neHHA B J(aHHOe BpeMA He ABnAeTCA

XOpOIIIHM MeTOJ(OM OL(eHKH COBOKynHOrO nOTpe6neHHA B TeLieHHe

J(eCATHneTHI%I, KOTOpOe Mo)KeT ABnATbCA CaMbIM Bâ)ICHbIM aCneKTOM

nOTpe6neHHA J.tJIA 41H3H4eCKOrO 3J(0p0BbA. YIiHTbIBaA, *-ITO nO)KHnbic

peCnOHJ>;eHTbI COKpaIIZaioT CBOe nOTpe6neHHe, J[JIHTenbHble

HCCneJZOBaHHA, 14CIIOnb3y5I J(aHHble nOTpe6neHHA MOnOJ(e)KH, 6yJ(yTCKJIOHATbCA K nepeOI(eHKe COBOKynHOrO KOnHLICCTBa noTpe6neHHA, H

TaKHM O6pâ3OM, MOryT HeJ(oOL(eHHSaTb 34)(1)eKTbI, npOH3BOJ(HMbleanKoroneM.

06bILIHO B HCCneJjOBaHHAX B3aHMOCB513H nOTpe6neHHA anKOrOnA

H 3a6OneBaeMOCTH HnH CMepTHOCTH H3MepAeTCA He COBOKynHOenoTpe6neHHe 3a JjJIHTenbHbiii nepHoJ(, a noTpe6neHHe 3aOTHOCHTenbHO OrpaHHLIeHHbni nepHoJ( BpeMeHH. KaK MbI yxceOTMeLIanH, 3T0 He JIy'iLllHii MeTOJ( oI(eHKH nOTpe6neHHA anKOrOnA 3aJ(nHTenbHblFi npOMe)KyTOK BpeMeHH. B 3aBHCHMOCTH OT

HCIIOnb3OBaHHbIX MeTOJ(OB, OH TaK)Ke MO)KeT He nOJ(XOJ(HTb J(nAOL(eHKH 06beMa nOTpe6neHHA H Jja.)Ke J(nA 6onee KOpOTKOrO nepHOJja.BOnpOCbI, KOTOpble (pOKyCHpyIOTCA Ha KOpOTKOM npOMe)ICyTKeBpeMCHH - LiaCTO HaCTOnbKO KOpOTKOM, KaK J(eHb HnH J(Ba B 3anHC5IX 0

paL(HOHe nHTaHHA - npHBeJ(yT K HeBepHOIi KnaCCH4314KaL(HH, H J(a)ICe

63

cnpalIIHBaSI o noTpe6nexHH 3a npeAblJZyyIuylO HeAenlo, MO)ICHO

npOnyCTHTb 4IaKTM noTpe6neHHSI anKorOnB peCnOHJleHTaMH, B LIbHXKynbTypaX CnOpa,i[HLiecKOe nOTpe6neHHe SIBnSIeTCSI 06bILIHbIM

(Simpura, 1988; Room 1990; Duffy and Alanko 1992).Tpa.i[HirHOHHbIIâ MeTOA onpoca o6 "06bITIHbIX" ypoBHHx noTpe6neHHslTaIUKe B pe3ynbTaTe npHBO,gHT K ,gOBOnbHO HenpaBHnbxoliKnaCCH(imHKauHH, TaK KâK C nOMOIubIO JjaHHOrO MeTOJja He yjjaeTCSiH3MepHTb HeLIaCTble enyiiaH CHJIbHOTO OnbSIHeHHSI, KOTOpble TiacTOCOIIyTCTByiOT perynSlpHOMy nOTpe6neHH10 anKOronSI B ManblX ,g03aX(Knupfer 1987). Z(axxoe HB000TBeTCTBHe B H3MepexHH cTpyKTypnoTpe6nexxsl H o6o61uexHH Hx npH axanH3e (Ferrence et al 1986;Knupfer 1987; Colsher and Wallace 1989; Midanik and Room 1992),LiacTO SIBnSIeTCSI OTpaxceHHeM Toro (l)aKTa, LITo anKOTOnb BBnHeTCSinHnlb OJjHHM 133 nOTeHuHanbHblX claKTOpOB pHcKa, H 1103TOMyBOnpOcaM nOTpe6neHHSI anKOronSl mensieTCSI MaJIO BHHMaHHSI.

06bILIHbIM CnescTBHeM H3MepeHHS1 TOnbKO 0J[HOI3 CTOpOHbI

n0Tpe6neHHSI anKOronSI HJIH H3MepeHHe ero TOnbKO 3a orpaHHLICHHbI13BpeMeHHOii nepHOA SIBnHeTCSi He,t[OOueHKa peânbHOli B3aHMOCB5I3HMexqry noTpe6neHHeM anKOronSl H ero nocne,IjcTBHSIMH. TeM HeMcHee, BO3MONCHO, LITO H3-3a CHCTeMaTHLIeCKH HeTOLIHOTO H3MepeHHSI

npOH30iïAeT nepeoueHKa B3aHMOCB5I3H. Kai( npHMep, MoxcHO

flHBCCTM HCCne,sOBaHHe noTpe6nexxx, npoae,seHHOe B ronnaH,i[HH.B TO BpeMSI KaK B 60nbIIIHHCTBe COBpeMeHHbIX HCCneJ10BaHH13jjaHHble c06HpanHCb npH 06CTOSITenbCTBaX, KOr,Tla OTBeT He BbI3b1BanHHKaKHX nOCne,gCTBHii jjJISI pecrlOHseHTa, caM00TLiëTbl peCnOH.geHTOB

JjaHHOTO HCCneAOBaHHSI 06 HX ynoTpe6neHHH âJIKOrOnSI SIBnSIIOTCSI6onee np06neMaTHLiHbIMH C 3TOIi TOLIKH 3peHH2, TaK KaK

pecnOmseHTbI .i[ei3CTBHTenbH0 603InHCb nOCneuCTBHFi - HanpHMep, BOTHOIIIeHHH BbInJIaTbI HM CTpaXOBKH. TaKHM 06pa30M, 06HapyxCeHHOe

yMeHbIIIeHHe TpaBMaTH3Ma npH pOCTe noTpe6neHHsl anKOrOJISI yKaTaIOIuHXCSI Ha rOpHbIX nbDICaX (Bouter 1988) paccMaTpHBaeTCSIaBTbpaMH KâK o6yCJIOBneHHOe peTpOCne1CTHBHbIM XapaKTepOM OTLIeTOB:

nocTpaAaBU1Hx onpaulxsanH o6 FIX BbInHBKe Llepe3 cTpaxosyloKOMnaHHIO, KOTOpOFi OHH npe,sOCTaBnSinH 3aSiBneHHe O BbIIInaTeCTpaXOBKH.

gaxce C CaMbIMH JjOCTynHbIMH BOnpOCaMH peCnOH,IjeHTbl o61uHX

OnpOCOB HâCeneHHSi CHCTeMaTHLieCKH HeJjOOueHHBaIOT 06bëM eBoerO

nOTpe6neHHSi Ha JtaHHb1H MOMeHT, LiaCTO B CpuHeM HanOJIOBHHy(Midanik 1988). 3-ro 03HaLIaeT, TITO ypOBeHb CMepTHOCTH

64

WIH 3a60neBaeMOCT11 MO>KeT B AeNCTB11Te51bHOCT11 COOTBeTCTBOBaTb B

ABa pa3a 6OnbHIeMy ypoBHlo noTpe6neHnA, 'lem TOT, O KOTOpOMcoo6luaEoT onpocbl.

3.3.2 Ilpo6neeea "3,gopoebix cy6beicToB" rt

npe,gwecTeywu{Hx 6one3HeH

Bo3pacT Bb16HpaeMblX peCHOHAeHTOB H MeTOA Bbl60pa MO)KeTnpHBeCTH K OIHH6KaM B HCCne,E1OBaHHAX O B51IIAHH11 ypOBHelï

noTpe651eHHA Ha (iH3Hi-IeCKOe 3nOpOBbe. B 60n6IDHHCTBe KOHTpOnbHbIX

HCC51eA0BaH11Nl Bbl6npaiOTCA Cy6BeKT6I noxcHnOrO Bo3pacTa, C y)KeBbIpa60TaHHbIM OTHOLIIeHHeM K aJIKOPOnIO. De Labry et al (1992),Hanp11Mep, HCKJHO,iHJIH cy6-BeKTOB C AHaPH030M cep5.[ei-IHbIX

3a6051eBaHH4i, paKa, Ana6eTa H rnnepTOHHH. TaKHM 06pa30M,BepOATHO, '-ITO HCKn101IâJIOCb 6onb111e nlolelï, 3noynOTpe6nA101uHxanKOroneM, 'ieM Tpe3BeHHHKOB, TaK KaK nOTpe6neHHe aJIKOPOnACB513aHO C 60nbLIIHHCTBOM 3THX 3a60neBaHHN, HO OCTâJIbHble nbi0iiwe

51E0A11 MOryT 06naAaTb nyiiLHHM 3JjOpOBbeM H BO3MO)KHO, 60nbLHeFi

COI1pOTHB51ACMOCTbIO K CBA3aHHbIX C aJIKOrOneM 3a6OJIeBaHHAM, 'lem

Tpe3BeHH11K11.

TaK KaK Cy6beKTbI 6y5(y111nx 11CCneAOBaHHii 06briH0Bbi6HpaIOTCA tlepe3 MeAHL[nHCKyiO 1151H CTpaXOByIO CHCTeMbI nyTeM

nOHCKa )KenaIOLLiHX HnH 'iepe3 npO(lieCCHOHanbHble aCCOLjHai[HH, TOnIOAH, HaxoJ[ALImecA B 6onbH141.1e 14511z1 ApyrnX y9pe)KneHnAx, nH6oniOAH C nJIOXHM 3AOpOBbeM, B OCHOBHOM, 11CIUI10'IaE0TCA. BHCcneAOBaHnAX, rAe 11CIIOnb3y1OTC51 1151aHbl MeA11n11HCKOti CTpaXOBKH

A51A Bbl60pa Cy6beKTOB, 6e3pa60THble 115111 He3acTpaXOBaHHble 5110A11

nCK51EO'ialOTCA. Bce 3TH O6CTOATenbCTBa npnaOAAT K Bbl60pycy61>eKTOB, 3AOpOBbe KOTOpbIX He TOnbKO nrIHle B CpeAHeM, HO HKOTOpble, BepOATHO, OCTaBan11Cb 6b1 3AOpOBbIM11, ecnn 6m OH113510ynOTpe6nAnH anKOPOneM. ga)Ke He yLInTbIBaA BO3M0)KH6IIi 34)(1)eKT

H3MepeHHA 3T11O51OrH'ieCK0H B3aHMOCBA3H, HCIUIIO'-IeHHe He3AOpOB6IX

Cy61>eKTOB TaK)Ke 03Ha'iaeT, LITO pe3y516TaTbl He MOIyr o606ii(aTbcAAnA HaceneHnA B IjenOM.

C ApyrON CTOpOHbI, BK51104CH11e Cy6BeKTOB c npeAHIecTBylOH.jeri6one3Hb10 MO)KeT TaK)Ke npi4BecTH K HenpaBHnbHOIi oitenxeB3aHMOCBA311 nOTpe6neHHA ânKOPOnA H (1)113H11eCKOÎI 60ne3Hn, TaK

KaK, KaK y)Ke OTMe'Ia510Cb BbIIIIe, 60nbHble peCHOHAeHTbI MOPyTCOKpaTHTb CBOe nOTpe6neHne. MeTOA0510rHL1eCKOe cpaBHeHHepaC'IeTOB HCCneAOBaHHIi CBA311 noTpe6neH11A anKOPO51A C

65

06pa30BaHIieM )Ken4HOr0 KaMHA nOKa3aJIO, 4TO Kâ)KyIljliiiCA

3aliji3THbI4i 3C1)CkeKT MO)KHO OTHeCTH Ha C4eT IIpeABapHTenbHOrOCOKpaIl[eHiiA nOTpe6neHHA aJIKOrOnA B CneACTBHH )Ken4eKaMeHHOIiAHcnencHH. (Thijs et al. 1991).

3.3.3 TpyAHOCTN, BHOC41MbI@ K)/p@HN@M, AN@TOH, O6pa3OM)K13H11 N ApyrNM CpaKTOpaMIA

B 60nb1iIHHCTBe COBpeMeHHbIX HCCne,IjOBaHHii BnHAHHA

nOTpe6neHHA aJIKOrOnA Ha (1)H3ii4eCKOe 3AOpOBbe AenaeTCA IIOIIbITKay4iiTblBaTb H 43aKTOp KypeHHA, HO CI-InbHaA B3aHMOCBA3b Me)K,gyynOTpe6neHHeM aJiKOCOJIA H KypeHlieM 3aTpyAHAeT 3TO. AJIKOrOni3KIi,

KOTOpble HNKOrAa He KypFInH, BCTpe4aIOTCA pe,IjKO, TaK )Ke KaK HCiinbHO KypALLliie Tpe3BeHHHKH.

gHeTa ABJIAeTCA Ba)KHbIM CkaKTOpOM p,.flA MHOrHX 3a60neBaHHii.OHa MO)KeT 6bITb CBA3aHa C OAHON TpeTbiO BceX cny4aeB KOpOHapHOIi

60ne3HH CepAL[a H paKa B CTpaHaX 3anaAa (ÜSDHHS 1988) H 6bITbnp114aCTHOii K BO3HiiKHOBeHHIO rNnepTOHHH, HHCynbTa, .I.ZHa6era HO)KNpeHHA. B 601IbnIHHCTBe itccneAOBaHHIi ,IiHeTa He KOHTpOJIHpyeTCA,

XOTA AaHHble CO6}ipaiOTCA 4acTo, 6o1iee TOFO, He3Ha4HTenbHbleKOne6aHliA npliBbl4eK B nHTaHHti y 60nbIIiFiHCTBa Ii3y4aeMOrOHaceneHHA MO)KeT CAenaTb TâKOIi KOHTpOnb He344eKTI-iBHbIM.

O6o61uaA, MO)KHO CKa3aTb, 4TO pa3nH4Hb1e THnbI noTpe6neHHAMOryT 6bITb CBA3aHbI C pa3H006pa3HbIMH CflaKTOpaMH o6pa3a )KH3HH H

BHAaMH nOBeAeHHA, KOTOpb1e MOryT BnFiATb Ha B3aHMOCBA3b Me)KAyIIOTpe6neHi3eM aJIKOCOnA H BO3MO)KHbIMLi nOCneACTBHAMH.

HanpHMep, 6bIJI0 BbIABneHO, 4TO Tpe3BOCTb B Te4eHi3e BCeü )KH3HH BCeBepxoii AMepHKe HMeeT MHO)KecTBO corlyTCTBytoLuHX noKa3aTeneli.OTMe4eH0, 4TO Tpe3BCHHHKIi B Te4eHHe Bceli )KiHHH - cTapwe, HIiNCen0 COL[HO3KOHOMH4eCKOMy cTaTyCy, )KHByT B npOMbllnneHHbIX 30HaX,

penHrH03HbI, HMetOT pOACTBeHHHKOB C npo6neMaMH, CBA3aHHbIMH CanxoroneM (Hughes et al 1985; Wannamethee and Shaper 1988),HMetOT nOBbILneHHbIIi ypOBeHb AenpeccHN H HCnbITbIBaIOT 60nb111eAenpeCCHBHbIX CHMnTOMOB nocne OnpeAeneHHbiX CO6bITHii B )KH3HI4,4eM HeMHOro H yMepeHHO nbtonlHe (Bell et al 1977; Neff and Husaini1982). Y4eT pa3H006pa3HbIX BapxauHli Tpe3BOCTH He 06313aTenbH0BnHAeT Ha p1iCK CMepTHOCTH (Camacho et al 1987).

TeM He McHee, He06X0AHM0 paCCMOTpeTb BO3M0)KHOCTb TOro,4TO TaKOe Bâ)KHOe cKOnneHHe pa3nH4HN MO)KeT He nOJIHOCTbiOnOAAaBaTbCA CTaTHCTH4eCKOMy y4eTy (Kozlowski and Ferrence

66

1990). "AMC KOHTpOnb OAHOrO IIOTCHIjNanbHO BnNAioujeTO (liaKTOpaMO)KCT TaHTb B ce6e CKpbITyiO OIIaCHOCTb. Tam, r,ije CyuleCTByeTItlyHKIjHOHanbHâA B3aNMOCBA3b MC)KAy IIOTCHIjHanbHblMH d)aKTOpaMH

pNCKa, CTaTNCTNLieCKNIi KOHTpOnb MO)KCT CAenaTb HeSICHbIMN

npN4NHHb1e CB51314. HaIIpNMep, ecnH noTpe6neHNe anKOrOnAperyns[pxo BeAeT K KypeHNIO, TO nOTpe6neHNe anKOrOnSI

AeiïCTBHTCnbHO nOTCHI(NanbHO O6naAaeT npNIiNHHOI%I 3aBHCHMOCTbI0

C nK)6bIM HaHCCeHHbIM KypeHNCM TSI)ICenbIM nOcneACTBHeM, HO 3TaB3aHMOCB5I3b He 6yAeT npOcne)ICNBaTbCSI, CCnN He y*-IHTbIBaTb

KypeHHe.

C Apyroil CTOpOHbI, npN nonbITKe y4eCTb BCC BnNSHOIi(NeCpaKTOpbI 14CCneAOBaH1151, MO)ICCT NHOrAa HeAOOIjeHNBaTbCSI BnNSIHHe

anKOrOJIA. HanpHMep, npH H3rICHNH HeCLIaCTHbIX Cny4aeB, B

KOTOpbIX )ICCpTBaMN CTaHOBATCA BOAHTenN, OKâ3aBIIINeCA B TOM we

MCCTe N B TO we BpeMA, LITO H BHHOBHble B npONCIIICCTBNN BOAHTenN,

HeAOOI[CHNBaeTCA BO3ACFiCTBHe ynOTpe6neHNA anKOTOnA, HOCKOnbKy

4aCTbK) Aei7CTB1451 ABJISITbCSI peüieHNe CXaTb B onacHOe MCCTO H BOnaCHOe BpeMA.

3.3.4 OrpaHH4eHNSl npH o6o6uAeHNS1x

Ba)ICHO BCë BpeMA nOMHNTb, 4TO nio6aA KpNBaA pHCxaAByXCTOpOHHeM B3aHMOCB51311 3aBNCHT OT OCO6bIX XapaKTepHCTHK

NCCneAyeMoro HBCeneHHSI. 3T0 OCO6eHHO O4CBNAHO AnA COI.jNanbHbIX

nOCnCACTBNId nOTpe6neHNA anKOTOJIA. KpNBble pNCKa B3aHMOCB51314nOTpe6neHNA anKOTOnA H npeCTynHOTO HacNJINA, O4eBHAHOOTpa)ICaIOT CnCI[mtH4H6IC AnA AaHHOFi KynbTypbl B3aHMOCB513N

BbInNBOK C HaCNnNCM (Lenke 1990), a Ha KpNBble pNCKa )KanO6 My)KaHJIN )KeHbI Ha BbInNBKH 6yAyT BnNATb npaBNna KynbTypblB3aNMOOTHOIneHNN MexcAy nonaMN. CpaBHCHHe KpNBbIX pHCKa AnAOAHOTO H TOTO )KC ABneHHA B pa3n144HbIX KynbTypaX H CJIOAX06H[eCTBa ACIiCTBHTenbHO ABnACTCA nOTCHIiNanbHblM HHCTpyMeHTOM

HCCnCAOBaHNSI 60nee rny6OKNX pa3nN4HH 3T14X KynbTyp.

KpNBble pNCKa Alm ApyrNX HOCneACTBHii TaK)Ke CB513aHbI, XOTA H

McHee O4eBHAHO, C XapaKTCpHCTNKaMH NCCneAyeMoro HBCCneHNA. B4aCTHOCTN, 6OnbIIINHCTBO KpHBbIX pNCKa poJIN anxoronA B

BO3HHKHOBeHNN XpOHN4eCKNX 3a60neBaHNN 6a3NpyIOTCA HaNCCneAOBaHNSIX HaCeneHHA NHAyCTpNanbHblX, aHrnorOBOpAHjHX NCeBepHO-eBponel%ICKHX 061I.TeCTB. no CpaBHCHNIO CO CpCAHNM

MNpOBbIM ypOBHeM, 3TN O61I(CCTBa O6naAaiOT HCKOTOpbIMN O61IjNMN

67

xapaKTeplicTl3KaMl3, KoTopble, CKOpee scero, BnHAIOT Ha (1)opMyKpHBbIX: HanpHMep, 60nbIDiiHCTBO HaceneHHA nbeT anKOrOnbHbleHanHTKH, nHTaHHe 6oraTo x(xpaMH )KHBOTHOrO npoHcxoxcAeHHA,,IIOCTaTOLIHO pacnpOCTpaHeHO KypeHHe. KpHBble pliCKa anKOrOnA HCMepTHOCTH AnA pa3BlisalOnjHXCA CTpaH MOryT BbIrnAAeTb

cosepHleHHO no-ApyroMy.

3.3.5 B3a14MOCBA3b IIOTp@6J7@HNA al1KOrOIIA NIIOCII@ACTBNN

KpliBble pHCKa KnaCCHileCKi3 HCHOnb30BanHCb, LITO6bI COOTHeCTH

BPHHTM nOTpe6neHH91 ânKOrOJIA C nOCJIeACTBHAMH, AnA KOTOpbIXnOTpe6neHHe ânKOrOnA He ABnAeTCA HH 065I3aTenbHOH, HH

CymeCTBeHHOFI npHLiHHON. ,LtOpO)KHaA asapHA MO)KeT CnyiIHTbCA H 6e3

nOTpe6neHiiA anKOronA, TaK )Ke, KaK H L[Hpp03 neiieHH. KpHBble pFiCKaAeiiCTBHTenbHO T-IacTO HCnOJI63yK)TC51 KaK yacTb HCCneAOBaHHÎ-i ARA

yCTaHOBneHHA HnH nposepKH npHiIHHHOIi CB5I3H Ha CpeAHeM ypOBHeMe)iCAy nOTpe6neHI3eM anKOronA H nOCneACTBHAMH: eCnH BCë npOiieeHaXOAHTCA Ha paBHOM ypOBHe, AaHHOe nOTpe6neHHe anKOrOJIABnHAeT Ha pHCK BO3HHKHOBCHHA AaHHbIX nOCneACTBHN. gaxce KOrAa

npliiIFiHHâA CB5I3b yCTaHOBneHa Ha 06O61I1ëHHOM ypOBHe, 3T0 ente He3Ha9HT, i-ITO anKOrOnb 065I3aTenbH0 BOBneiieH B TO, LITO npOHCXOAHT B

AaHHOM Cnyiiae Ha HHAHBHAyanbHOM ypOBHe.

3TOT KnaCCHileCKHN BHA aHan143a MO)KeT 6bITb BbIBeAeH 3apaMKH TeX nOCneACTBHii, AnA KOTOpbIX OH TpaAHL[HOHHO

npHMeHAeTCA, HO B I-iCCneAOBaHHAX Ha HHAHBHAyânbHOM ypOBHe er0

npHMeHeHHe AnA TaKHX nOCnCACTBHFi, KaK npecTynneHHe HnH

pa3pyHleHHe CeMbH, CO3AaeT rpOMaAHble MeTOAOnOrHiieCKHe

np06neMbl: nOTCHL(HanbHble B3aHMOBnHAHHA, KOTOpble OTpâ)KaIOTCAHa npiiilHHHOi%I B3aHMOCBA3H, CTaHOBATCA OYeHb MHOrOiIPICneHHbIMLi.

KaK MbI ewe 6yAeM 06cy)KAaTb, HaH6OJIee y6eAHTenbHbieAOKa3aTenbCTSa npHiIHHHOI-I CB5I314 B 3THX O6naCTAX npeAocTaBHnHHCCneAOBaHHA nOTpe6neHHA Ha o606LIjeHHOM ypOBHe.

CylljeCTByeT ABa OCHOBHbIX cnoco6a BbICTpOHTb Ha OCHOBeAaHHbIX B3aHMOCBA3b Me)KAy nOTpe6neHHeM anKOrOnA H eronOCneACTBHeM. OAHH - n0 BHeLHHHM npOASneHHAM. HeKOTOpblenOCneACTBHA ABnAIOTCA CB513aHHbIMH C anKOrOneM no OnpeAeneHHK);

HanpHMep, apeCT 3a BO)iCAeHHe B HeTpe3BOM COCTOAHHH. 3Aecb 3aKOH

H o(tHljep nOIIHLjHH onpeAenAeT (paKT noTpe6neHHA anKOronA, LITOXapaKTepH3yeT IIyTb npecTynneHHA. RpyrHe sHenIHHe npOABneHHA

68

MoryT noCTynaTb OT nepcoxana CnyNC6 3Z[pasooxpaxeHHSi HRHCOuHanbHOii CnyNC6bI, HanpHMep, )2(HaTHO3bI anKOrORbHOrO I.jHppo3aHRH aJIKOrOnbHOii 3aBHCHMOCTH, RH60 OTHeCeHHe K KaTerOpHH6e3,TjOMHOTO anKOronHKa.

Apyroï-I OCHOBHOIi BHA OnpeAeneHHSI - 9T0 CAenaHHbli4 CaMHMHRH caMoii LIacTo B onpocax HaceneHHSi pecnOHAeHTOBnpocSlT onHCaTb CBOii "OnbIT ynoTpe6neHHSi aRKOrOnsi", BKJIIOIiasicouHanbxble, nCHxonOTHLieCKHe H Me,aHuxxcKHe nocneZ[CTBHSI. A TO,Koma H npH KaKHX 06CTOSITenbCTBâX peCIIOHAeHTbI cnenaK)TnOAo6Hble npHLIHHHble onpeAeReHHSI, SIBRSIeTCSI BaNCHbIM BOnpOCOM

HCCne,aOBaHHii. IIpH AaHHOM yposxe HRH cnoco6e noTpe6ReHHSIKpHBaSI pHCKa nOKa3bIBaeT, *-ITO TaKâSi-TO LiaCTb nbIOLuHX COO61uHna o

CBOeM He6RarOnpHSITHOM HnH nORONCHTenbHOM OnblTe ynOTpe6RCHHSi

ânKOTOnSI.

IIpH ApyrHx 06CTOSITenbCTBaX MONCHO COBMeujaTb 3aslBneH145InbioII.jerO H Cy)KAeHHe np0ltecCHOHana. O6bILIHO OTBeTOB nbioiuer0 BOnpOCHOM nHCTe AOCTâTOLIHO AnSI rpy6oro AHarxo3a aRKOTOnbHOii3aBHCHMOCTH. Ho AHarH03 aJIKOTOnbHOIi 3aBHCHMOCTH 3TM CTaBHTCSI

Ha OCHOBe npOCpeCCHOHânbHOTO MHeHHSI, nH6o np0(DeCCHOHanOM, R460

no COCTaBneHHOMy npo(PeCCHOHâROM anrOpHTMy B AHarHOCTHLIeCKOI%I

aHKeTe.

He06X0AHMO OTMeTHTb, Lnb npHIIHHHâSi CBSI3b TaKHX nOCneACTBHIi

HRH OnbITa OTHOCHTCSI K anKOTORio B0061ue, a He K KaKOMy-nH60OnpeneneHHOMy cnoco6y noTpe6neHHSI anxoronsi. He cyHtecTByeT06313aTenbH0i4 npHLIHHHON CBSI3H MeNCny KOHKpeTHbIM CnOCO6OM

nOTpe6neHHSI aJIKOTOnSi H CBSI3aHHbIM C aRKOroneM nOCneACTBHeM,

KOTOpOe nOKa3aHO Ha rpa(iHKe. He Bcerna SICHO H HanpaBneHHenpHLIHHHOii CBS13H. B LIaCTHOCTH, OnHCbIBaeMOe noBeneHHe nbiOÜHX

MO)KeT 6bITb KaK CneACTBHeM, TaK H npHLiHHOH aRKOTOnbHOii3aBHCHMOCTH.

O6cyxcnaeMasl HaMH KpHBasi pHcxa neiiCTBHSi ânKoronSl TaKHM06pa30M, OTnHLIaeTCSI OT 06bILIHbIX KpHBbIX pHCKa nnSl palm HillnopONCHbIX asapHii. UeHHOCTb KpHBOI4 He 065I3aTenbH0 3aKRiOLIaeTCSIB nposepxe npHLIHHHOH B3aHMOCBSI3H, a cxopee B BO3MONCHOCTHOnpeneRHTb BepOSiTHOCTb B03HHKHOBeHHSi CBSI3aHHOrO C âRKOTOneM

nocneACTBHSI npH pa3nHIIHbIX ypoBHSix noTpe6neHHSI.

69

3.4 IIOTPE6J1EHVIE AJ1KO1-OJ1A M BEPOATHOCTbf1O3VITVIBHbIX COIAVIAJ1bHbIX f1OCJ1Ej.1CTBVIVI

B nOCnenHNe OCHOBHOe 06Cy)K,LIeHNe noTeHuNanbxO1103NTNBHbIX nOCnenCTBNÎ-1 nOTpe6neHNA anKOrOnA CCpOKyCNpOBaHoHa BO3M0>KHOIi ponN anKOI'onA B COKpanteHNN pNCKa BO3HNKHOBeHNA

KOpOHapHOi%I 60ne3H11 cepnita (KBC) H Mbl ente BKpaTL[e BepHeMCA K3TOMy Bonpocy. TeM He McHee, 60nbwNHCTBO cny4aeB nOTpe6neHNAanK0r0J151 113HaMânbHO He 06yCJIOBneHbI 3a6OTOFl o cepnLte.YnoTpe6neHNe anKoronA B 06LLtecTBe H 4yBCTBa, nOABJIAfOLi[NeCAnOCne 3TOro, AnA MHOrNX 51BJ15IeTC51 NCTOMHNKOM yAOBOnbCTBNA. TaK

KaK OCHOBHON liapMaKOJ1orNLIeCKN4i 3CM:IeKT 3TaHOna nenpecCNBHblN,

nOTpe6neHNe anKOrOJIA TaK>Ke TpanNLtNOHHO NCnOnb3yeTCA nnAB03ne1%lCTBN51 Ha HaCTpOeHNe NJIN KaK ycnOKaNBaion.tee CpenCTBO.

ARA HenpNBbIKwNX K ânKOronK> nioneN nOJIOxcNTenbHblenOCneACTBNA nOTpe6neHNA MOryT BO3HNKaTb npN ynOTpe6neHNNAOBOnbHO ManOrO KOJIFIMeCTBa anKOrOJIA. Ha CaMOM Aene, OxCNnaHHSI,CB3I3aHHble C Bb1nNBKON, MOryT npON3BOANTb nOnO>KNTenbHblÎ-i

34)C13eKT, naxce ecnN B HanNTKe OTCyTCTByeT anKOrOnb, nOCKOnbKyn03NTNBHble 4yBCTBa 4aLLte CB513aHHb1 C Co6bITNeM N KOMnaHNeN, 4eMc 3TaHOJ10M (Lang 1983). TeM He McHee, B 06LqNX onpocaxHaCeneHN51 Te, KTO nbeT MHOro, nNwyT O 11O3NTNBHbIX 3li)CpeKTaXnaine, 4eM Te, KTO nbeT manu. (Hauge and Irgens-Jensen 1990). 3TOHe 3HaMNT, LITO MânOnblontNe 6ynyT nNCaTb O TaKOM )Ice ypOBHe11OJ1O>KNTenbHblX 34p(1)eKTOB, eCJ114 Ha4HyT nNTb 6onbwe; 3AeCb,BO3MOxCHO, Cpa6aTblBaeT Bb16Op04HbIN 344eKT, npN KOTOpOM Te, KTOnony4aeT 6onbwe 1103NTNBHbIX 3C14eKTOB, Mante CTaHOBATCA

nbSIHNLtaMN.

I10J10xCNTenbHble 11OCneACTB1451 noTpe6neHNA anKOrOJ151 AJIA

nN4HOCTN MaCTO 06CyxCAaIOTCA C nO3NLtNN NneanN3NpOBaHHONKapTNHKN npy3ei1, BbInNBaIOLItNX BMeCTe 60Kan-npyroi7 BNHa 3ayxcNHOM. TeM He Mexee, Hauge N Irgens-Jensen (1990) o6HapyxcNnN,4T0 n03NTNBHble 34)CtleKTbl 6onee CBA3aHb! C 4aCTOTON OnbAHeHNA,4eM C 0611tNM O6beMOM noTpe6neHNA. 3T0 NCCnenOBâHNe OnNpanOCbHa OT4eTb1 xCNTeneN 4eTblpeX CKaHANHaBCKNX cTpaH, rAe OnbAHeHNeABJ1AeTC51 TpaANLtNOHHbIM CTHJIeM 3HaMNTenbHOrO noTpe6neHNA, Hpe3ynbTaTbl, HanpNMep, B CpenN3eMHOMOpCKNX CTpaHaX MOryT3Ha4NTenbHO OTJ1NMaTbC51. I'ICNOnb3yA naHHble 3TOrO xCe

NCCnenOBaHNA no CDNHJIAHANN, Mäkelä H Mustonen (1988) noKa3aJIN,4TO KOJIN4eCTBO 1103NTNBHbIX 34)ClleKTOB nOBblwaeTCA MenneHHeN npN

70

pocTe noTpe6neHIiSI, YeM He6naronpHSlTHasl COgHanbHasi H

OCpHL[HanbHasl peaxLjlisI Ha nbslxCTBO. )11JISI nblolijeFl nHLIHOCTH nepesec

11O3HTHBHbIX Hajj HeraTHBHbIMH nOcneACTBHSiMH, TaKHM 06pa30M,yMeHbllIaeTCSI C yBenHLIeHHeM ypOBHSi nOTpe6neHHSi; CaMbIIi BbICOKHI-i

nepeBec 1103HTHBHbIX nOCneACTBHII Hag HCraTHBHbIMH 6bin cpeAHpecnOHAeHTOB, nHCaBIIIHX, LITO OHH BbInHBaIOT OT OAHOII AO LIeTbIpeX

A03 B AeHb (1 A03a - 10 r LiHCTOrO anKOrOnsi).

PICCneAOBâHHSI, KOTOpble 3aHHMaIOTC5I KpHBbIMH BO3MOxCHOCTH

n03HTHBHbIX nCHXOJIOrHLIeCKHX H COLjHanbHbIX 3C1)(1)eKTOB nOTpe6neHHSI

ânKOrOnsl, no-npe)KHeMy MânOLIHCneHHbl; nOAXOAbI CpaBHeHHSI

KpHB6IX pHCKa 11O3HTHBHbIX H HeraTHBHbIX nOCneACTBHÎi Mäke lä H

Mustonen ,IjOn)ICHbI 6bITb HCnp06OBaHbI H Ana H3yLieHHSI HaceneHHSIpa3HbIX CTpaH.

3.5 I1OTPE6J1EHVIE AJ1K0r0J151 N I1O311TNBHbIE0:1V13144ECKME rlOCJ1EACTBNA

3.5.1 KopoHapHasi 6one3Hb cep,qua

B psl,Ije HccnejjoBaHHN nOxa3aHO, LITO noTpe6neHHe OT oJjHOii AO,ijByX AO3 anKOrOn51 B Zjexb (npH 3IIH3OAH4ecxOM ynoTpe6neHHH AoIIIeCTH )103 B AeHb), oLIeBHAHO, npeAcTasnsleT npeHMyLgeCTBO ;Trim3A0P0B651 no CpaBHeHHIO C Tpe3BOCTbIO B TeLIeHHe BCel1 )KH3HH.CpeAH n0A06H6IX OTLIeTOB H 0630pOB MoxcHO ynoMSlHyTb: Anderson1994; Friedman and Kimball 1986; Klatsky et al 1981; Marmot et al1981; Marmot 1984; Beaglehole and Jackson 1992; Kemp 1993;Shaper 1990, 1993; Stampfer et al. 1993. CyujecTByeT 6onbnleAaHHbIX O My)KLIHHaX, LIeM O xCeHLLjHHaX, HO B3aHMOCB5I3b, n0-

BHAHMOMy, Ae11CTBHTenbHa will o6oHX nOJIOB. XOTSI 3TH TpyAblMO)KHO KPHTHKOBaTb n0 MHOrHM MeTOAOJIOrHLIeCKHM nyHKTaM,

KOTOp6Ie 06Cy)ICAanHCb BblLUe B pa3Aene 3.3, MO)KeT 6bITb cAenaHonpeABapHTenbHOe 3aKnIOLIeHHe, LITO nOTpe6neHHe ânKOrOnbHbIXHanHTKOB B He6onbIIIHX go3aX, BeposlTHO, coxpaujaeT pHCK

BO3HHKHOBeHH5I KOpOHapHOii 60ne3H14 cepALja (KbC) Ans[ HaceneHHSIHeKOTOpbIX cTpaH. Ha HnnloCTpaIjHH 3.1 npeAcTasneHbl B

rpacl)HLIecKOi1 ctlopMe pe3ynbTaTbl CeMH HCCneA0BaHH11, KOTOpble11OKa3bIBafOT OTpHIjaTenbHylO B3aHMOCB313b MexcAy noTpe6neHHeManKOrOnsI H CMepTenbHblM HCXOAOM Anx MyxCLIHH B pe3ynbTaTeKOpOHapHOIi 6One3HH cepALja. Bo BCeX npOLjHTHpOBaHHbIX

71

HCcneliOBâHHSiX npe,ijCTasneH npHBe,rieHHblii OTHOCHTenbHbll-1 pHCK.Pa3nHLIHble HCCne,IjoBaHHSI paccMaTpHBanH MHOr006pa3HblenepeMeHHble (liaKTOpbI, HO yLIHTbIBanH, no Kpai%IHeLi Mepe, BO3paCT HKypeHHe.

Be,rieTCSI aKTHBHbIH nOHCK 6HOJIOTHLIeCKHX McXaHH3MOS,

06131CHSIIOLuHX cOKpaiueHHe pHCKa KBC H HeKOTOpbIX jjpyrHX THnOBcepAeLIHo-cocy,IuiCTbIX 3a6OneBaHHii (CC3), HO nOKa 6e3ycneIIIHo.bOnbLIIHHCTBO yCHJIHIi 6bIJI0 CKOHueHTpHpOBaHO Ha aHânH3e ypoBHelinHnH,Iios H arperauxH TpoM6ouHTOB (Rankin 1994).

11oTpe6neHHe anxoron3l noBblIIIaeT BbICOKyIO H nOHH)KaeTHH3Ky1O TUIOTHOCTb nHnonpoTeHHOB (Rankin 1994; Arria and VanThiel 1992; Renaud et al 1993). B pa6oTax AMepxxaHcxoro ueHTpano H3rIexHIO nxnH,IioB H lleHTpa HCCneJ[OSaHHFi cep,Iiva I'oHOJIyJIyOKOJIO nOJIOBHHbi cnriaeB cOLIeTâHHSI Tpe3BOCTH H KOpOHapHOii6one3HH cepziva XapaKTepH3yK)TCSI ,IiOCTOBepHbIM cO,Eiep)KaHHeM

XonecTepona npH nOBbILIIeHHOiï rIJIOTHOCTH nHnOnpOTeHHOB. bbInOBbI,IiBHHyTO npe,iinOJIO)KeHHe, L1TO HeKOTOpOe KOnHLIeCTBO ZiaHHbIX

3(ti(tieKTOB OrpaHH9eH0 reHeTHLieCKHMH OCO6eHHOCTSIMH noArpynnHaceneHHSI. AnKOTOnb MO)KeT TaKXCe BO3jieiiCTBOBaTb H 6oneeHenOcpejicTBeHHO, COKpaIliaSi pHCK BO3HHKHOBeHHSI cep,rieLIHOTO

npHcTyna IIyTeM yMeHbiueHHSI CBOpaLIHBaeMOCTH KpOBH (Rankin1994; Zakhari 1991).

B cBeTe ,IiaHHbIX 3nHJieMHOJIOTHLIeCKOH nHTepaTypbl MO)KHOonpelienHTb HeKOTOpble napaMeTpbI nK)6oTO no,ri06HOT0 COKpaIueHHSIpHCKa:

1. CaMoe 60nbinoe cOKpaiiieHHe OTHOCHTenbHOTO pHCKa noCpaBHeHHK) C Tpe3BOCTb10 BO3HHKaeT Ha oLieHb HH3KOM ypOBHe

nOTpe6neHHn, TaKOM KaK OT O,IiHOii jiO3bl Liepe3 ,tieHb Ji0 jiByX ,Iî03B,IieHb (1 ,riO3a - 10 r LIHCTOTO anKOrOJI31). Jho 6oe jianbHeiiiIIeeCOKpaLueHHe pHCKa B03HHKHOBeHHSI KOpOHapHOii 60ne3HHCepuua, KOTOpOe IiOCTHraeTCSi npH nOTpe6neHHSi anKOTOnSI statuenpHBeliëHHOrO ypOBHSI, BepOSITHO, nOTepSIeT CMbICJI H3-3anOBbILIIeHHSI pHCKa ,ripyrHX He6naronpHSITHbIX nOcnelicTBHH.

72

1.2

1.0

0.2

000 2G 40 60 80

rpaMMbl âJIKOrOJISI B AeHb

100

14JIJIIocTpauHA 3.1. CMepTHOCTb B pe3yJIbTaTe KOpoHapHo i 601Ie3HHcepwwa cpe,IZN My)KLIHH: noTpe6neHne aJIKOrOJI5I H OTHOCHTeJIbHb1H

pHcK. Pe3yJIbTaTbl CeMH HCCJIe,IjoBaHHg. Hennekens et al (1978), ;

Rimm et al. (1991), +; Gordon and Kannel (1983), ; Gordon andDoyle (1987), ; Boffeta and Garfinkel (1990), ; Scragg et al.(1987), 0 ; Jackson et al (1991), A .

2. B LIaCTHOCTH, 3HaLIHTeJlbxoe ylloTpe6JIeHHe aJIKOroJISI IIO

BbIXOAHbIM B 06beMe, KOTOpbIN Mo>KeT B CpeJmCM

COOTBCTCTBOBaTb J(ByM HJIH TpeM Ji03aM B jjeHb, HeCeT B ce6epHCK KaK ,E1JI5I II)H3H4eCK0P0 3,i1OpOBb5I, TaK H JtJ15I COLjHâJIbHbIX

nOCJIeJ(CTBHN H TpaBMaTH3Ma, B TO BpeMSI KaK ewe He SICHO,COKpaTHT JIH TaKOe KOHIjeHTpHpoBaHHOe IIOTpe6JIeHHe aJIKOrOJISI

pHCK BO3HHKHOBeHH5I KOpOHapHOI%I 60JIe3HH cepgua.

3. Bb16op aJIKOrOJIbHbIX HatIHTKOB, OLIeBHJJ<HO, He BJIHSIeT Ha

coxpaiueHHe pllcxa.

4. CyLueCTBeHHOe coxpameHHe a6COJIK)THOrO pHexa He B0311HKaeTnpH noTpe6JIeHHH aJIKOI'0JI5I B He6onb1IIHx ,LjO3aX JtJISI MrKLIHH

73

Monoxce 35 H ami xceHnHH npeuxnHMaxTepHHecxoro Bo3pacTa,TaK KaK KOpOHapHaSl 60ne3Hb cepAUa He SIBnSIeTCSI Ba)KHOii

rlpHtiHHOii CMepTHOCTH unu 3THX KaTerOpHi%[ nloteï-i, ecnH HeyLIHTbIBaTb npetnOJIOxceHHU, LITO 3HaLIHTenbHbIIi n03uHeIiLLIHIi3aI11HTHbIii 30(13eKT OCHOBaH Ha paHHeM nOTpe6neHHH.

5. LiRA TeX, *ibe nOBeDeHHe y)Ke CB5I3aHO C COxpaLLjeHHeM pHCKaB03HHKHOBeHHSI KOpOHapHOIi 60ne3HH CepJjIja (HeKypSILLjHe,

3aHHMaIOLI.[HeC51 (1)H3KynbTypOi3, npH,uepxcHBaIOLI(HeCSI nHeTblHH3KOi3 xCHpHOCTH), nOTpe6neHHe änKOrOnSI B MânbIX Do3aX spinRH npHBeneT K tOHOJIHHTenbHOMy COKpaIIjeHHio a6COnIOTHOrOpHCxa. FnaroAap51 CB113aHHOMy C HH3KHM pHCKOM noseneHHU,XapaKTepHOMy J.jnSi HeKOTOpbIX KynbTyp, OCO6eHHO B putepâ3BHBaIOLLjHXCSi CTpaH, KOpoHapHaSl 60ne3Hb CeptL;a TaM nOLiTHHeH3BecTHa; npH naHHbIX 06CTOSITenbCTBaX nOTpe6neHHeanKOrOJISi B MaJIbIX to3aX He MOxCeT HpHBeCTH K COKpaLLjeHHIoa6conIOTHOrO pHCKa.

6. BepouTHO, LITO coxpaLueHHe pHCxa nyTeM noTpe6neHHU anxoronuB ManbIX nO3aX MOxCeT 6bITb Taxxce tOCTHrHyrO npyrHMHCHOCO6aMH, HanpHMep: H36eraT6 BO3tCÎICTBHSI Ta6aLIHOrO tblMâ,ycHnHBaTb (1)H3HLieCKyiO aKTHBHOCTb, npHtepxcHBaTbcu nHeTbl CHH3KHM COnepxcaHHeM xCHpOB HnH npHHHMaTb no non-Ta6neTKHacnHpHHa Hepe3 nenb (Drugs and Therapeutics Bulletin 1994).ans! Tex, y KOI'O eCTb npHLIHH6I H36eraTb noTpe6neHHuanKOronSl, TaxHM o6pa3oM, eCTb npyrue BapHaHTbI coxpaLLteHHupHCKa BO3HHKHOBeHHSI KopOHapHOH 60ne3HH Ceptna.

3.5.2 ,gpyrHe r103HTHBHbi@ IIOCn@pCTBHA ,gJ1A 3,4OpOBbA

KpoMe nHTepaTypbl n0 KFiC eCTb HeKOTOp6Ie pa60TbI, ruecoo6maeTCSi o noTpe6neHHH anxoronu B He6onbLllHx to3aX, KoTOpoeCOKpaLuaeT pHCK B03HHKHOBeHH51 upyrHx npo6neM CO 3nOpoBbeM(Colsher and Wallace 1989; Poikolainen 1994). RocTaTOLIHO BecKHeDOKa3aTenbCTBa no HLIIeMHLIeCKOMy HHCynbTy, HO He n0 KpOBOH3nHSIHHIOB MO3r, OTMeLieHbl HH)Ke. B OTHOLIIeHHH HeKOTOpbIX upyrl-ix3aLIjHTH6IX 31P(PeKTOB, KaxCyUjHeCSi nOJIOxCHTen6HbIMH pe3ynbTaTbl,

CKOpee BCero, He COOTBeTCTByiOT teNCTBHTenbHOCTH (Thijs et al1991; Bouter 1988, CM. BbILLIe).

74

3.6 IIOTPE6J1EHVIE AJIKO1-011A 14 HErATV1BHbIEcD13114ECKVIE I1OCf1E,gCTBN1A

3noynoTpe6neHHe anxoroneM noBbllnaeT pHCK 3a6oneBaeMocTHH CMepTHOCTH, H CTeneHb pHCKa B03paCTaeT C nOBbIIIIeHHeM ypOBHSI

noTpe6neHHx. Haine noxHMaHHe TOrO, LiTO KpOeTCSI 3a 3THMyTBepxcAexxeM, o6oraukeno pa6oTaMH, npose,rkexxblMH 3a nocneAHHe20 neT. C O,gHOii CTOpOHbI, HMeHHO B 3TOT nepxoA HaKOIIHnHCbMHOrHe H3 TOnbKO LITO paCCMOTpeHHbIX ,Ij0Ka3aTenbCTB, KOTOpbleII0Ka3bIBaiOT, LITO nOTpe6neHHe B He601IbLIIHX ,Iko3aX MO)KeT CHH3HTb

pHCK BO3HHKHOBeHH51 KbC. C jjpyrOii CTOpOHbI, 3a 3TH jjeCSlTHneTHSI

6bin npoAneH nepeLiexb npo6neM 3.ijOpOBb5I, B BO3HHKHOBeHHH

KOTOpbIX noTpe6neHHe anKOronSI HrpaeT OnpeAeneHHyIO ponb, a CHna,IftOKâ3aTeJIbCTB npHLIHHHOrO BnHSIHHSI anKOrOnSI B03pOCna. O606LuaSI

3TH AOKa3aTenbCTBa, MbI OnHpaeMCSI 3AeCb B OCHOBHOM Ha nOCJIe,ijHHe

o63opbl coorseTCTByiouceH nHTepaTyp6l (Anderson et al. 1993;Anderson 1994; Duffy 1992).

BepxblM oCTaeTCSI TO, LITO B HaLLIeM pacnopxxceHHH 6onbLLle3nxAeMHOnorHLiecKHx AaHHbix o cMepTHocTH, geM o 3a6oneBaeMocTH.r10 3TOi-i npHIIHHe OCHOBHOe BHHMaHHe 3ACCb 6OnblIIei%[ LIaCTbIOCKOHLjeHTpHpoBaHO Ha CB5I3aHHOii C nOTpe6neHHeM aJIKOTOnSi

CMepTHOCTH. TeM He McHee, Hy)KHO npH3HaTb, LiTO nOTpe6neHHeanKOTOnSI CB5I3aHO TaK)Ke C 6OnbIIIHM KOnHLIeCTBOM 3a60neBaHHIi,KOTOpble He npHBOASiT K CMepTH.

3.6.1 3noKayecrseHHbie onyxonN

B o63ope AanxbIx Me)KAyxapoAHoro areHTCTSa Hccne,IjosaHHi%Ipaxa (1988) cAenaxo 3aKJIIOLIeHHe, LITo anxoronb HMeeT npHLIHHHyioCBSI3b C BO3HHKHOBeHHeM paKa pOTOBOil nOJIOCTH, rnOTKH, ropTaHH,

IIHII(eBOAa H neLIeHH. B 60nbiIIHHCTBe HCCneAOBaHHM rOBOpHTC51 OcylljeCTBOSaHHH B3aHMOCB5I3H "Ao3a - OTBeTHaS1 peaKL;HSI" nocneyLIeTa nOTeHuHânbHblX COCTâBnSIK)LuHX, TaKHX KaK KypeHHe; H 3TaB3aHMOCB5I3b, no-BHAHMOMy, AeliCTBHTenbHa KaK AnSI My)KLiHH, TaK H

AnSI )KeHIuHH. ,E(aHHaSI B3aHMOCB5I3b He 51BnS1eTCSI npSIMOnHHeiiHOi%I, a

nOKâ3bIBaeT nOA-heM KpHBOH npH BbICOKHX ypOBHSIX noTpe6neHHSI(Duffy and Sharples 1992). no ouexxe Rothman (1980) H3-3anpHLIHHHOrO yLIaCTHSi B BO3HHKHOBeHHH 3THX THIIOB paKa ânKOronb

OTBeTCTBeHeH npH6nH3HTenbH0 3a 3% BCeX CnyLlaes paKa B CHIA. BApyrHx cTpaxax, C ApyrOH cXeMOii paCnpOCTpaHeHHOCTH pa3nHLIHbIXTHnOB palm, BenHLixxa, BepoSITHO, 6y,tkeT ApyroH.

75

3a nocne,gHNe HeCKOnbKO neT 6bin ony6nNKOBaH pAA

NCCneJ),OBaHNii no aJIKOronlo H paxy rpyJiN y >KeHLuNH.

HaKanJINBaIOTCA ,IZaHHble HO B3aNMOCBSI3H "JZ03a - OTBeTHâA peaKuNSI"

(cM. nJInIoCTpauNlo 3.2.), nOKa3bIBaIOII[Ne OTHOCNTenbHO MeJZneHHOe,HO cTa6Nnbxoe noBbIIIIeHIie plicxa C yBenNT-IexxeM noTpe6neHNAaJIKOronA. CynJecTByloT HexoTOpble pa3nNLINA B pe3ynbTaTax, NOTHOCNTenbHblÎl PUCK HeBenNK, XOTA CXOAeH no BenNT-INHe CO

MHOrNMN gpyrNMN yCTaHOBneHHbIMN clalcTOpaMN pNcxa paxa (Kelsey1993), a MHeHNA O TOM, CyII(eCTByeT nN 3,IZeCb npNT-INHHâA B3aNMOCBA3b,

no-npexcneMy pacxoJjATcA (Hunter and Willett 1993; McPherson et al1993; Rosenberg et al 1993). OTHOCNTenbxblïl PUCK ananN3NpoBancAC yLi2TOM HeKOTOpbIX nOTeHuNâJIbHbIX COCTaBnAx)IIjNX CpaKTOPOspNCKa. BCe npouNTNpOBaHHble NCCnegOBaHNA yiiNTbIBâJIN nOKâ3aTenbMaccbl Tena, a Schatzkin et al 1987 H Willett et al 1987 TaKxceyLliiTblBanN JjNeTy.

Tal0Ke HaKaIIJINBaeTCA BCe 60nbule AaHHbIX 06 OTHOCNTenbHOCna60Ii B3a1,1MOCBA3N "Jj03a - OTBeTHaA peaxuNA" Me>KJjy noTpe6neHNeM

aJIKOPOJIA H BO3HNKHOBeHNeM paxa npAMON H TOnCTOIi KNUIKN j[JIA0601fX nOJIOB, C BO3MO>KHbIM CneuNCIINHHbIM 34pC1.1eKTOM npNnoTpe6JIeHNN nNSa (Longnecker 1992; Meyer and White 1993). Floouenxe Longnecker,aJlKOronb noTeHuNanbxo HeceT OTBeTCTBeHHOCTb3a yLiaCTNe B BO3HNKHOBeHNN 3THX JjByX BNJjOB paxa H 3a 1% BCeXcnrlaes paxoBblx 3a6onesaHNH B CILIA.

3.6.2 %iHCyJ1bT N nNfl@pTOHH4@CKâA 6011@3Hb

ITOBbIuleHHOe KPOBAHOe JjaBneHNe CNJIbHO BnNAeT Ha

BO3MO>KHOCTb BO3H14KHOBeHH51 NHCynbTa, H 3T0 o3HaTiaeT, LITO B

,rk aHHOIi O6naCTN MbI MO>KeM OHNpaTbCA Ha NCCnegOBaHNA H n03a60neBaeMOCTH, N no CMepTHOCTN. bOnbIIINHCTBO NCCneJjOBaHHIiMy>oiNH, npoaHânN3NpOBaHHbIX B Anderson et al (1993),nOKa3bIBaIOT CyüjeCTBOBaHHe B3aNMOCBA314 " Jj03a - OTBeTHaA

peaKuNA" Me>ICuy nOTpe6neHNeM ânKOrOnA H Kat( RNaCTOnNileCKNM,TaK H CNCTOJINLIeCKNM KpOBAHbIM AaBneHNeM, H B OKOJIO nOJIOBNHeNCCneJIOBaHNII TaK>xe 06Hapy>KNBaeTCSI 3Ta CBA3b. JIA06o14X nOJIOB (1)aKTbI, KaCaIOUjNeCA BOnpoca, CyujeCTByeT RH JjaHHâAB3aNMOCBA3b TOnbKO BbIUle noporosoro ypOBHA noTpe6neHNA,npoTNBOpeigNBbI (Beaglehole and Jackson 1992).

76

3.5

3.0

2.5

2.0

1.5

1.0

0.5

000 10 20 30 40 50 60

rpaMMbI âJIKOrOJISI B eHb

70

HJIJIIOCTpagHH 3.2 CMepTHOCTb B pe3ynbTaTe palm rpyAH yWeHI1114H: noTpe6neHlie aJIKO1-On5I H OTHOCHTenbHbIli pHCK. 1-15ITb

AnHTenbHblX HCCneAOBaHHIi. Hiatt and Bawol (1984), ; Hiatt et al.(1988), +; Schatzkin et al. (1987), ; Willett et al. (1987), 1=1;

Gatspur et al. (1992), .

MHoro nbIOLL[He My>ICYHHbI nOABepraioTCA nOBbIHIeHHOMy pHCKy

cMepTH OT nio6OrO BHAa HHCynbTa (HnnioCTpaLIHA 3.3). 3TOT

pe3ynbTaT, BO3MO>KHO, npHMeHHM TaK>Ke H An5I >KeHI1jHH.

Bo BCeX HCCneAOBaHHAX, npeACTaBneHHbIX Ha AaHHOH

HJInK)CTpaLIHH, OTHOCHTenbHblÎ-i pHCK paCCi-IHTbIBanCA npH rte-reBo3pacTa H KypeHHA, a B HceneAoBaHHAX Kono et al (1986), HBoffetta H Garfinkel (1990) TaK>Ke yLIHTbIBanCA nOKâ3aTenb

KpoBAHOro AaBneHHA. r1pHAep>KHBaAcb 3TOrO O6LLIerO BbIBOAa no(13H3HOnorHtlecKHM H 3nHAeMHOnormecKHM npHLIHHaM, Mo>KI-Io

npeAnOJIO>KHT6, 3Ta CB5136 C nOTpe6neHHeM anKoronA MO>KeT6bITb pa3nHLiHa AnA pa3nHLIHbIX BHAOB HHCynbTa (Arria and Van Thiel

77

1992). TaKHM O6pa3OM, BbIACHHJIOCb, 'ITO CyLueCTByeT

npH6111431-1TenbH0 npAMOnHHeiiHâA B3aHMOCB513b Mexcziy KOJIH'IeCTBOM

nOTpe6neHH51 H BO3HHKHOBeHHeM KpOBOH3nHAHHA B M031", no KpaiiHeii

Mepe, B npeuenax OnpejjeneHHOrO CeKTOpa KpHBOÎi pucka; c JzpyroiiCTOpOHbl CyIIÿeCTByIOT HeKOTOpble ,ZZOKa3aTenbCTBa J-O6pa3HOtiB3aHMOCB513H C HLIIeMHLIeCKHM HHCynbTOM, nOKa3bIBaK)LuHe, 'ITO

no-rpe6neHue B MânblX Jÿ03aX COKpaLuaeT pHCK, a B 60nbLnHX -nosbiLLlaeT ero (Arria and Van Thiel 1992; Anderson et al 1993;Beaglehole and Jackson 1992).

3.6.3 CeppevHble 3a6oneeaHNsi (KpoMe K5C)

3noynoTpe6neHlie anxoroneM CB513axO c nosblllleHIieMBO3MO)KiIOCTH BO3HHKHOBeHI351 Cepjje'IHoti apHTMHH, KapgHOMHOnaTHH H

BHe3anHOrl KOpOHapHOri CMepTH, }COTA CpaKTOB Jÿ0 CHX nop HeJÿOCTaTOLIHO, 'iTO6bI OnpeJÿenHTb B3aHMOCB513b ",I[03a - OTBeTHaA

peaKLlnA" (Anderson et al 1993). OuexKH nponopuHH cnytiaeBKapJÿHOMHOnaTHH, KOTOpble MO>iCHO COOTHeCTH C nOTpe6neHHeManKOrOnA, BapbHpyioTCA OT 21% go 32% B 3aBHCHMOCTH OTXapaKTepa rpynnbl H3ytiaeMOrO HaceneHHA (Arria and Van Thiel1992). Nccne>zosaHHe cnymaeB clH6pI-inAuHH npeAcepJÿHA y nioJÿert BBO3paCTe AO 65 neT nOKa3an0, TITO noTpe6neHHe aJIKOronA 6bIJI0npHLiHHOri, HnH O,ijHOii H3 npHLIHH B JÿByX T1JeTbHX BCeX cnytiaeB(Arria and Van Thiel 1992).

3.6.4 1..(Nppo3 neyeHN

POnb nOTpe6neHHA aJIKOrOnA B BO3HHKHOBeHHH L(Hppo3a ne'IeHH

TOLIHO yCTaHOBneHa (Smart and Mann 1992). B HeTponHmecKHxCTpaHaX CO 3Ha'IHTenbHbIM ypOBHeM n0Tpe6neHH5I aJIK0ro116,BepoATHO, HeCeT OTBeTCTBeHHOCTb 3a 60nee 9eM 80% Bcex cny'iaesCMepTH B pe3ynbTaTe uHppo3a (Schmidt 1977; Puffer and Griffith1967). B3aHMOCB513b "jÿo3a - OTBeTHaA peaKL[HA" JÿJIA )ICeHLuHH, KaK

B6ISICHHJIOCb, ABJIAeTCA 60nee pe3KOIi, 'IeM JÿnA My)K'IHH (Anderson etal 1993).

3.6.5 OCO6eHHOCTN (pOpMbI KpNBbIX pNCKa

Cne,i);yeT Bo3gepmaTbcA OT n106oro O6O6LuaioLuerO yTBeNiC,IleHHAn0 KpHBbIM pHCKa TaKHX pa3HOO6pa3HbIX naTOJIOrHrI. AJIA uHppo3a

ne'-ieHH COOTHOLneHHe mower npH6nH]KaTbCA K 3KCn0HeHTe, B TO

78

3.0

2.5

2.0

1.5

1.0

0.5

000 10 20 30 40 50 60 70

rpaMMbI aJIK0r0JI51 B ,itexb

80

HJInIOCTpaLjHSI 3.3 CMepTHOCTb B pe3ynbTaTe HHCynbTa cpeAHMy>KLIHH: nOTpe6neHHe anKOTOnA H OTHOCHTenbHbIli pHCK. CeMbHccneAosaHHFt. B AoxnaAe Kono et al (1986) rIHTbBan HapAAy coCMepTHOCTbIO cnyLiaH BO3HHKHOBeHHA HHCynbTa. Donahue et al(1986), ; Gill et al (1986), +; Kono et al (1986), ; Semenciw et al.(1988), ; Shaper et al (1991), A ; Ben-Shlomo et al (1992), O ;Boffetta and Garfinkel (1990), A .

BpeMA KaK AnA pa3nHT-IHbIX THROB palm B3aHMOCB5I3b Bblpa>KeHarpaitiHKOM 6onee nHHeIiHON ItlOpMbI, HO C pe3KHM nOAbeMOM HaBbICOKHX ypOBHAX nOTpe6neHHA. ,EJIA OnpeAeneHHorO =menunaTOJIOrHIi MO)KHO 06OCHOBaHHO 3aKn101-IHTb, LITO KaK AMA My>KLIHH,

TaK H AnA >KeHIIjHH pHCx yBenHLIHBaeTCA Ha 10% - 30% npH ypoBHenoTpe6neHHA OKOno 20 r B Aexb.

79

3.7 f10TPE6J1EHVIE AJ1KOt-01151, HEC4ACTHbIE CJIY4AV1N HACMJ1VIE

Anxoronb AeJiaeT nbiouwero *Ienosexa HenosopoTnHSbLM, HapyutaeTCnOCO6HOCTb MbICnHTb, BOCnpHHFiMaTb H JjBHraTbCA, 60nblAeeKOnH9eCTBO BbInIiTOrO BbI3bIBaeT 60nbnIyl0 HeyKnIO)xecTb. TaKHMo6pa30M, anKOrOnb HrpaeT 3HaLIHTenbHylO pall/3 B BO3HHKHOBCHHHHenpe,i(HaMepeHHbIX TpaBM H CMepTeI%I (Romelsjö 1994). LIacTHtIHOH3-3a Crl00060B nOTpe6neHHA, LlaCTHLIHO H3-3a OTCyTCTBHA OnblTa HBbIHOCJIHBOCTH, n0J106Hble TpaBMbl 0006eHHO 'IaCTO CnyLiaLOTCA CMOJIOJ1;bIMH nIOAbMH BO MHOTHX o61IJeCTBâX. CBA3aHHble C anKoroneM

TpaBMbi BHOCAT 3HaLIHTenbHbiii BKnaJj B KOnHLIeCTBO CMepTeii,CBA3aHHbIX C anKOrOneM, OCo6eHH0 KOrJta 3T0 BbIpâ)KaeTCA B L[HcppaX

nOTepAHHbIX neT )KH3HH. HanpHMep, Koma J2,aeTCA oLieHKa TOrO, LITOB ABCTpanHH anKOTOnb HeceT OTBeTCTBeHHOCTb 3a 26% LIHCJIO cMepTeii,

CBA3aHHbIX C HapKOTHLIBCKHMH BemeCTBaMH (npoTHB IJHLppbl - 71% J[JIA

Ta6aKa), TO OH OTBeLIaeT 3a 40% nOTepAHHbiX neT )KH3HH (Pols andHawks 1992).

CYLuecTBYLOT JZaBHO ycTaxosnexxbie TpaJÿHLJHH HCCneJ10BaHHid BOTHOLLIeHHH HapyLIIeHHA nOBeJIeHIiA nOJl BnHAHHeM anKOTOnA,

COpHeHTHpOBaHHble, B OCHOBHOM, Ha H3yLIeHHe nOBeAeHHA npHBO)KJjeHHH aBTOMO6HnA, H K 3TOLi nHTepaType MbI BepHeMCA eme pa3B rnase 7. B OTLIeTe KoHrpeccy HaIjHOHanbHâSi aAMHHHCTpaLIHA6e3onacHocTH 4opoxcHOro JZBH)KeHHA CILIA (U.S National HighwayTraffic Safety Administration 1992) nouBena HTOFH no BnHAHHIOnoTpe6neHHA anxoronA B oTHOCHTenbxO He6onbLLlHx KOnHLIecTBax Hapa3nHLlHble THnbI nOBeJ1eHHA npH BOW,LIeHHH TpaHCnOpTHbIX CpeJZCTB

HnH CBA3aHHbIX C 3THM HâBbIKOB. HapyLLIeHHA B nOBeJZeHHH, KOTOpble

MO)KHO H3MepHTb, nOSIBnALOTCA Jjâ)Ke Ha ypoBHe nOTpe6neHHA oJZHOii

J103bI, XOTA CaM BbInHBIllHFi LIâcTO yBepeH, LITO ero noBeAeHHe HaCaMOM Jlene ynyLLLIIHJIOCb (Morrow et al 1991). COOTBeTCTBeHHO (KâKnOKâ3aHO Ha I'IJInIOCTpaLjHH 3.4) He CYLLjeCTByeT LIeTKOrO noporOBorOyposHA JIJIA B3aHMOCB513H co,iJepACaHHA anKOronA B KpOBH HJtopo)KHbix asapHii.

To we cnpaBeaJIHBO H AAA CBA3aHHOii C 3THM cMepTHOCTH,npI-iLIeM oHa pe3K0 ysenHLlHBaeTCA C nOBbIIIIeHHeM co,LjepxcaHHAaJlxoronA B KpOBH (National Highway Traffic Safety Administration1992). XOTA nbloujHe 6onee cTaplllero Bo3pacTa, nOTpe6nALOLIjHeanKOTOnb LLaLIZe, MeHee BOCnpHHMLIHBbi K ero B03JZeiiCTBHLO,

B3aHMOCBA3b OCTaeTCA ,noCTaTOLIHo nOKa3aTenbHOii.

80

700C73

600

ta.500

400

300CG1

Ox ? 200Fr

a) 100

0sa,

0.01 0.02 0.03 0.04 0.05 0.06 0.07 0.08 0.09 0.10

YpoBeHb CAK

i(JIJIEOCTpaI(HA 3.4 ,LlOpO>iCHO-TpaHCnOpTHble npOHCLHeCTBHM:

ypOBeHb CAK BoAHTeJ151 H OTHOCHTeJIbHbIN PUCK B031114KHOBeHi35IasapHH, 0603HaileHHbIFi OTAeJIbH0 B 3aBHCHMOCTH OT LiaCTOTbI

noTpe6neHH5I. gaxxble Grand Rapids BTOpHHHO npoaHaJiH3Hposaxbl.HaL[IiOHâJIbHble AaHHble no CHIA. Pa3 B rOA - R; pa3 B MeCMt[ -+;pa3 B HeAenio - ; Tpli pa3a B He,IZeJIo - ; e)KeAHeBHO- A .HCTOtIHHx: National Highway Traffic Safety Administration (1992).

AJIKOrOJIb Tax)Ke CBM3aH C npeAHaMepeHH6IM HaCHJIHeM KaK n0OTHOIHeHHIO K ce6e, TaK H K ApyrHM (Romelsjö 1994). 3Aecb npHpoAaB3aHMOCBM3H 605Iee cnOpHaM; B AonoJIHeHHe K nCHXOaKTHBHbIM3(lCpeKTaM, CBM3b MexcAy anxoroJIeM H HacHJliieM oTpa>KaeT

CCpopMlipoBaxxoe KyJlbTypOH BOCnpH51THe anKOrOJIM H Aa>Ke pOJIHBbInHBKIi KaK CMMpIaloHjero O6cTOMTeJIbcTBa. B O61AeM, CLIHTaeTCM

Heltenecoo6pa3HbIM cpasHHBaTb cooTBeTCTByIOIuHe xpHSble pHcxa nonOCTpaAaBLHHM H no oxâ3aBLLIHMCSI TM )Ke HenocTpaAaBIIIIiM JIiOAMM,

KaK 3T0 AeJIaeTCM npH AOpO)KHO-TpaHCnopTHbIX npOHCIIIeCTBHMX. HeT

CMbICJla, HanpHMep, CpaBHHBaTb KOHneHTpanHiO aJIKOrOJIM B KpOBH

CaMOy6H4iL[bI, KOTOpbIFi cHpbIrHyJI C MOCTa, H 3Ty )Ke KOHLjeHTpaL[Hio

y iieJIOBeKa, KOTOpbIl3 HAeT no TOMy )Ke MOCTy, B TO)Ke BpeMM HacJIeAyiOLLtHN AeHb. .J1yLüHHe AOKa3aTeJIbcTBa npHIiHHHOIi B3aHMOCB5I3H

nOTpe6JIeHHM anKOrOJIM H caMOy6HiicTS, HaCHJIH5I B CCMbe H ApyrHxCB513aHHbIX C HaCHJIHeM npeCTynJIeHHA MO)KHO cxOpee HOJIyLIHTb Ha

yposxe o6o6HteHHM, =IeM Ha OCHOBe HHAHBHAyaJIbHbIX AaHHbIX, H

81

no3TOMy 3TO o6cy)KaaeTCA B cneJjyrolijei4 rnaae (cM. TaioiCe Romelsjö1994).

TeM He McHee, HeT HHKaKOTO COMHeHHA, LITO ypOBeHbnoTpe6neHHA anKOronA CBA3aH B 3HatI14TenbHO14 cTeneHIi C

KpHM1414anbHbIM nOBeJieHHeM. TlacTi3TIHO, 3Ta B3aI3MOCBA3b npocnexcexa

6naroJiapA Cne1iH4HTIHbIM npecTynneHHAM: BoxczteHHe B HeTpe3BOMBHJie H nbAHCTBO B o61IjeCTBexxbIX MecTax. I4J1n1ocTpagHA 3.5a,HCHOnb3y5I ,IjaHHble HCCneJ(OBaHHA 60nbulOi4 rpynnbl B3pOCnbIX

rpaxcRaH CHIA B 1988 roJty, nOKa3blsaeT, LITO npogeHTHaA JiORAnroJiei4, oco3Haroujiix, i-ITO OHH BOJi14nH mammy B Te'IeHHenOCne,gHero roJia "Hoene CJIHLIIKOM 6Onb4110r4 ,g03bI BbInI-ITOrO",HaLIHHaeT yBeJI1iLIriBaTbCA C HyneBOro yposHA noTpe6neHHA HJieriCTBHTenbH0 pe3K0 B03paCTaeT Ha ypOBHAX HHxCe OJjHOri JiO3bI BJienb (1 Jio3a - 10 r LIHCTOro anxoronA) (Midanik et al 1994). B 3TOHxce rpynne JionA nloAeH, coo611ia1ouiHx, tlTO OHH "6bInH apecTOSaHbrHRH HMenH npo6neMbl C nORH1(Herr 143-3a csoero COCTOAHHA

onbAHexHA" B TegeHHe npoulnoro roJia (HnnlocTpauHA 3.56)yBenHLIHBaeTCA B 6onee McJ(JIexxOM TeMne c nosblIIleHlieM o6veMaBbInHTOrO npH oTCyTCTBHH nOpOrOBOrO ypOBHA JiRA MyxCLIHH

(Midanik 1994).

OJiHa 143 CaMbIX T-IeTKrILX B3a14MOCB51361, KOTOpâA npoCnexCriBaeTCA B

nHTepaType, 3T0 - MexCJly noTpe6ReHHeM anKOrOnA H HeKOTOpbIMHcliopMaMH B14KTHMH3a1iHH (Room 1983a). Orpa6neHHe H

H3HaCHJI0BaHHe ABRAIOTCA npeCTynneHHAMH, ARA KOTOpbIX genOBeK B

COCTOAHHH OnbAHeHHSI MOxCeT CTaTb RerKOÎ4 xcepTBOH. bonee 7-IaCro

HaCHnHe npOABJISIeTCA ripa noTpe6neHHH anKOronA B hapax HRH BJipyrHx yCROBHAX, I'ne H HacHnbHHK H xcepTBa BMecTe BbInHBaIOT. BKaxaJicKOM HanHOHanbxoM onpoce (Canadian national survey, Roomet al 1994) yKa3bIBâROCb Ha BeCbMa CTa6HnbHOe nOBbIIneHHeBO3MOxCHOCTH TOrO, LITO B TelIeHHH rOJia Bac "TORKHCT, yJiapHT HRHHa Bac HanaJieT nbAHbIri LIenOBeK"C nOBbIUIeHHeM o6beMa BbInHTOTOCaMHM peCHOHJieHTOM (I4JInK)CTpanHA 3.6.). PeCnOHJieHTbl, KOTOpble

BbInHBâJIH 5 rpaMM 3TaHORa HnH 6o11ee J1O3 3a oJiHH npneM XOTA 6b1pa3 B MeCAIi, 6onee BepOATHO, LIeM JipyrHe c T0M we ypOBHeMnoTpe6neHHA, noJiBepranHCb HacHRHrO Co CTOpOHb1 JipyrrlxBbInHBarOIIjHX, HO JiaxCe xis' TeX, KTO He nbeT TaK MHOFO, BO3MO)KHOCTb

nOJjBeprHyrbCA HacHnH10 CO CTOpOHbI JipyrHx BbInHBaIOL1[HX Bo3pacTaeT

nocTeneHHO c pocTOM ofteMa noTpe6neHHA.

82

60

50

40

30

20

10

20

(a)

0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6

KOnHLIeCTBO BbIHHBOK B AeHb 3a npeAblAyIIIHN rOA

0.5 1.5 2 2.5 3 3.5 4 4.5 5 5.5

KOJIHLreCTBO BbIHHBOK B AeHb B rlpoulnoM ro,gy

6

HJIJIIOCTpauHH 3.5 BONCjjeHHe B HeTpe3BOM BHAe. (a) IIOTpe6JIeHHeaJIKOrOnSI H HpOneHT COO6MIiBIIIFiX, LITO BOAHnH MaIIIHHy "noc.neCJIHÜIKOM 60nbIII0ir A03bI BbIHHTOI'O" 3a Hpe,ablAyIIjHe 12 MeCSIr[eB,AaHHble IIO MpKLIHHaM H xKeHII.[HHaM AaHbI OTAeJIbHO. US NationalHealth Interview Survey, 1988. I4CTOLIHHK: Midanik et al. (1994).(6) ApeCT HJIH Hp06neMbl C rIOnHuHei%I H3-3a HeTpe3BOI'O COCTOSIHHSI.

83

r10Tpe6neHHe anKOrOnA H npOljeHTHaA AOnA CTOJIKHyBIIIHXCA C

noA06HbIMH np06neMaMH 3a npeA6IAyH(He 12 MeCALteB, AaHHble noMyxCLIHHâM H )ICeHH(HHâM ABHbI OTAeR6H0. 1'1CTO'-IHHK: Midanik et al

(1994). - MyxcgHHbI, - x<eHnjHHbI.

$3aHMOCBA36 0fteMa nOTpe6neHHA anKOrOnA H CMepTH OTHaCHnHA KaK cnytiailHOii, TaK H npenHaMepeHHOFI, ABnxeTCA 6oneeCHRbHOI-i, LIeM RIo6aA ApyraA B3aHMOCB513b MexcAy noTpe6neHHeMaJIKOrOnA H CMepTbIO MOROAOIi LIaCTH HaCeneHHA. HanpHMep,l'1JIniOCTpaIjHA 3.7 nOKâ3bIBaeT B3aHM0CBA3b MexCAy OfteMOMnOTpe6neHHA, KOJIH4eCTBOM cnygaeB HaCHnHA H ApyrHX BHAOBCMepTH cpeAH HccneAyeMOH rpynnbl MonoAexcH LLIBenHH,

npocnexcenxblx 3a 15-neTHHH nepHoA c 18 - 19 neT.

25

o0.5 1 1.5 2 2.5

KOnHLieCTBO BbnIHBaeM6IX A03 B AeHb 3a npe,gblAyHjHIi rOA

HJIJIIOCTpaI(HSi 3.6 CJIyiiaH HanaAeHHIi, COBepIIIëHHbIX nbAHbIMLIenOBeKOM. 110Tpe6neHHe anKOronA (AO3bI B AeHb, 1 A03a - 10 ryHCTOrO anKOrOJIA) H npOljeHTHOe KOnH11eCTBO COO611114BIIIHX, IITO 3a

npeAblAyHjHe 12 MeCAH;eB HX "TOJIKHyJIH, yAapHRH HRH Ha HHX HanannbAHblli LIenOBeK". gaHHb1e onpoca AâHbI pa3AenbHO B 3aBHCHMOCTHOT IIaCTOTbI nOTpe6JIeHHA OnpaIIlHBaeMOro nATH A03 HRH 60nee A03

3a OAHH pa3: - McHee, LIeM pa3 B MeCAIj HRH COBCeM HeT, - noMeH6IHei3 Mepe pa3 B MeCAIj, - B O6H{eM. gaHHble HaL(HOHânbHOroonpoca KanaAbl. HcTOIIHHK: Room et aI. (1994).

84

50

40

1 -100 101 -250 251 -400 > 400

IIOTpe6JIeHI4e âJIKOI'OJISI B HegeJIfO (r)

HJIJIiOCTpa[(HA 3.7 CMepTHOCTb CpeAH MOJIOAbIX MymKLIi3H-

npH3bIBHHKOB B apMHIO IIOTpe6neHHe aJIKOronSi (rpaMMbI BHeAeniO) H CMepTHOCTb Ha 1000 LIenOBeK 3a nOCneAyiOluHe 15 neT B

pe3ynbTaTe HaCidnHSI ( ) H Apyrxx npHLIHH ( ). I'ICTOiiHHK :

Andréasson et al.(1988).

3.8 HE6J1AfOf1PVIfITHbIE COL.WIAJIbHbIE f1OCJ1E,gCTBV151f1OTPE611EHV1FI AJIKOrOJ1f1

I'IccneAoBaHIiH TeHAeHul3%i B COuHanbxoii 3nH0/eMHOJI0rHH anKOronSl

o6Hapy]KHJIH nIHpOKHI%I Kpyr COuHanbHbIX npo6neM, CBSI3aHHbIX CnoTpe6neHHeM anxorOJlSi, ynoMHHaeMblx B 061uHX onpocax HaceneHHSI,BKniOLIaSI np06neMbl B CeMbe, C Apy3bSIMH H Ha pa6oTe, (iHHaHCOBblenp06neMbl, apeCTbl H npo6neMbl c nonnuHeli. EcnH paccMaTpHBaTbHX C COuHOJIOrHLIeCKOIi TOLIKH 3peHHSi, 60nbIIIHHCTBO COuxaJlbHbIX

noCneACTBHii nOTpe6neHHSI anKOrOnSI COCTOSIT H3 AByX 3neMeHTOB:

85

CO6CTBeHHO nbAHCTBa HnH CBA3aHHOI'o C HHM nOBejteHHA H peaKuHAKOTO-TO eue (TLneHa CeMbH, Jtpyra, ociHuepa nonHuHH, HailanbHi3Kano pa6oTe H TaK ,Ranee) Ha 3T0 nOBeJteHHe. C 3TOii TOi-IKH 3peHlüfKpHBble pHCKa MO)KHO paCCMaTpHBaTb KaK nOKa3aTenb BepOATHOCTHTorO, TITO JtaHHOe nOTpe6neHHe anKOronA BbI3OBeT onpe,ReneHHylocpOpMy cOuHanbHOFi peaKuHH.

Mkel (1978) H Midanik (1994) paccMaTpHBanH B3aHMOCB513bonpeJtenexxbix THnoB noTpe6neHHA H COuHanbHbIX nocnej(CTBHIi.OCHOBHOi-I BbIBO,R COCTOHT B TOM, TITO BepOATHOCTb COL[HânbHbIX

nOCneJjCTBHi7 BO3paCTaeT C ypOBHeM nOTpe6neHH5I anKOrOJIA, KaK 6bI

OH He H3MepAJICA. 1'1JUIIOCTpauHA 3.8 JteMOHeTpHpyeT 3T0 npHMepaMH

JtaHHbIX 143 KaHa,nCKOrO HauHOHanbHOro onpoca niOJteli CTapnIe 15 neT(Room et al 1994), B KOTOpOM IIbIOIItHX CnpaulHBaloT: LIysCTBOBanH nHOHH, TITO MX BbInHBKa HMena oTpHuaTenbxoe BnHAHHe 3a npeJtblJtyLuHe12 McCAueB Ha Ka)knyIO H3 IIIecTH Ccpep IIX >KH3HH.

25YeenHVeHHOe H3o6pa>tceHme neeoro HMKHero yrna

0 1 1.5 2 2.5

KOJIHTIeCTBO BbInHBaeM6IX J103 B ,i(eHb 3a npOLLLnblii rOJi

HJInIOCTpauHII 3.8 HeraTHBHble COUHanbHble nOCneJjCTBHA

nOTpe6neHHA anKOrOnA. rloTpe6neHHe anKOrOnA (KOnHTieCTBO ,RO3 -10 r TLHCTOro ânKOTOnA - B JteHb) H HaHeCëHHblii yntep6 B 6 c(PepaX)KH3HH no COO6LIteHHIO peCnoH,ReHTOB. gaHHble HauHOHânbHOrO

onpoca Kaxa,Rbi. l'1cTOTIHIiK : Room et al 1994. JE1pyx(6a - * ,

3,Roposbe - +, CTiaCTbe - , ,ROMaLIIHAA )1CH3Hb -O , pa6oTa, yTie6a,BO3MO)ICHOCTb yCTpOHTbCA Ha pa6oTy - , (l)HHaHCbI - .

86

41,1I51 Kâ>iCAOIi Cctlepbl >KH3HH COOTHOIneHHe npii'-IHHeHHOrO Bpesqa

yBenHLIHBaeTCSI AOCTâTO'-IHO nOCTeneHHO C nOSbIIIieHHeM 06beMaBbInHTOrO 6e3 OnpeAeneHHOI%I KpHTH'-IeCKOÎ-i AO3bI anKOrOnSI, HH>Ke

KOTOpOi3 nbloll[He He HaHOCAT ce6e speAa. B uenOM, B H3rIaeMoiirpynne LIHCno niOAeii, co06ivasIIIHX, tITO noTpe6neHHe a.nKOronslHaHOCHT BpeA B AByx HnH 6onee Ci-4)epaX >KH3HH, TaiUKe noCTeneHHoBo3paCTaJio C nosblIIleHHeM O6beMa BbIHHTOI'O (HnniOCTpaI(HA 3.9). Bonpoce B3pOCnbIX, npoBeAeHHOM B HoBOii 3enaHAHH, 14CHOnb30BanHTaKHe >ICe BOnpOCbl H o6Hapy>KHJIH n0'ITIi npslMOnHHeiiHyiO B3aHMOCB5I3b

Me>KAy o6beMoM noTpe6neHHSi H cpeAHHM 'IHCJIOM Ccpep >KH3HH, BKoTopbix, Kai( coo6luanocb, noTpe6neHHe anicoronsl Haxecno y'uep6 npuHeKOTOpOM cHH>KCHHeM ypoBHSI HaHeCeHHA yiuep6a Ha BbIcH.IdiKaTeropHH noTpe6nexHA anxoronsl (Wyllie et al 1993).

KOnH4eCTBO BbIHHBaeMbIX AO3 B AeHb 3a npOIIIJIbIIi rOA

HJIJIIOCTpaIuHi 3.9 OnbIT AByX Hull 6onee OTpHuaTenbHbIXnOCneACTBHiï nOTpe6neHHA anKOronSl. rlOTpe6neHHe aJIKOronSl(KOJ1HPieCTBO A03 - 10 r LIHCTOro anKOronA B AeHb) H npoueHTpecnoHAeHTos, COO61uaiolgHX o Asyx HnH 6o5Iee nocneACTBHAx:My>KiiHHbI - , >KeHn.[HHbI - 11, B 061ueM - . gaHHbieHaI(HOHanbHOrO onpoca KaHaAbi. l'ICTO'iHHK : ROOM et al 1994.

87

B KaHa,IjCKOM HCCnej[OBaHHH Ha HH3KHX ypOBHAX nOTpe6neHHA

My)K9HHbI 6onee LIaCTO, item )ICeHIIjHHbI c006njaK)T O Bpe,ge B AByxHJIH 6onee 3aTpOHyTbIX cd-Jepax, HO BbIIIIe ypOBHA 11On-j103bl (5 rLIHCTOrO aJIKOronA) B JjeHb, pe3ynbTaTbl RRA My)ICLIHH H)KCHIIjHH 6b111H

CXOjIibIMH (IIJIJIfOCTpaL[HA 3.9). Pe3ynbTaTbl jl,nA ypoBHeH noTpe6neHHA

6onee nOn-J103b1 B JjeHb noATBepxcgaloT 06HjHN BbIBOjj, 'ITO )KeHIIjHHbIMeHee OXOTHO C0061IjaIOT O COIjHanbHbIX np06neMax, BO3HHKâIOII(HX Ha

OnpegeneHHOM ypOBHe noTpe6neHHA, item My)K'IHHbI. C IjpyrOHCTOpOHbI, MOJIO,L[ble JHOjjH 06bIinI0 c0061I(aKYr o 60nbIIIeM KOnHLIeCTBe

COIjHanbHbIX npO6neM, iieM peCHOH,IjeHTbI cpe,AHerO BO3paCTa npHpaBHOM yposxe noTpe6neHHA (Midanik 1994).

KaK H B Cnyllae C pe3ynbTaTaMH 0 BO3MO)ICHOCTH noz[seprHyTbcAHaCHJIHIO CO CTOpOHbI JjpyrOrO nbIOIIjerO, B KaHaj(CKOM

HCCneJjOBaHHH Te, KTO BbInHBaeT nATb (1 p03a - 10 r'iHCTOrOanKOrOJIA) HnH 6onee ,gO3 3a O,IjHH npHeM XOTA 6bI pa3 B MeCAL[, 6onee

OXOTHO, item zipyrHe, nOTpe6n5loujHe anKOPOnb B TOM xce

KOnHi-IeCTSe, COO6HjanH O HaHeCeHHOM Bpe,Ae B JjByX HnH 6oneecctlepax )ICH3HH (HnnIOCTpaIjHA 3.10). TeM He Mexee, 'iaCTbcoo6n1HBIIIHx o6 yujep6e npO,gOnxcaeT ysenHYHBaTbCA H cpe,ijH Tex,KTO He BbInHBaeT nATb JjO3 =taule, qeM pa3 B MeCAI[.

TaIOKe Hy)KHO yLIHTbIBaTb BnHAHHe Ha B3aHMOCBA3b Me)ICZjynOTpe6neHHeM H BO3HHKHOBeHHeM npo6neM yCJ1OBHFi H BH,IjbI

nOTpe6neHHA anKOrOJIA. HapAAy C ApyrHMH %jOKa3aTenbCTBaMHBa)KHOCTH yCJIOBHFI noTpe6neHHA, HeAaBHO npOBeJjeHHOe B HOBON3enaHA1114 HCCne,IjOBaHHe, nOKa3bIBaeT, '-ITO K0.111,11-IeCTBO ânKOI'OnA,

KOTOpOe 06bI'IHO noTpe6nsxeTCA B 6apax, 6onee CHnbHO CBA3aHO CânKOrOnbHbIMH npo6neMaMH,'IeM CnIipTHOe, noTpe6nAeMOe B ApyrHxMecTax (Casswell et al 1993).

3.9 Al1KOrOJ1bHAA 3ABI4CNIMOCTb

COIjHanbH0-3111,1,I1eMHOJIOrH' eCKHe HCCne,IjOBaHHA anKOrOnbHbIX

npo6neM nOCTOAHHO BKnIO'Ia'OT B Ce651 BOnpOCbl O(1)H3HLIeCKHXCOCTOAHHAX, COrIyTCTByiOnjHX nOTpe6neHHIO anKOrOnA, TaKHX KaKa6CTHHeHTHbII%I CHHjjpOM H TOnepaHTHOCTb, aCneKTOM OnbITHOrOxapaKTepa, TaKHX KaK coo6lgeHHA o npHCTpaCTHH H yXyJjHIeHHHKOHTpOnA Hag noTpe6neHHeM H O CHMI1TOMaTH'teCKOM nOBe,IjeHHH -

88

05 15 2.5

KOnHTIeCTBO BbIHHBaeMbIX J103 B,I(eHb 3a HpOLLInbI1i ron

>FInnIOCTpagHA 3.10 CnyLIaH Asyx HnH 6onee OTpHgaTenbHblXnOCnenCTBHii nOTpe6neHHSI anKOronSI H B3aHMOCB5I3b C BHjjOM

nOTpe6neHHni. 110Tpe6neHHe anKOrOnSi (A03b1 BneHb) H npOLjeHT

pecnOH,qeHTOB, C006LIjaIOLqHX o ,i(ByX HnH 60Ree ,i[03 3a OnHH pa3: -

McHee, TieM pa3 B MeCSiL[ HRH BO06LLje HeT; - no MeHbLileii Mepe pa3B M0CSm. gaHHble HamHOHanbHOro OnpOca KaHa,i(bI. IYICTOTiHHK :

Room et al 1994.

nonblTKaX COKpbITHSI (paKTa nOTpe6neHHSi anKOrOJIA H HeperynSlpHOMnpHeMe nHutH i73-3a 3T0r0. KaK OTMeT3aeT Midanik (1994),60nbIHHHCTBO 3nHneMHOROrHTteCKHX AaHHbiX no B3aHMOCBSI3H Mexcny

ypOBHeM nOTpe6neHHSi H anKOrOnbHON 3aBHCHMOCTbiO npOHCXOZ[HTH3 COL[HanbH0-3nH,ileMHOJI0rHtieCKHX TpaZjHLjHIi, KOTOpble He(POKyCHpOBanHCb Ha nCHXHaTpHLIeCKOH HO3OROrHH. l'ICHOnb3yS1

AOnORHHTenbHblli pian CHMHTOMOB 3aBHCHMOCTH, HCCneZ[OBaTenHo6HapyxcHJIH, LITO 9eM BbIIIIe ypOBeHb noTpe6neHHSI anxoronx, TeM60nbHIe KORHTieCTBO C0061L[aeMblX CHMHTOMOB 3aBHCHMOCTH.

l'ICHOnb3y5i AaHHble n0 l'IOBOii 3enaH,1(H14, Wyllie et al (1993)o6HapyxcHnH HeKOTOpble npH3HaKH nOpOTOBOrO 3(1)(1)exTa WISI

noxa3aTeneiï xaca1011(HxcSI (1)H3HT1ecKHX act-winos 3aBHCHMOCTi3

(sbinxBKa yTpoM cpa3y nocne nogbeMa, nocne ynoTpe6neHHSIânKOrOnSI C yrpa CHnbHO TpSicyTCSI pyKH). rlpH 3TOM KOJIH*ieCTBO HnepHO,EMLIHOCTb BbInHBOK HaLIHHa1OT 3HaLIHTenbHO yBenHTiHBaTbCSI

}MIMIC ypOBHSI 12 nHTpOB anKOrOnSI B r0,1;. C jjpyrOli CTOpOHbI, H0T

89

Hi-ixaKIix j10Ka3aTenbcTB CyujeCTBOBaHHA nopora jLnA noxa3aTeneN,KaCaIOLLjHXCA nci-17Conori3LIecxi3x acneKTOB 3aBHCFiMOCTH, TaKHX KaK

ynoTpe6neHÏ-ie anxoronA, Kor,ija eCTb Ba)KHaA npHLiHHa ocTasaTbCATpe3BbIM. I'IJInIOCTpaIjHA 3.11 nOKa3bIBaeT KpHBble pliCKa jjnA

My)KLiHH H)KeHLLjHH no jjHarH03y ICD - 10 TeKyüjeii anKoronbHOFi3aBHCHMOCTH (noJIO)KiiTenbHbIli OTBeT Ha 3+ KpHTepliA 3a nocnejjHHe

12 MecAweB). gaHHble B3ATbI 143 HaL(HOHanbHOro MejjHLjHHCKOrO

onpoca CIlIA 1988 r. (Midanik et al 1994). KaK cpejjH My)K9HH, TaKH cpejl',i-i )KeHIItLiH cOOTHOIIIeHHe KonHiIecTSa CnyiIaeB 3asiicHMOCTH,nOjjnexcaujHX jjiiarxocTi-iposaHmo, j:10CTaTO'-IHO nocTOAHHO ysennHFi-BaeTCA C nOBbILIIeHHeM nOTpe6neHHA anxoronA. Hcnonb3yA Te )KejjaHHble, Dawson H Archer (1993) noKa3anH, LiTO COOTHOuIeHHe

j(14arH030B no 3+ H DSM-III-R KpHTepHAM anKOrOnbHOii 3aBHCHIvIOCTH

yBenH'-IHBaeTcA nOCTeneHHO C yBenHLIeHHeM o6luero ofteManOTpe6n5leMOrO anKOronA, HO Ha nro6oM jjaHHOM ypoBHe

noTpe6neHFi2 BO3HHKHOBeHHe 3aBHCHMOCTH CHnbHO CBA3aHO C

KOnHiieCTBOM CnyLIaeB noTpe6nexliA nATH (50 r LiHCTOrO anKoronA)1411 60nee jj03 3a OjjHH pa3.

3T14 jjOHO1IHHTenbH6le 3CI)CtleKTbI OCTaIOTCA CHnbHbIMH H nocne

yea jjeMorpaCpHtleCKorO CpaKTOpa, HCTOpHH anKOrOnbHbIX npo6neMB CeMbe H BO3paCTa nepsoro nOTpe6neHHA aJIKOronA.

3.10 V1H,gV1BN,gYAJ1bHbIV1 YPOBEHb f1OTPE6J1EHVIA NO6LLIAA CMEPTHOCTb

HeT coMHeHHA, LITO ynoTpe6neHHe anKOronA HaxoCHT

Cepbe3HbIN Bpejj 4H3H1IeCKOMy 3jjopOBbIO. Ho cyMMa BceX 3THXTHIIOB pHCKa He Bblpa)ICaeTCA B npAMOnHHeÎiHOÎ'i 3aBHCHMOCTH Me)iCjZy

HHjjHBHjjyanbHblM ypOBHCM noTpe6neHHA H CMepTHOCTbIO, B BbIBOjjaX

HcenejjoBaHHii HaLIHHaA c 1920-x rojjOB noBTOpAnacb J-o6pa3HaAB3aHMOCBA3b Mexcjjy noTpe6neHHeM anKOrOnA H 06LLjeFi CMepTHOCTbIO

(X0TM OHa He yHHBepcanbHa). (Pearl 1926; Anderson 1994;Beaglehole and Jackson 1992). B 6o11b111 HHCTBe cny'IaeB yKa3bisaeTCAHa nOBbIIHeHHyK) CMepTHOCTb Tpe3BeHHHKOB 110 CpaBHeHHIO CynOTpe6nAlou.[HMH anKOrOnb B ManbIX j103aX. B HeKOTOpbIXHCCnejjoBaHHAx oTMeLIaeTcA, '-ITO CMepTHOCTb jjnA KaTeropHHnb101iji3X B OtIeHb ManblX jj03aX TaKxCe HeCKOnbKO BbIUIe noCpaBHeHHiO c nblou.1HMH HeMHOro 60nbule (CM. HnnloCTpaLjHIO 3.12).Bce HCCnejjoBaHHA, npejjCTaBneHHble Ha 3TOii HnnIOCTpaLjHH,

90

60

o0 0.5 1 1.5 2 2.5 3 3.5 4 4.6 6 5.5 8

KOJINLIeCTBO A03, BbIHHBaeMbIX B AeHb 3a npOIHJIbIIi rOA

HJIJIIOCTpaqHH 3.11 AJIKOrOJIbHaSI 3aBHCHMOCTb. rlOTpe6JIeHHeânKOf OJIA (1103bI B AeHb) H IIpOLjeHT peCnOHj(eHTOS, coo6lualouil-IxCHMHTOMaM, n0 KOTOpbIM HM MO>KHO BbICTaBHTb ICD-10 AHarxO3ânKOTOnbHOFi 3aBHCHMOCTH (nOJiO)KHTenbHbIii OTBeT Ha 3+ KpHTepHSI):

- My>K4HHbI H - >KeHÜjHHbl. Z(aHHble HanHOHânbHOrO onpocaCll1A. I4CT04HHK: Midanik et al 1994. .

yLIHTbIBaIOT H so3pacT H (taxTop xypeHHSI, 3a HCKniO4eHHeM Kagan etal (1981), rAe y4HTbIBaeTC5i TOnbKO so3pacT. OcHOBHOe 06-bSICHeHHe,npeAJIO>KeHHOe Ans' nony4aeMbIX .I-06pa3HbIX KpHBbIX, Bblpa.>KaIOU>;HX

CB5I3b MexcAy nOTpe6neHHeM aJIKOTOna H o6u>;erI CMepTHOCTb10,3aKnio4aeTC5I B nOTeHuHanbHOM CHH>KeHHH pHCKa BO3HHKHOBeHH5I

KOpOHapHOId 60ne3HH CepAUa rlpH HH3KHX ypOBHSIX nOTpe6neHHSI, 4T0

yxce 6bIJI0 paCCMOTpeHO BbllIIe.

B 60nb111HHCTBe HCCneAOBaHHii nOTpe6neHHSI aJIKOronH H

CMepTHOCTH npeo6naAaloT CJIy4aH CMepTH nO>KHnbIX My>K4HH. BHeCKOnbKHX nOCneAHHX HCCneAOBaHHHX H3y4anC31 pHCK B03HHKHOBeHi35I

3a6OnesaHHli H CMepTHOCTH cpeAH nloAeri MOJIOAOro B03pacTa(Andréasson et al 1982; cm. HnnlocTpauHlo 3.7) H cpeAH xcexuJ;HH(Stampfer et al 1988). 31H Hccne,IjoBaHHSI noxa3blsalOT cna6ylo H HeBCerAa CTaTHCTH4eCKH AoCTOBepHyIO nO3HTHBHy1O B3aHMOCB5I3b Me>KAy

91

noTpe6neHiieM anKOronSl n o6111eFi cMepTl-IOCTbio. B 6011b1.11nHCTBe, HO He

BO Bcex nCCneJrOSaHHSIx, rge 06LLraSl cMepTl-IOCrb noApa3AenSlercx noOTJJcnbHblM npl3Hi3HaM, o6Hapy)Kexo COxpaureHHe oTHOCxTenbxoropnCKa CMepTn OT KopOHapHOIi 6o1Ie3HFi CepJjLja npi-I noTpe6neHiiH OTHeCKOnbKHX 210 40 r B AeHb. 1iOnbnIiiHCIBO ApyrHX npI-ItIHH cMepTHOCrH

aCCOL[i3HpOBanHCb C nOBbIIIIeHHeM pnCxa CMepTH Ha BCeX ypoBHSiXnorpe6neHnx n0 CpaBHeHHiO C Tpe3BeHI-IiiKaMH.

HccneTroBaHHR, C(pOKyCHpOBaHHble Ha H3yLIeHnH pa3nH1-IHbIXrpynn, OTJIHLIaIOIi[nXCSI no nOny, 3TH44,-IeCKNM 131114 COL[iiO-

3KOHOMnLIeCKHM npH3HaKaM LIaCTO He npHBOJjSIT K TeM xce

pe3ynbTaTaM, LITO H HCCneJtOBaHHSI 110)KnnbIX My)iCLINH 3anagHbIXCTpaH (Ferrence 1994). IIpose,aëHHble SIHOHCKiiMH BpaLIaMH

nCCneJZOBaHHSI nOKa3anI-I, IITO B3aHMOCB5I3b MexcRy anKOrOneM Ho61.1.Jeii CMepTHOCTbIO, O KOTOpOÎI rOBOpHTCSI B HCCneJloBaxnsixHaceneHliSl 3anaZjxblx cTpaH, He o6Hapy)iCeHa y SinOHCKOrO HaceneHiiH,rJre ypOBeHb BO3HI4KHOBeHH5I KOpOHapHOrr 60ne3H14 cepJjl(a HaMHOrO

Hn)Ke, a ypOBeHb BO3HIiKHOBeHHSI HHCynbTa, KOTOpbIii nMeeT npxMyK)

B3aHMOCB5I3b C nOTpe6neHHeM anKOronSI, HaMHOrO BbInIe. BbpnTaHCKOM perHOHanbHOM HCCneJ);oBaHHH n0 BOnpOCaM cepJZeHHbIX

3a60neBaHnii rOBOpnTCSI O 3aLLjnTHOM 3(14eKTe TOnbKO JZnSI KypSILI[HX

H pa6oiinx pyLlHOro TpyJra (cM. Taxxce Kozlowski and Ferrence 1990).EAnHCTBexxoe KpynHOe HccneAosaxne, paccMarpnaaioiueecMepTHOCTb cpe,ijH nio,L[ei3 MOJIOJjOro Bo3pacTa - nCCneJrOBaHHenpn3blBHIiKOB B 111BeLjnH, noKa3âno OTCyTCTBne npeHMyLI[eCTB

nOTpe6neHHSI anKOronSl B MOJIOJ)',OM Bo3pacTe (CM. nnnK)CTpa1[410 3.7).

3.11 ,f111J1EMMA f1bFOLLtErO 4EJ10BEKA 11 051.1.1141316AJIAHC

MbI yxce OTMeLIanH B HaLIane 3TOIi rnaBbl, LITO nbIOIII;Hii =lei-roser(cTanKHBaeTCSI co BCë 6onee CJIO)ICHOii 3a,Ljaileii axan1,13Hp0saTb HCpaBHHBaTb nOTeHHnanbHble yJZOBOnbCTBnSI H HenpHSITHOCTn,

KOTOpble SIBnSIIOTCSI pe3ynbTaTOM noTpe6nennsl anKOronsl npHBbl60pe: nHTb nn ,aanbLUe, J_jenaTb CneJE(yK)LL[nIï rnOTOK HnH HeT.3nHJZeMHOJIOrHLIeCKaSI nHTepaTypa Mo)KeT npeJUloxCHTb RHUM

HeKOTOpble yKa3aHHSI Ha TeMy OnbITa yJjOBOnbCTBHii H

HenpHSITHOCTeFi. L1TO KaCaeTCSI 60nce BeCOMbIX nOCneJZcTBiHli, TM HeMcHee, KapTnHa AOCTaTOLIHO npOSICHHnaCb.

92

3.0

2.5

2.0

1.5

1.0

0.5

00 10 20 30 40 50 60 70 80 90

1 1 1 1 1 1 1 1 1

rpaMMbl aJIKOI'OJISI B AeHb

HAnEOcTpauxA 3.12 CMepTHOCTb cpeAH MyxcLIHH 110 pâ3nH9H6IMnpHqI4HaM. 170Tpe6neHHe aJIKOI'OnA (rpaMMbl B AeHb) H

OTHOCHTen6Hblli PUCK. BOCeMb ,IjnHTen6HbIX HCCne,IT,0BaHH13.

Dyer et al. (1980), Shaper et al. (1988), +; Kagan et aI. (1981), ;

Klatsky et al (1986), ; Kono et al (1986), O; Marmot et al. (1982),A ; Boffeta and Garfinkel (1990), 0

rlOTpe6neHHe anKOrOJIS1 nOBblLnaeT PUCK BO3HHKHOBeHH51

HeC'-IaCTHbIX cnrIaeB H COIatâJIbHbIX npo6neM, 60nbHIHI3 ypOBeHbnOTpe6neHHA Be,qeT H K 6OnbineMy pHCKy. DOnbLIIHHCTBO AaHHbIX n0HeCLIaCTHbIM CnyiiaAM H COLjHanbHblM npo6neMaM nOKa3bIBaeT, T-ITO,Z1,JI51 pHCKa He CyII(eCTByeT zIeTKOro HH)KHCrO npe,gena. C ToLIKH3peHHA 3THX pa3HOO6pa3HbIX H nOTeHL(iiaJI6H0 Cepbe3HbIX npo6neMOCHOBHaA peKOMeHgaLjHA ,TI;JIA 6e30naCHOrO nOTpe6neHHA aJIKOrOnA -3T0 "iieM MeHbLLIe, TeM nyLIIIIe".

LITO KaCaeTCA nOCneACTBHI%I AJIA 3,40p0Bb51, HCCneAOBaHHA,paCCMOTpeHble B 3TOIi rnase, nojjTBepKnaloT KOnHr-IeCTBeHHyiOB3aHMOCB513b MeNc.ny noTpe6neHHeM anKOT0JI51 H mom pa3H0o6pa3lIbIX

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TeM He McHee, C TOLIKH 3peHHA npO43H1IaKTHKH HejtOCTaTOLiHO

3HaTb, LITO noTpe6neHHe 6onbluoro KonHLlecTSa CnHpTHOrO LIaCTonOBbinlacT CTeneHb HHj(HBHjlyanbHOrO pHCKa. Ham TaKXCe HeO6XOAHMO31-IaTb, KaK Onpej[enAeTCA ypOBeHb npo6neM BCerO HaceneHHA.pOBeHb CB5I3aHHbIX C anKorOneM npo6neM HaceneHHA 3HaLIHTenbHOMeHAeTCA B pa3nHLIHbIX KynbTypaX H pa3nH1-IHbIX CnOAX 3THX KynbTyp,

TaK)ICe KaK H B npej<enax Ka)KaOi%I KynbTypbl C TeLIeHHCM BpeMeHH(Ledermann, 1956; Mäkelä et al 1981; Popham 1970). llenb ,gaHHOH

rnaBbl COCTOHT B TOM, LIT06bI CBA3aTb HHjjHBH,ayanbHblM ypOBeHbpHCKa C nOHHMaHHeM 06o6LI[ëHHOCO ypOBHA HnH ypoBIIA npo6neMHaCeneHHA.

JlorHzlecxHH nyTb noAxoAa K Bonpocy o6 yposxe npo6neMHaCeneHHA 3aKnIOLIaeTCA B BbIACHeHHH TOro, KaK HHjZHBHj(yanbHbIlipHCK MeHAeTCA B OTBeT Ha H3MeHeHHe KOnHyeCTBa nOTpe6neHHA, a3TM B BbIACHCHHH CTpyKTypbl HaCeneHHA, COCTOAIijerO 143 nHJgeii,HMeIOLLmX pa3nHYLHble npHBbILIKH noTpe6neHHA H, Cne4oBaTenbHo,pa3nHLiHyIO CTeneHb pNCKa. OgHa MaTpHL[a 3TM KâK 6b1

HaxnaAblBaeTcA, yMHOxcaeTCA Ha Rpyrylo.

3Ta rnaBa 6yjZeT nOCTpoeHa CnejrylonjHM o6pa3oM. MbI HaLIHëMc yTOtIHA1oLuero OCHOBbI pa3Aena, rge 6yjieT HccneAOBaH xpyrOCHOBHbIX aHanHTHLieCKHX BOnpOCOB, OTHOCAIijHXCA K 06o6LLjeHHHJ

pâ3nH'-IH6IX cTeneHeii HHj(HBHjiyanbHOro pHCKa, n03BOnAIOLLjHX

nOHATb ypOBeHb np06neM HaCeneHHA (4.1). 3jjeCb H B nOCnegyIOLIjeMpa3uene (4.2), B KOTOpOM HCCnejjylOTCA TeopeTHiecxLle BOnpOCbl,xacalowHecA pacnpejzeneHHA noTpe6neHHA anxoronA cpeAHHaCeneHHA, MbI XOTHM onpegenHTb npHpogy B3aHMOCBA3H 3TOHCpyHKLjHH (HH,IIHBHLEIyanbHblli pHCK nOTpe6neHHA anKOronAyMHO)xeHHblii Ha pacnpelieneHHe noTpe6neHHA anKoronA cpeliHHaCeneHHA, iiTO, KaK 0)KHgaeTCA, o60CHyeT, 061ACHHT H

npejjonpe,genHT nOCnej1yfOlLjHe 3MnxpI-I=IecKHe BbIBOgbI OTHOCHTenbHoHaceneHHA (4.3). MbI 3aKOHLIHM rnaBy KpaTKHMH npeABapHTenbHblMH

3aMeTKaMH O HOTeHL[HanbHbIX nonHTH9eCKidX BbIBOj(aX. KaK H B rnaBe 3,

6yjZyT HCCnejlOBaHbI BOnpOC61, KaCafOn.jHeCA BO3M0)KHOrO 3aLLjHTHOro

3c1)ctieKTa nOTpe6neHHA anKOronA JUTA KOpOHapHOii 60ne3H14 cepgLja,HO Ha 3TOT pa3 He Ha HHjjHBHgyaJIbHOM ypoBHe, a Ha ypoBHeHaCeneHHA.

4.1 OT VIH,qNBeiYAJ1bHO("O PNCKA K OI.IEHKE PACKAHACEJ1EHVIA: AHAJ1ViTV14ECKNE BOf1POCbI

4.1.1 O6bënn rnH,griBH,gyanbHOro noTpe6neHHSa, cpopnnacpyHKIAHN rIH,gNBrl,gyanbHOrO pNCKa N napa,goKCnpocprinaKTNKN

B 3TOM pa3,11ene MbI XOTHM BbIACHHTb HCKOTOpb[e Bâ)KHb1eBOnpOC6I, OTHOCAUjHeCSI K CBA3H (bOpMbI (kyHKLjHH B3aHMOCBA3H

106

HHjjHBHjjyanbHOTO pHCKa AAA ,IjaHHOTO THna CBSI3aHHbIX C aJIKOTOneM

np06neM C ypOBHeM npO6neM HaceneHHSi. ,EI,JISI 3TOii item! MbI Cy3HM06CyxCjjeHHe CHTyaIjHH, KOTjja COBOKynHbli3 06bëM nOTpe6neHHSi,

a He tiaCTOTa nOTpe6neHHSI B 6o1IbIIIHX KOnHLIeCTBaX anKOTOnSI OTCnyiiaSi K CJIyLiaiO, SiBnSIeTCSi TnaBHbIM OlIpejjenRK)üjHM rtiaKTOpOMnp06neMbl.

IHTyHTHBHO MO)KHO npejjnoJlOxCHTb, tiro ypOBeHb npo6neMHaCeneHHSI 6yjjeT, B OCHOBHOM, OnpeJjeJISITbCSI KOnHLIeCTBOM iipe3MepH0

nbK)IIiHX niojjei3. TeM He McHee, 3T0 He COBCeM TaK. BKnajjLIpe3MepHO nblOnjHX B O61IjyiO CyMMy npo6neM peuiaioujHM o6pa30M3aBHCHT OT TOTO, KaK CTeneHb pHCKa MeHSIeTCSI C KOnHIICCTBOMnOTpe6neHHSI. 3TOT CpaKT ne)KHT B OCHOBe TaK Ha3bIBaeMOTOnapajtoxca npocjHnaKTHKH (Rose 1981, Kreitman 1986).

t-1T06bI nOHSITb 3TOT apryMeHT, paCCMOTpHM cJIytraH, Tjje pHCKBpejja BblpaxcaeTCSi nHHeIIHOii (kyHKgHei-i OTHOCHTenbHO KonHtieCTBa

nOTpe6neHHSi (COOTHOCHTCSI C KOnHiieCTBOM nOTpe6neHHSI npslMonponopijHOHanbHO). KaxCjjaSl jjOnOJIHHTenbHaSl jj03a aJIKOTOnSI

npHHOCHT paw-roe npH6aBJIeHHe B COBOKynHbIii ypOBeHb npO6JIeM BHe

3aBHCHMOCTH OT TOTO, nOTpe6nSleT JIB 3Ty jZO3y LienOBeK, KOTOpbliinbeT ManO HJIH MHOTO. CJIejjOBaTenbHO, npn nHHeFiHON (l)yHKIjHHpHCKa He HTpaeT pOnH, nbiOT JIB BCe Ha a6COnIOTHO paBHOM ypoBHeHRH KTO-TO nbeT yMepeHHo, B TO spew' KaK HeKOTOpble nbIOTLIpe3MepHO MHOTO. pOBeHb npO6JIeM HaCeneHHSI 6yjjeT OjjHHaKOBbIM

B 060HX cnyLIaSiX H 6yjxeT 3aBHCeTb TOnbKO OT ypOBHSI nOTpe6neHHSIHa jjyllry HaceneHHSI (Skog, 1985a

Oj[HaKO, 06bIiIHO B3aHMOCB5I3b Me)Kjjy pHCKOM BO3HHKHOBeHH5I

pa3nmHbIX THIIOB Bpejja H KOJIHzIeCTBOM noTpe6neHHSI BblpaxcaeTCSICpyHKIjHeii B CpOpMe H30THyTOI%I KpHBOii. PHCK HeBenHK H MejjneHHO

noBbllllaeTCSi npH HH3KHX ypOBHSIX nOTpe6neHHSI, 3TM OH HaLIHHaeT6bICTpO paCTH npH BbICOKHX ypoBHSIX nOTpe6neHHSI.

IIpH TaKHX O6CTOSITenbCTBaX H 'rpm HenHHekiHOii CpyHKIjHHCOOTBeTCTBeHHbni BKnaj[ pâ3HbIX Tpynn nIO,1jeÎi, OTnHLiaiOIIjHXCSI no

ypOBHSIMH nOTpe6neHHSI, B COBOKynHblii ypOBeHb npO6neM HaCeneHHSI

OnpejjenSleTCSi n0 TOLIHOMy H3TH6y KpHBOi%I ClryHKIjHH pHCKa. 1-1TO6bI

npOHnnK)CTpHpOBaTb H OCMbICnHTb 3T0 noHaLiaJIy jjOBOnbHO CJIO)KIiOe

npejjnO)ICeHHe H CjjenaTb ero nOHSITHbIM, MbI npHBOj[HM B Ta6nHIje 4.1Asa THIIOTeTHLIHbIX H KOHTpaCTHbIX CnyYaSl. CpejjH npej[nonaTaeMOTO

HaCeneHHSI 60% xciireneil noTpe6nslioT anKOTOnb B ManblX j[03aX,

107

Ta6nNl.Aa 4.1 OTHOCV1TenbHb10 pNCK M BKr1a,g B 06L14MN ypOBeHbnpo6neM rpynn c pa3nV14HbIM ypoBHeM noTpe6neHNA Arm ,4ByxrNnoreTVl4ecKV1x anKOronbHblx npo6neM (npe,gn0naraeTCA, 4T060, 35 M 5% HaceneHNA V1MeK)T COOTBeTCTBeHHO HM3KM0,CpeAHMVI M BbICOKMN ypOBHM nOTpe6neHMA).

flpo6neMa 1 Ilpo6neMa 2

YpoaeHb OTHOCHTenb % OTHOCHTenb- %noTpe6neHNA HbIl71 pNCK npo6neM HbIN pNCK npo6neM

HN3KNN 1 20 1 9

Cpe,qHNH 4 47 4 20

BbICOKNN 20 33 100 71

B CyMMe 100 100

35% - ynoTpe6nAIOT B cpejjHNx npejJenaX, a ocTaBuINeCA 5% nbIOTvpe3MepHo. gnA o.tjHoro Tuna BpejJa Mb1 npeJJnonaraeM, 4To14HJJNB14)2JyanbHbll7 OTHOCNTenbHblN PUCK (OP) nOBbIUIaeTCA OT 1 AO 4,H 3aTeM jJ0 20, npu nepexojle OT HN3KOr0 ,no CpenHero, a 3aTeM jToBbICOKOrO ypOBHA nOTpe6neHNA. B 3TOM CnyLiae, OjJHa TpeTb o6LLJerOypOBHA np0611eM 6yjJeT NCXOjJNTb OT 4pe3MepHO nbIOLLJNX, B TO spew'KaK 1104TN nOJIOBNHa (47%) uCXOjJNT 143 CeKTOpa nbIOLLJNX HaCpej(HeM ypoBHe. aJ[A BTOporo Tuna pea MbI npej);nonoxcNnN, MTOOTHOCNTCnbHbIFi pNCK nOBblu]aeTCA ropa3jZ0 6onee pe3K0 Ha BbICOKNXypOBHAX nOTpe6neHNA, B 4aCTHOCTN OT 1 AO 4, 14 3aTCM jJ0 100. B3TOM Cny4ae 11131011.114e MHOrO BHOCAT BKJIaJI, B 6011bUINHCTBO

BO3HNKaEOLLJNX np06neM (71%), B TO BpeM51 KaK nbIOHJNe Ha Cpe,nHeMypoBHe OTBe4alOT TOnbKO 3a OjJHy nATyiO BCeX npo6neM. BnOCnejJHeM cny4ae peg}, MO)KCT MATH o6 ojJHOM N3 XpOHN4CCKNX3a6oneBaHNN, KOTOpOe ABnAeTCA CnejJCTBNeM jJJINTenbHOTO

3noyn0Tpe6neHNA anKOroneM, TaKNM KaK, HanpNMep, LLNppo3 neMeHN(Pequignot et al 1978), B TO spew' KaK B npeJJbljJyuJeM cny4ae pe4bcxopee Bcero Mo)KeT WITH o6 onpejJenexxoM TNne OCTpbIX

COLJNanbHbIX npo6neM (Moore and Gerstein, 1981; Skog 1985a,Kreitman 1986).

CJIeJJOBaTenbHO, Ha ypOBHC HaCeneHNA OTHOCNTenbHOe 3Ha4eHNe

pâ3nNMHbIX rpynn nOTpe6nAiOLqNX aJIKOrOnb nlOjJel%I B OTHOLLIeHNN HX

108

BKnaJja B O6Luyio CyMMy pea itiMeeT TeHAeHuHIO McHATbCA B3aBHCHMOCTH OT THna anKOrOnbHOIi np06neMbl H Ii)OpMbI (1)yHKLjHHpHCKa. Henb351 CiiHTaTb, gpe3MepHO nbK)IIme 1110J114 Bcer,aa,7=1On)KHbI 6bITb OCHOBHOIl LjenbiO np0(1)HnaKTHKH. TeM He McHee,TaK)ICe MbI He MO)KCM CLIHTâTb, LITO napaJ[OKC np0(l)I-iJIaKTi-IKH

Jieï-iCTBHTeneH ,aJIA BCeX THnOB npo6neM, KaK 3T0 CAenanH MHOriieaBTOpbI (Kendell 1987). HanpHMep, OH He Aeï-1CTByeT npHânKOrOnbHOM L[HppO3e, role 60nb1uHHCTBO carmes BO3HHKHOBeHH513TO11 6011e3H14 6bIJI0 o6HapyxceHo cpeAH r-Ipe3MepHO nbIOLLjFiX

(Pequignot et al 1978).

go KaKOro TOLIHO npeAena H OTHOCHTenbHO KaKHX npo6neMJieHCTBHTeneH napaAoxc npo411,111aKTHKH, JI o CHX nop He 5ICHO.MnF1pHLIeCKHe aaHHble O ero COCTOATenbHOCTH, B OCHOBHOM,

6epyrcA 1,I3 OnpOCOB HaCeneHHA. OT6op pa3nHliHbIX rpynnHCCneAyeMOrO HacenenxA, nocTOAHHble N3MexeHliA B )iCenaHFIIi

BOCnpHHHMaTb HJIIi HeT 3Ty npo6neMy, HeBO3MO)KHOCTb ygeCTbpa3nHLlHylo CTeneHb Cepbë3HOCTFi npo6neM, J(JIHTenbHblN CKpbITbINnepHoA H TaK Aanee - BCë 3T0 MO)ICeT npHBOAHTb K pâ311H1-IHbIMOTKJIOHeHHAM B TOM 141IH HHOM HanpaBneHHH. He06XO,aHMOHCIIOnb3OBaTb 601Iee COBepLIIeHHble MeTOJjbI, 9T06b1 nOnyLIHTb 60neeOnpeaeneHHble BbIBOJjbI.

4.1.2 H@06XO,gNMOCT6 y411TbIBBTb CTp)/KTypy HaC@n@HHAno ypOBHfIM nOTpe6n@HNA al1KOrOJIA

B npHBeAeHHOM malle npHMepe MbI npeAnonaranH, LITO

pacnpeAeneHHe ypoBHeH noTpe6neHHA anKOrOJIA cpeAH HaceneHHASIBnAeTCA nOCTO51HH6IM H 3TM HCCne,aOBanH 344eKT 1-13MeHeHIi51

B3aHMOCBA3H MexcJjy HH,11HBH,gyanbHblM ypOBHeM noTpe6neHHA HpHCKOM BO3HHKHOBeHH51 npo6neMbl. EcnH HHJjHBHJlyanbHbIli pHCKBbIpaNCaeTCA nHHeÎiHOIi ItlyHKL[HeN, TO CTpyKTypa HaCeneHHA noypoBHlo noTpe6neHHA anxoronA 6yAeT BnHATb Ha 0611HH ypOBeHbnpo6neM, H 3T0 BOnpOC, K KOTOpOMy MbI XOTHM cerriac BepHyTbCA.,T(Ba HapOJja C O,1HHaKOBbIM ypOBHeM noTpe6neHHA Ha AyLLry

HaCeneHHA, TaKHM o6pa3oM, MOryT HMeTb a6COnEOTHO pa3HbIHypOBeHb npo6neM. 1V1HOro neT Ha3a,a 3TOT (baKT 6bin OTMelIeH JOIIIÎeH Jellinek (1941) JjJIA LlHppo3a neLIeHH B HX HCCne,t1OBaHHH

COOTHOIHeHHA MC)iCay ypOBHeM CMepTHOCTH H ypOBHeM nOTpe6neHHA

anKOrOnA Ha JjyLÜy HaCeneHHA no nlTaTaM CHIA.

109

Ta6nlnua 4.2 CMepTHOCTb B pe3y1lbT8Te 3a60neBâHmA c3KCflOHeHTHOVI cpyHKLAV1eVl pVICKa cpe,gH Tpex rVIfIOTeT1,14HbIXrpynn HaCelIeHNA, pa311V14alOLl;NXCA pacflpeAeJleHV1eM IIbIOLIiVIXno ypOBHAM IIOTpe6lleHVIA, HO C O,gNHaKOBbIM ypOBHeMIIOTpe6lleHHA Ha ,gyllJy HaCeIIeHNA.

rpynna 1 rpynna 2 rpynna 3

nove- OP6neHHe Kon- YpoeeHb K011- YpoaeHb K011- YpoBeHb

BO cMepT- BO cMepr- BO cMepr-nro,qeN HOCTIA no,qeN HOCTI4 nro,qeN HOCTII(TbI C. ) (TbI C. ) (TbI C. )

0 1 20 0.2 20 0.2 20 0.2

1 4 40 1.6 55 2.2 58 2.3

2 16 40 6.4 15 2.4 11 1.8

3 64 - 6 3.8 3 3.8

4 256 3 7.7 2 7.7

5 1024 1 10.2 20.5

B cyMMe 100 8.2 100 26.5 100 36.3

To, B KaKOFI cTeneHH pa3nHtII3A B pacnpeAeneHHli yposHeKnoTpe6neHNA CpeAH HaceneHi-IA 6yuyT BniiATb Ha ypoBeHb npo6neM,3aBHpCHT OT itOpMbI (isyHKuHH pHCKa. ECM,' KpHBaA cpyHKuHH pliCKaCHJIbHO 3aKpyrnAeTCA, KaK B ityHKuHI-i uHppo3a netleHH, MOxcHoO)KidZjaTb 3HaL11,1TenbHbIX pâ3nI3LIHii B ypOBHe npo6neM npHpa3nFiLixoM pacnpe,ijeneHliH ypoBHeii noTpe6neHliA aJlKoronA CpeAHHaceneHHA. 3TOT 44)aKT npoHnnlocTpfiposaH Ha Ta6nime 4.2. Ta6nHuanOKa3bIBaeT, KaK ypOBeHb CMepTHOCTH OT uHppo3a 6y,L(eT MeHATbCAAAA Tpex npeAnonaraeMblx rpynn HaceneHHA, Ka)ICgaA H3 KOTOpbIX

COCTOHT 1,13 100 000 LIenOBeK. BCeX rpynn HaceneHHA cpegHHAypoBeHb nOTpe6neHliA O,L[HHaKOB, HO pacnpezjeneHHe ,^.O ypOBHAMnoTpe6nexHA anKOronA pa3nHilHoe. rlpeAnonaraeTCA, LITO

OTHOCHTenbHbIii pHCK (OP) 6yAeT Bo3paCTaTb n0 3KCHOHeHTe npHpocTe FIHAHSHpryanbxoro noTpe6neHIIA. BH,aHO, B rpynne 1, rRei-Ipe3MepHO nbiOÜjHe OTCyTCTByIOT, 061IjH14 ypoBeHb CMepTHOCTHCOCTaBnACT BCero 8,2% Ha 100 000 HaceneHHA. Bo BTOpON rpynne,rge )10n51 noTpe6nAion.[HX anKOrOnb Ha BbICOKOM yposHe BenHKa,

110

ypOBeHb cMepTHOCTI3 B TpH pa3a BbIlue - 26,5%. B TpeTbeli rpynne,KOTOpaSI CXOAHa CO BTOpOii, KOnHTIeCTBO ilpe3MepHO nblOnjHX nloAeri

enjë BbIIIIe, H ypOBeHb CMepTHOCTH TaK)Ke BbIIne - 36,3%.CneAOBâTenbHO, Aa>Ke He60nbmOe H3MeHeHHe B COCTaBe HaCeneHHSt

no yposHlo noTpe6neHHSI anxoronSl OKa)ICeT 3HaTIHTenbHblli 3C1)ClIeKTHa ypOBeHb CMepTHOCTH, KorAa CtiyHKIjHSI pHCKa 3KCnOHeHTHa.

BbIBOA, KOTOpOÎi BbITeKaeT H3 3TOTO rHIIOTeTHLIHOrO, HO

CBSI3aHHOTO C npaKTHKOIi aHanH3a, COCTOHT B TOM, TITO COCTaB

nb1011ter0 HaCeneHHSI MO)KeT 3HaTIHTenbHO BnHSITb Ha ypOBeHbnpO6neM HaceneHHSI. Cne,aOBaTenbxO, B HHTepecax o6nteCTBeHHoro3ApaBOOxpaneHHSt Heo6xoAHMo o6naAaTb HHcPopMaqHeli o pacnpeAe-neHHH HaceneHliSi no yposHSIM noTpe6neHHSI. 3C19cteKT, KOTOpbIIi6yAeT OKa3bIBaTb H3MeHeHHe B ypOBHe noTpe6neHHSi Ha AymyHaCeneHH51 Ha ypOBeHb npo6neM, 6yAeT 3aBHCeTb OT TOTO, KaKH3MeHeHHe B nOTpe6neHHH paCnpeAenAeTCSi CpeAH HaCeneHHSI, H 3TOOCO6eHH0 BepHO jLrIA 3a6oneBaHHN C CHnbHO 3aKpyrneHHOii KpHBOiiCl)yHKL(HH pHCKa. MbI 06paTHMCSI K 3TOMy BOnpOCy 60nee AeTanbHO

HHxce, B pa3Aene 4.2.

4.1.3 cDyHKItHH pHCKa, Bblpa)K@HHbI@ rpaCtHKOMJ-06pa3HON CpOpMbI

KaK yKâ3blBânOCb B rnaBe 3, B HCCKOnbKHX HCCneAOBaHHSIX 6bIJIo

CAenaHO npeAnOnO)KeHHe, TITO Ha HHAHBHAyaJIbHOM ypOBHe aJIKOTOnb

MO)KeT OKâ3bIBaTb nOJIO)ICHTenbHblii 3CpitleKT npH HH3KOM ypoBHe

nOTpe6neHHSi, B TO BpeMSi KaK pHCK BpeAHbIX nOCneACTBHri

yBenHTIHBaeTCSI npH BbICOKOM ypoBHe nOTpe6neHHSI. CneAOBaTenbHO,AnSI OnpeAeneHHbIX 3a60neBaHHii KpHBaH CItyHK14HH pHCKa MO)KeTHMeTb J-o6pa3l-Iylo CtlOpMy, HanpHMep, AnSI KOpOHapHON 60ne3HHCepAua. cDyHKLjHSi pHCKa J-06pa3HoFi Cl3OpMbI npeAnOnaraeT HanHTIHeAnti OTAenbHOii nHTIHOCTH OnpeAeneHHOTO "oIITHManbHorO" ypOBHSInOTpe6neHHH, npH KOTOpOM ypOBeHb pHCKa MHHHManeH.

CneAyiOLL[Hii BbITeKaIOIi[HIi OTCIOAa HHTepeCHblii BOnpOC: KaKOTO

poAa B3aHMOCBSI3b MbI nOnyTIHM Ha 06o6uteHHOM ypoBHe, ecnHB3aHMOCBA3b Ha HHAHBHAyanbHOM ypoBHe HMeeT J-06pa3HyioCitOpMy? LITO Cny'-IHTCSI C ypOBHeM CMepTHOCTH HaceneHHSI B

pe3ynbTaTe onpeAeneHHOrO 3a60neBaHHSI, eCnH nOBbICHTCSI

COBOKynHbliï ypOBeHb noTpe6neHHx? 3T0, KOHeTIHO, B 6onbmoliCTeneHH 6yAeT 3aBHCeTb OT paCnpeAeneHHSi noTpe6neHHSI anKOrOnslCpeAH HaCeneHHSI.

111

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K09.LE.IElfOUl7adu 1.3t1X9 01G Ox9IfOMOEH `0M911O10EH KO.LH.LEdNOO

OH KHHaLraOEH H1OOH1d3111O 9HaaodX `/IYYiCwH.LUO ÂOH91fEiCitHaHt71LH wOHHEd àHaodÂ 11I3H1l0dO EH `wo£Ed90 MIMEZ '011191r09 91I11

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KO.LaKIfaK ÒHhaHOM `waxaOdX 1119H911EwH.LUO wI9H9LCEXI7HaI11/HH

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o6pa3oM, 3HatIIiTenbxo MeHbuie, 'rem npeJJnonaranocb B aHanH3e,OrpaHHmeHHOM nOHHMaHHeM ABJIeHHA Ha HHJJHBHJJyanbHOM ypOBHe.

OnpeJxenAA nonHTHKy 06LLJeCTBeHHOrO 3,apaBOOXpaHeHHA npHHânHLIHH iflyHKIIHH pHCKa J-06pa3HOM (OpMbI, KpaiiHe Bâ)KHO JlenaTbpa3rpaHHLIeHHe MexcJry "OnTIiMâJIbHbIM" ypOBHeM JInA nHLIHOCTH HJJnA HaCeneHHA. 143-3a CHnbHOTO pa36poca B pacnpelieneHHHnoTpe6neHHA BepOATHO,LITO "OnTHManbHbIH" ypOBeHb n0Tpe6neHH51,gJIA Ha.CeneHHA 6yJJeT 3HaLIHTenbHO HHKe, i-IeM "011THManbHbn%I"

ypOBeHb JJJIA nHLIHOCTH. HaCKOnbKO HH)Ke - 6yJJeT 3aBHCeTb OT(pOpMbl cl-iyHKLJHH pHCKa H OT H3MCHCHHH B pacnpeJJeneHHHnOTpe6neHHA anKOrOJIA, a TaK)ICe H3MeHeHHA ypOBHA nOTpe6neHHAHaCeneHHeM. IIpH He CnHLIIKOM HepeanbHblX 06CTOATenbCTBaX(npOnopCjHOHanbHble H3MeHeHH5I nOTpe6neHHA) "OI1THManbHbiii"ypOBeHb noTpe6nexHA JuIA HaceJIeHHA MO)KeT 6bITb McHbIIIe, =ieM"OnTHManbHblli" ypOBeHb JJnA nHtIHOCTH B 3 HnH ;lance 5 pas (Skog1992). 3TO 03HaLIaeT, IiTO 60nbLLIHHCTBO 3anaJjHbIX CTpaH y)KenOTpe6nAeT 6oJIbuie, lieM OnTHManbHblN ypOBeHb AJIA HaCeJIeHHA.ECJIN 3To BepHo, TO B cny9ae o6lgero noBbILHeHHA noTpe6neHHA nonpFIiIHHe nepcneKriisbl npeHMyLL[eCTBa 3JZOpOBbA OT noTpe6neHHA

aJIKOronA JJJIA ManOnbK)nJHX MO)KeT B JJeNCTBHTenbHOCTH npHBeCTH K

061ileMy nOBbILUeHHIO ypOBHA CMepTHOcTId. TeM He McHee, KaK 3T0yxce OTMeyanOCb, 3HaiiHTenbHOe H3MeHeHHe B o61IJeM pacnpeJJeneHHHnOTpe6neHHA anKOCOJIA, ecnH OHO npOHCXOJJHT OJJHOBpeMeHHO,

TeopeTH=IecKH MoxceT npeJJoTBpaTHTb 3To.

4.1.4 AJ1HTeJ1bHOCTb BO3/4eNCTBH51 H npO6JleMaBpeMeHHOrO OTCTâBaHHA

HpocToe cpasxexxe TeHJJeHIJHK noTpe6neHHA anxoronA Ha JJyutyHaCeneHHA H TeHJIeHLJHti CMepTHOCTH MO)KeT HHOrJIa 6bITbHeaJJeKBaTHbIM, nOTOMy IiTO KpaTKOCpOLIHbni aHânH3 MO)KeT

HeJJOOLJeHHBaTb BO3MO)KHON CJIO)KHOCTH JJJIHTeJIbHOCO H nOJIHOCOB03JJei-iCTBH51 H3MeHeHH2 nOTpe6neHHA Ha 3JJOpOBbe HaCeneHHA.MHOCHe 3a60neBaHHA pa3BI4BaIOTCA TOnbKO nOCne JInlaTenbHOrOnoTpe6neH1451 anKOrOnA B 60nbIIIHX KOnHiieCTBaX. 3TOT (1)aKT

OKâ3bIBaeT 3HaiIHTenbHOe BnHAHHe Ha O6LIJyiO B3aHMOCB5I3b MexcJlynOTpe6neHHeM anKOCOJISI H 3a6OneBaeMOCTbiO H CMepTHOCTbiO (Skog1980b). IToCneJICTBHA JJJIHTenbHOCO CKpbITOCO nepxoJla HaHHJJHBHJ(yanbHOM ypOBHe O6bIi1HO 6yJJyT Bblpa)KaTbCA B TaK

Hâ3bIBaeMOM BpeMeHHOM OTCTaBaHHH Ha O6O6LIIeHHOM ypOBHe.341)eKT nOBbItIIeHHA COBOKynHOCO nOTpe6neHHA H, TaKHM o6pa3oM,

113

pocTa lincna MHOr01161OHji3x 6yj(eT npOABnATbCA Ha 11p0T51)Kexi314MHorOneTHerO nepnOJja. L1aCTHLIHO nOBbllileHne ypOBHA CMepTHOCTn6yzeT, TM He McHee, OLIeBIiJ];HbIM 11011TH cpa3y xce Hnn B npe,genaxnepBblX gByX neT, XOTA nOJIHbIIi 3(1-43.eKT He npOABIiTbCA paHee, LIeM

Llepe3 20 neT (Skog 1984a).

3cpcDeKT HaxonnexHA o61,51CHAeT HenleJjJleHHbIH 34)cpeKT. BcerJ>;acymecTByeT OnpeJZeneHHOe 1114CJI0 nblonjnx, KoTOpble noTpe6nAIOTLryTb MeHbIIIe anKOrOnA, LIeM Heo6XOgnMO J)JIA TOrO, LITO6bI yMepeTb,

CKa)ICCM, OT L[nppO3a ne9eHn. OAHaKO, eCJIn I3){ ypOBeHb nOTpe6neHnApaCTeT, 3a60neBaHHe pa3BliBaeTCA 6bICTpee, H OHn MOryT yMepeTb OTunppo3a 3a KOpOTKHI3 nepno,q BpeMexn. Z(JiA JTpyrnx nb101IÿI4XnoTpe6yeTC51 6011bIIIHA OTpe3oK BpeMexH Ha pa3BnTHe Ijnppo3a HCMepTb B pe3yn6TaTe 3TOrO 3a6oneBaHnA, H 3T0 6y41eT cLInTaTbcAOTRanCHHbIM 3eeKTOM.

bblCTpble OTBeTHble H3MeHeHH51 CMepTHOCTH npn 3HaLInTenbHOMH3MeHeHnH COBOKynHOrO ypoBHA noTpe6nexHA 6binn Han60neey6eJjnTenbHO npOHnnIOCTpnpOBaHO JjaHHbIMH 143 Hapnxca 3a nepnoJjBTopOii MHpOBOi-i BOIiHbI. B 1942 roAy 6bina BBegexa KapTOmHaACHCTM Ha npoJiaxcy anKOTOnA n3-3a CHnbHON HeXBaTKn

anKOTOnbHbIX HannTKOB, H, KaK cnencTBHe, Ha6nioJ1aJIOCb

3HaLIi3TenbH0e cOKpan.jeHne nOTpe6neHIiA ânKOTOJISI, KOTOpoe

Jxnnnocb go 1947 roAa. HopMa cocTasnAna 0.5-1 n Blixa B HeJxenlo, HnoTpe6nexne Ha JzyHly HaceneHHA CoKpaTHnocb B nepnOJ1 BOFiHbI Ha80% nnn 6011ee. Bo3J1elicTBiie Ha ypoBexb cMepTHOCTH OT uHppo3a6bIJIO CTOnb )Ke 3HaLInTenbHblM. CIIyCTA 1 rog ypoBeHb CMepTHOCTnCOKpaTHJICA 6onee, LieM Ha 50%, a CnyCTA 5 neT - 6onee, LIeM Ha 80%OTHOCHTenbxO ypoBHA 1941 roJia (1%innlocTpauraA 4.1).

34)(1)exT BpeMeHHOro oTCTa6aH145I o3HaLIaeT, LITO H3MexenneyposHA CMepTHOCTIi 6yJZeT J)O HeKOTOpON CTenexH OTCTaBaT6 OTH3MeHeHHf4 B nOTpe6neHHH aJIKOTOnA. 31i)(ioeKT 6yJjeT oco6eHHo0L1eBHJ:1HbIM B TeX cnymaAx, KorAa noTpe6nenne MCHAJIOCb

J1n14Ten6H0e BpeMSI B OAHOM HanpaBneHnH, a 3TM pe3KO(i3MeHH11OC6 B Jl;pyrOM. B 3TOIï CHTyannH MbI MO)KeM 0)K14JjaTbOnpeJZeJIeHHOro nepeXOgHOrO nepnOJ;,a, B TeLiexne KOTOpOTO

nOTpe6neHne 6yueT pâ3BIiBaTbCA B OJI,HOM HanpaBneHnH, a ypOBeHbCMepTHOCTH - B npOTmBOnOJIO)KHOM. 3T0 6yteT npOUCXOnHTbnOTOMy, LITO nOJIHbIIi 3(1)(peKT nepBOiA TeHJZeHHHH eH.je He nOJIHOCTbK)

npOABIiTCA cpa3y nOCne H3MeHeHHA 3TOii TeHgeHL[nn. 3MnnpnLIecKâA

114

KapToYHaA cHcTeMa

C

IInnlocTpauHSi 4.1 CMepTHOCTb B pe3ynbTaTe uHppo3a B IlapHxce B1930-1956 rr. (Aannbie H3 Ledermann 1964).

HnnlocTpauHA Taxoro po,aa cHTyauHH Ha6nlOganacb, CpegH npoYHxPopham (1970) o6HapyxcHn, YTO B

TeLieHHe 1931-58 rOJjOB Ha6nIOJjanOCb HeraTHBHas' KoppenAuHA

(r=0,61) MexcRy noTpe6neHHeM anKOronA Ha jZynly HaceneHHA HypOBHeM CMepTHOCTH B pe3ynbTaTe uNpp03a. Bo BCeX OCTanbHbIXBpeMeHHbIX CepHAX Popham o6HapyxcHn 1103HTHBHyIO KOppenAljHEO.IIpH 60nee neTanbHOM aHanH3e CTanO OYeBHJjHbIM, YTO 06b5ICHeHHenOJ[06HOr0 aHOManbHOrO ABneHHA, BO3MO)KHO, 3aKJnOYaeTCA B TOM,

YTO nOTpe6neHHe anKOrOnA CHnbHO CHH314J1OCb C HaYana CTOneTHA Jx0

HaYana 30-x rOJjOB. 3aTeM nocneJjosan nepHoJ[ JjnHTenbxoCTbIOOKOJIO 15 neT, Korna Ha6nIOnanacb TenjjeHljHA yMepennoronOBbiHIeHHA nOTpe6neHHA, B TO BpeMA KaK ypOBCHb CMepTHOCTHnpOJjon)Kan CHH)KaTbCA Jjo HaYana 40-x rOJjOB. KOrJZa naHHbie 6bi11H

npoaHanH3iipOBaHbI BTOpHYHO H yYTëH 30I1:leKT BpeMeHHOrO

oTCTasanHA, KOppenAuHA cTana no3HTHBHOÎ-i (r=0.87) H coBnana coBCeMH OCTanbHblMH JZaHHbIMH (Skog 1980b).

3cpctleKT BpeMeHHOrO OTCTaBaHHA HeO6XOnHMO o6513aTenbH0yYHTbIBaTb npH oueHKe TeHneHuHFi B npO6neMax, CB513aHHbIX CXpOHHYeCKHM nOTpe6neHHeM. 3a nOcnenHHe rOJZbI 6bIJlH

pa3pa60TaHbI CTaTHCTHYeCKHe MeTOJjbI yYCTa 3TOr0 ABneHHA, H OHH

npHMeHAnHCb B HCCne,aOBaHHAX no anKOrOnIO. bOnee ,aaBHHe

115

iiccneRosaHiiS{ H Aaxce, K co)KaneHFIIO, psi nOCneAHHX, me HeyIIHTbIBanCM 3C1(1JeKT BpeMeHHOI'O OTCTaBaHHSI, MOryT nerKO npNBeCTH

K He061eKTHBHbIM pe3ynbTaTaM, H FIX He06XOnHMO TpaKTOBaTb CoCTOpoxcxoCTblo. ara npo6neMa cTana oc06exxo oCTpoH B

nocneAHHe rOnbl, c Tex nop KaK TeH,geHLjHH nOTpe6neHHA BO MHOrnxc-rpaHax He pa3BHBaIOTCSI 605Iee B o,AHOM HanpaBneHHH.

O,AHaxo B CnyLlae nocne,ACTBHIi Tx)Kenoro OnbSIHeHHSi 343IPeKTspeMexxoro OTCTaBaHHSI 06bIiiHO He npencTaBnMeT cepbe3HOlinp06neMbl. B 3TOli cHTyaL[Hid, BepoxTHO, HaH6onee cepbe3Hylonp06neMy npe,AcTaBnSIeT TO, KaK npH aHanH3e yLIeCTb B3aHMHOeBnHSIHHe anx0ron5l H ApyrHX CliaKTOpos.

4.2 PACIIPE,gE11EHV1E IIOTPE611EHV1S1 A11KO1-01151

4.2.1 VlcTOpH4ecKaR cnpaeKa

KaK MbI y)Ke o6cy)IC,AanH, B03Ae1iCTBHe H3MeHeHHii B

nOTpe6neHHH Ha nyLHy HaCeneHHA 6yneT 06bILIHO 3aBHCeTb OT TOrO,KaK 3TH H3MeHeHHA pacnpenenAK)TCA CpenH HaceneHFiA.

He06X0,AHMOCTb yi-IHTbIBaTb 3TOT 4JaKT 6b1na BnepBble nOJIHOCTbiOOCO3HaHa C1)paHL(y3CKHM AeMOrpa(tOM Sully Ledermann.

HaL1HHaA c 1946 roAa Ledermann ony6nHKOBan cepHloHCCneAOBaHHFi no BeKOBbIM TeHneHIjHMM H perHOHanbHbIMH3MeHeHHAM ypOBHA CMepTHOCTH BO CDpaHL[HH H ApyrHX CTpaHaX. OH

o6HapyxcHn 3HaLIHTenbHble CoBna,AexHA B H3MeHeHHMX B

npocTpaxCTSe H BpeMeHH Me)Kay noTpe6neHHeM anKOrOnA Ha nyulyHaceneHHM H ypOBHeM CMepTHOCTH, H 3T0 nOCny)KHJIO TOnHKOM KCO3AâHHiO ero H3BeCTHOIi TeopHH O pacnpeneneHHH noTpe6neHHManKOrOnM. BKpaTue, 3Ta TeOpHA yrBepxcnaeT, LITO AOn)KeH

Cyn.[eCTBOBaTb OHpeneneHHblii HOpAAOK B TOM, KaK nbK)Ii[He

pacnpenenMlOTCA no HlKâne noTpe6neHHA anKOrOnM, H LITO 3T0pacnpeneneHHe MOxCeT 6bITb npH6nH3HTenbHO BblpaxCeHO TaK

Ha3blsaeMOli nor-HOpManbHOFi BepOATHOCTHOIi KpHBOH. bOnee TOro,Ledermann npennonoxcHn, LITO cyLnecTByeT HOCTOAHHaA B3aHMOCB513bMexCny cpenHHM ypoBHeM nOTpe6neHHA H OTKnoxeHHMMH B

pacnpeneneHHH. ara B3aI3MOCB5I3b o3HaLIaeT, LITO H3MexeHldA

cpenxero yposHA noTpe6neHHA 6yAyT 06bILIH0 conposoxcAaTbcM

116

H3MeneHHSIMH Ha Bcex yposHAx noTpe6nexi-iA, BKnIOLiaA TsnICenoenbSIHCTBO (Ledermann 1956).

TeopHA pacnpeneneHHA Ledermann noponHna cnopbl,AJIHBIIIHeCA nocneZjHHe 25 neT, H nocny)KHna TOnLIKOM Z[J731 cepHH3MnHpHiiecKHx H TeopeTHLIecKHx HccneAOSaHHFi. TeopeTwiecKHeOCHOBbI H 3MIIHpHLIeCKâA LjeHHOCTb OCHOBHOIi rHIIOTe3bI 3TOH TeOpHH

COBepIIIeHHO cnpaBejjnHBO no,IjBepranacb COMHeHHIO, H CerOAHAo61i(enpH3HaHH0, LITO npaKTHLIeCKOe pacnpeneneHHe He HMeeTaOCTaTOLIHO OnpeneneHHat MaTeMaTHLIeCKON (bOpMynbl. TeM HeMcHee, 66InH 06Hapy)KeHbI HeKOTOpble 3aKOHOMepHOCTH B KapTHHaXpacnpe.geneHHA, H 3TH 3aKOHOMepHOCTH HMe1OT OTHOIHeHHe KB3aHMOCB313H MexcAy o61I[HM ypoBHeM noTpe6neHHA anKOrOnA s06LijeCTBe H COBOKynHbIM ypoBHeM npO6neM. MbI AanHM KpaTKHiio63op AByx OCHOBHMX BbIBOAOB HCCne,gOBaxHIi - Bo-nepBblX, T000(paKTa, LITO pacnpe,geneHHe ABnAeTCA BecbMa acHMMeTpHLIHbIM, H BO-BTOpbIX - 43aKTa O TOM, LITO paCnpOCTpaHeHHOCTb TA)KenOrO nbAHCTBa

palme-ma B pâ3HbIX 061neCTBâX, TaK )Ke KaK H B npenenaX OAHOrO061(jeCTBa B pâ3HOe BpeMA, H 3TH H3MeHeHH51 CBA3aHbI C H3MeHeHHAMH

B 06LIJeM ypoBHe noTpe6neHHA.

4.2.2 ACVIMMETPVI4HOCTb PACI1PE,gE11EHVIA

A npHOpH, pacnpeneneHHe HacenexHA B,gOnb IIIKânblnOTpe6neHHA nOTeHljHanbHO MO)KeT HMeTb pa3nHLIHb1e 4:lOpMbI. OAHa1,13 BO3M0)KHOCTeii - 3T0 OJjHOpO,gHOe pacnpeneneHHe (A) C

OAHHaKOBbIM LIHCJIOM ni0Aek1 B KaxcAOM HHTepBane ypOBHA

nOTpe6neH4A. Pâ.CnpeneneHHe, BblpaN(eHHOe rpa(pHKOM B(DOpMeKOJIOKOna, KOTOpOe CXOAHO C HOpManbHblM pacnpeneneHHeM (B),SIBnAeTCA elljë OAHOii BO3MO)KHOii (1)OpMOii, H H3BeCTHO, LITO OHO06bILIH0 OTHOCHTCA K HeKOTOpbIM LienOBeLICCKHM CBOHCTBaM.

bHMOAanbHaA (bOpMa (C) TaK)Ke BO3MO)KHa - "yMepeHHO nb10IIlHe"paCHOJIO)KeHbI B HH)KHeH LIaCTH LLiKânbl nOTpe6neHHA, a"anKOrOJIHKH" 6onee HnH Mexee ACHO BbIAenAIOTCA Ha BbICLIIHXypOBHAX. I-1eTBëpTâA anbTepHâTHBa - 3T0 aCHMMeTpHLIHOe

pacnpeneneHHe (D) 6e3 LIeTKorO pa3AeneHHA Me)KAy HOpMânbHblMnOTpe6neHHeM H 3noynOTpe6neHHeM. P1eKOTOpb1e H3 3THX BapHaHTOBMOryT 6bITb oTBeprHyTbl C TOLIKH 3peHHA 3npaBOrO CMbICna.CHMMeTpHLIHOe pacnpenenellHe, TaKOe Kat( OnHOpOAHOe H

rayCCOBCKOe, He A01TyCKaeT CyLL[eCTBOBaHHe nioneFi nbIOLLjHX BnBOe

117

6onbule cpeAHero ypoBHSI, TaK KaK HHKTO He MOwKeT nHTb MeHbnleH0n5I. Ho MbI 3HaeM, MTO B 6onbLIINHCTBe o6u.tecTB, r,ge noTpe6n5IIOTaJIKOI'Onb, CyHteCTByeT 3HaL1HTenbHOe KOnH4cCTBO nblOÜtHX nIOjteIi, H

HX ypOBeHb noTpe6nexHSl 3HaLIHTenbHO 6onbule, item s ABa pa3anpesbllIIaeT CpejtHl-iI%I ypOBeHb. 3TOT apryMeHT y6eAHTenbHo,nOKâ3bIBaeT 4T0 pacnpeAeneHHe JjonNCHO 6bITb aCHMMeTpH4HO H COCABHrOM B npasylo cTOpOHy (=no 5IBn5IeTC51 1103HTHBHOi-I

acHM MeTpi34HOCTbIO).

IIJIJIIOCTpaullia 4.2 I'rinoTeTH4eCKoe pacnpeAeneHHe nbiouteroHaceneHHa no exceroAHOmy ypOBHIO noTpe6neHHSI.

TeM He McHee, OCTaëTC5I MHONCeCTBO BO3MONCHbIX

ztonOJIHnTenbHbIX BapHaHTOB KpiiBbIX. FiHMOjtanbHaSl CpopMa

pacnpeAeneHlisl MOweT 6bITb nocTpoexa MHONCeCTBOM CIIOCO6OB, aKnacC KpHBbIX Oj[HOBOJIHOBOro aCHMMeTpFi4HOi'o pacnpeAenexxslTatoKe BenHK. Bo3MONCHO nH Bb16paTb 60nee OrpaHH4eHHbIFi KJIaccpacnpejteneHHSI Ha OCHOBe TeopeTliLIecKFix apryMeHTOB HnH KaKIiM-nH6o ApyrHM o6pa.3oM? Bailee TOrO, BO3MONCHO nH, LITO6bI

nOTpe6neHHe anKOrOJIA nOjt4HH5IJIOCb KaxoMy-nH6O 3axoHypacnpeAeneHHSi?

143 ,ItpyriiX OTpacneli HayKH O NCH3HH H3BeCTHO, 4TO HeKOTOpbleLienOBeiIecKHe npOSisneHHH 11O,VIiiH5I10TC5I 3aKOHaM pacnpeAeneHHSt,no KpaliHert Mepe npH6nH3HTenbxo (Anastasi 1958). HanpHMep,3KOHOMHCT6I noKa3anli 3aKOHOMepHOCTH B pacnpeAeneHHH6naroCOCT051Hii51 H ZtOXO,ita. 3TH 3aKOHOMepHOCTH O6bI4HO 5IBn5IIOTC51

o4eHb aCiiMMeTp144HbIMH H HanOMHHalOT TeOpeTii4eCKyIO KpHByiO,

118

H3BecTHylo KaK IIapeToso pacnpeneneHHe (Blinder 1974). TaKxceH3BCCTHb1 ApyrHe npHMepbl H3 HCCneA0BaHH13 nOBeneHHA LIenOBeKa

npH noTpe6neHHH, H noTpe6neniie MHOrxX THnoB ToBapoBnpH6nH3HTenbH0 COOTBeTCTByeT MaTeMaTHLIeCKOii KpHBOrI H3BeCTHO1i

KaK nor-HOpManbHOe pacnpeneneHHe (Aitchison and Brown 1969),KOTOpaA BblpaxCaeTCA OAHOBOJIHOBbIM aCHMMeTpH'-IHbIM rpacpHKOM c

AnHHHbIM OTBeTBneHHeM n0 HanpaBneHHIO K BbICOKHM ypOBHAMnOTpe6neHHA.

3TH npH6nH3HTenbHble "3aKOHbI" pacnpeneneHHA 06b1'iHO

06-b5ICHAIOTC51 CTpyKTypHbIMH XapaKTepHCTHKaMH MeXaH43MOB,

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BnHSiHH10 rlpHSbILIeK nOTpe6neHHSI anKOrOnSI, npHHSITbIX B HX

COL(HanbHOM OKppKeHHH (Skog 1980a). TeopHSi COuHanbHOTO

B3aHMOBnHSIHHSI npH nOTpe6neHHH anKOTOnSI, TaKHM O6pa3OM,11O3BOn5IeT npegnOJIO)KHTb, LITO HH,RHBH,RyyM, )KHByluHii B

AOCTaTOLIHO 6naronpHSITHOM OKpy)KeHHH, MO)KeT cKOpee CTaTb

"MânonbiOII(HM" LIenOBeKOM, B TO BpeMSI KaK TOT )Ke HH,IjHBH,IjyyM MOr

6bI CTaTb "MHOronbK)ILjHM" B He6naronpHSITHOM OKpy)KeHHH, rijeanKOTOnb ,RenIes, jjOCTyneH H HsnSIeTCSi COCTâBHOIi LiaCTbiO

nOBCejIHCBHOM )KH3HH. TaK KaK HH,RHBHjIyanbHble npHSbILIKH

nOTpe6neHHSI anKOTOnSI H3-3a COIIHanbHOTO B3aHMOBnHSIHHSI

B3aHMOCBSI3aHbI, HH,RHBH,DyanbHble H3MeHeHHSI npHBbILIeK nOTpe6neHHSI

anKOronSI HMeIOT TeH,ReHuHio 6bITb CHHXpOHHbIMH, H TaKHM o6pa3oM,

BO3HHKaeT KOnneKTHBHaSI KapTHHa H3MeHeHHiï (Skog 1979). TaxHM

06pa30M, Ha6niOjlaeMble KOnneKTHBHble KapTHHbI H3MeHeHHIi,

HaH60nee BepOSITHO, SIBnSIIOTCSI pe3ynbTaTaMH ,ReHCTBHSI COuHanbHblX

H KynbTypHbIX MexaHH3MOB.

51BHOe OTCyTCTBHe TeCHOii B3aHMOCBSI3H Me)Kzly ypOBHeMTpe3BOCTH H ypOBHeM nOTpe6neHHSi anKOronSi MO)KeT HaiiTH csOeo615ICHeHHe B paMKaX TeOpHH COLjHânbHOrO B3aHMOBnHSIHHSI. ECnH

Tpe3BeHHHKH H nbioLRHe SIBnSIiOTCSI TOnbKO cna6o CB5I3aHHbIMHnoArpynnaMH o61uecTBa, H3MeHeHHSI s npe,Renax no,RrpynnbInbiOLlMx MoryT OKa3bIBaTb nHIIIb He6onbllIOe BnHSIHHe Ha no,RrpynnyTpe3BeHHHKOB. Cna6y10 CB5l3b MO)KHO OTHeCTH Ha CCTH,ReonOrHLIeCKOl3 HanpSUKeHHOCTH H ,RpyrHX (l)aKTOpOB.

gaHHble, xOTOpbMe Mbl npoaHanH3HpoBanH, O6bILIHO OnHCbIBaiOTTO, LITO MO)KHO 6bin0 6bI Hâ3BaTb "3anajlHbIM MHpOM nOTpe6HTeneiiCBO6o,RHOTO pbIHKa", KOTOpbIii XapaxTCpH3yeTCSI OLICHb Cna6bIMnpSIMbIM O(1)141L14âJIbHbIM COUHânbHblM KOHTpOneM HHjIHBH,RyanbHOTO

nbioLuerO. B 06LueCTBaX C ropa3jl0 60nee CHnbHbIM KOHTponeM Ha,RKâXCjIbiM nbIOIIIHM MbI MO)KeM nerKO npe,RCTaBHTb, LITO

pacnpeuenexxe nbx)LuHx no yposxSlM noTpe6neHHSi 6yneT coBCeMHHbIM. Cne,ROSaTenbHO, ecnH O(lHuHanbHbIii HnH HeO41HIIHanbHblliCOuHanbHbIii KOHTpOnb nbx)njHX 6bin 6bI yCHneH, pacnpe,RenexxenOTpe6neHHSi H3MCHHJIOCb 6bI, H MbI ,ROnNCHbI O)KHgaTb, LITO M6IyBH,RHM cOKpaLueHHe paCnpOCTpaHeHHOCTH nOTpe6neHHSI anKOronSl B

6onbLUHX KOnHLieCTBaX 6e3 COOTBeTCTByIOLuHX H3MeHCHH11 B CpeAHCM

yposxe noTpe6neHHSI (Skog 1980a).

Norström (1987a) noxa3an 3c14exT OcDHLlxanbxorO couHanbxoroKOHTponSi Hap( pacnpenenexxeM noTpe6nenHSi anKOrOnSI B

127

HCCneJiOBaHIii3, TaK Ha3bIBaeMOii, CHCTeMbI llipaTra B LLIse1jHH. 3To6bIna KapTOtIHaA cHCTeMa. KoTOpaA 6bina BBeJieHa BO sperm' nepeoliMIipOBOii BOi3HbI (Kai( anbTepHâTHSa "CyXOMy 3aKOHy") H KOTOpaAJieHCTBOSana go cepeAHHbI 50-x ro,aOB. Norström noxa3an, 4ToKapTO4HâA CFiCTeMa 3Ha414TenbHO COKpaTIiJIa Kone6aH{iA

pacnpegeneHI-iA H pacnpoCTpaxeHHOCTb TANCenOrO nbAHCTBa noCpaBHeHFIIO C JipyrHMH CTpaHaMli CO CXOJiHbIM CpeJiHHM ypOBHeMnoTpe6neHI3A. 3T0 OKa3anO 3Ha41iTenbHbIi-i 34(1JeKT Ha CMepTHOCTb Bpe3ynbTaTe uHppo3a ne4eHH (Norström 1987a) H KonHVeCTBOnpecTynneHHï-I, CBA3aHHbIX C HaCiiJIFieM (Lenke 1990). JllaHHbIH

npliMep LLIBeuHH, TaKiiM o6pa3oM, HnnloCTpHpyeT OCHOBHOe

nonoxceHHe o TOM, 'ITO Ha6nIOJjaeMble B pacnpeJjenexxH nio6oiïCTpaHbl 3aKOHOMepHOCTid MoryT 6bITb Si3MeHeHbI C nOMOn.[bIO

OnpeJieneHHbIX Bo3JZeiïCTBFiFi Hnii MeXaHFi3MOS H, CneJtOBaTenbHO,"3aKOHbI O paCnpeJieneHNH" Henb351 npHMeHATb 6e30 BCAKIIX

OrpaHn4eHFiH.

4.2.5 floTpe6neHHe anKoronn B 6onbwHx KonNyecTBaxrt npo6nenna "npHpoAa/BocnHTaHHe"

B nOCneJjHHe rOJibl >KeCTKaA KOHuenIjHA "anxoronii3Ma" KaK4e1O-TO onpe,aenexxoro, Ka4eCTBeHHO oTni3i-Ia101uerocA OT

HOpManbxoro noTpe6neHHA anKOrOnA, 6bina 3aMexexa 6onee r136KOIiByXOCesoiï KOHljenuHeii, rJje "anxoronbxaA 3aBHCHMOCTb" ABJIAeTCA

OJiHOii OCbIO 1i3MepeHi3A H "npo6neMbl, CBA3aHHble C anKOroneM" -JipyroH OCbIO (Edwards et al 1977). 3TO N3MeHeHHe KoHuenuHH03Ha'-IaeT npii3HaHiie TOrO, LITO Hâ3bIBaeMOe "anKOrOn143MOM"

COCTOAHHe ABJIAeTCA MHOrOrpaHHbIM.

bonee Toro, noTpe6neHHe, 3noynoTpe6neHlie H 3aBHCi3MOCTbMoryT 6bITb pa3nH4HOFi CTeneHii, H nepexoJi OT TaK Hâ3bIBaeMOrO"HOpMânbHOro" nOTpe6neHiül anKOronA K "HeHopManbHOMy"ABnACTCA cKOpee noCTeneHHbIM, 4eM pe3KHM.

ara HOBaA KOHuenul4A CO BCeMH BXOJiAIIjliMii CioJia BOnpOCaMH,COrnaCyeTCA C HaMe'ieHHOii 3JieCb nepCrleKTI3B0Î-i. MbI BbIACHHnH, 4TOCBA3aHHOe C BbInHBKOFi nOSeJieHFie noJisepraeTCA BniiAHHIO

6OnbLIIOro KOnH4eCTBa (DaKTOpOS, KOTOpble 06bI4H0 KOM6HHi3pyIOTCA,

npHyMHOxcaA JieHCTSiiA Jipyr Jipyra. CneJiosaTenbHo, noTpe6neHHeânKOronA B 6onbiuFiX KOnA'IeCTBaX BO3HnKaeT H3-3a MHOweCTBanpii'IHH, H MHOrOnbiOnjHi-i 4enOBeK - 3TO nid'IHOCTb, rJie CXOJii3TCABo3JieliCTBHe OrpOMHOro 'IHCna HMeiOniHX TeHJieHuiiio nOBbILUaTb

128

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xI4waEaH1faEU0Â90 àodo1MEC11 xH11I0IE1EUOUOEd?tadu axxalrgad.LOu

'-ITO HaII1 apryMOHT OCTaHeTCA BepHbIM 6e3oTHOCHTenbH0 K TOMy,BbICOKaA HnH HI-13Ka5I KOppenAlrHA 6y,rjeT KOr,ga-nH60 yCTaHOBneHaMc)xJZy 6HOJIOrHeCKOii KOHCTHTyn;Hei4 H npo6neMHbIMnOTpe6neHHeM anKOronA. Aa)Ke B ManOBepOATHOM Cny'iae nO'-iTii LITOCOBepIIIeHHOIi KOppenAIJHH MbI 6yAeM o)KHj(aTb, LITO

pacnpOCTpaHeHHOCTb "anKOrOnIdKOB", "KpailHe 3aBHCHMbIX OT

anKOrOnA nbI011[HX" H T.A. 6ygeT 3HaLIHTenbHO MeHATbCA B

npOCTpaHCTSC H BpeMeHH B OTBeT Ha H3MeHeHHe 06iijeer0 XapaKTepaHe6naronpHATHOrO OKpy)KeHHA B o61IleCTBe.

FiHOnorH4eCKHe (1)aKTOpbI, BnHAIOIqHe Ha CB5I3aHHOe C

anKOroneM nOSeJjeHHe, MHOr04HCneHHbI H pa3H006pa3Hbi n0npHpone (Jaffe 1988). Henb351 nOnaraTbCA Ha KaKON-TO eJ[HHblfl "reHnbAHCTBa". HeKOTOpble HeflpOTpaHCMHTTepbl MOryT BnHATb HaBO3HHKHOBeHHe yAOBOnbCTBi15I y n10Jiefi (3Î3(loOpHH), MeTa60nH4ecKHe

(paKTOpbI MOryT BbI3bIBaTb y HeKOTOpbIX peaKl(Hi0 OTBpanjeHHA Kanxoronlo (Agarwal and Goedde 1991), H orpoMHOe KOnH4ccTBo6HOnorHLlecKlix MexaxH3MOa oxa3blBaeT 6onblIIe HenpAMOe BnHAHHeHa CB513aHHOe C aJlxoroneM noseJ[eHHe, sO327tei-ÏCTBy51 Ha JjpyrHe THnbI

noBepeHHA, KoTOpble B CBOiO o'IepeJjb BnIiAIOT Ha noTpe6nexi7eanKOronA. pionee Toro, 3TH CBA3H Me)Kny reHeTH4eCKHM cTpoeHHeM HnoBeAeHHeM B HeTpe3soM COCTOAHHH He ABnAIOTCA MexaHH'ieCKHMH H

HeH36e)iQ-IbIMH. HanH4He noAo6Hblx (kalCropos "npeApacnonoxceHHOCTx"MO)KeT HpHBeCTH TOnbKO K nOBbII1IeHHOMy pZlC1Cy, a 6yAeT Jill 3TOTpHCK MaTepHâJIH3OBaH B aJIKOronbHylO npo6neMy, 3aBHCHT OTOKpy)KeHHA.

TaK KaK Mo)KHO npeJ[noJIO)KHTb MHO)KeCTBO He3aBHCHMbIX

reHeTH4eCKHX (l)aKTOpos, reHeTH'ieCKaA npejjpacnOnO)KeHHOCTbJjonACHa npOSIBnATbCA B pa3nH4HON CTeneHH, H MbI MO)KeM

npc,LICTaBHTb pacnpeZjeneHHe HaceneHHA BJjOnb IIIKanbI, KOTOpaAH3MepAeT "6HOJIOrH4eCKyIO npeJf,paCHOJIO)KeHHOCTb". HeKOTOpbie

JIionH o6nâJ>;a.IOT BbICOKOH, HeKOTOpble yMepeHHOi%I H HeKOTOpble HH3KOfi

npeJ[paCnOnO)KeHHOCTbIO. B O61I[eCTBe C HH3KHM nOTpe6neHHeManKOrOnA J);OCTynHOCTb aJIKOronA ABJIAeTCA B CpeffleM nOCTaTO4HOHe60nbIlloii. B OCHOBHOM, nIO,IH C BbICOKOi4 npe.LpaCHOJ1O?KeHHOCTMO

MOryT ROBeCTH CBOe nOTpe6neHHe Jj0 nOABneHHA anKOrOnbHbIXnp06neM B ,r];aHHbIX yCJIOBHAX. B"MOKpOM" 061IjeCTBe, TM He McHee,BnHSiHHe anKOrOnA BenHKO, H Jlaxce Te, KTO o6na,qaeT JZOCTaT04H0yMepeHHOii npeJJpacnoJIO)KeHHOCTbIO, MOryT JjOBeCTH CBOe

nOTpe6neHHe J><O noABneHHA npo6neMbl (cm. HnnlocTpagHlo 4.7).

130

CneAOBaTenbHO, paCnpOCTpaHeHHOCTb anKOrOnbHbIX npo6neMuonxcxa 6bITb BbIIIIe B nOCneuHeM cnyiiae, TITO H noxTBep)KAaiOTHMeIOn1;HeCSI B HanHLIHH (paKTbI (cM. pa3uen 4.3 HH)Ke).

KonevecTeonroneï

HH3KâA CpeAHAA BbICOK3A

npeJIpaCHOJIONCeHHOCTb

11JIniOCTpawHN 4.7 FHnoTeTHLIecxoe pacnpeueneHHe HacenexHSI nonpe,qpaCnOJIOXCeHHOCTH K anKOrOnbHbIM np06neMaM.

CXOuHble apryMeHTbI TaIOKe ueI3CTBHTenbHbI H B npeuenaxKâxCuorI KynbTypbl. YpOBHH nOTpe6neHHSI H npaKTHKa nOTpe6neHHSI3HaLIHTenbHO MeHSIIOTCSI B pa3nHLIHbIX CJIOSIX HaCeneHHSI (Clark and

Hilton, 1991 npeAcTaBIUIH BCeCTOpOHHHe uaHHbie no CHIA B 3TOMBonpoce), H jjOCTaTOLiHO "cyXaH" KynbTypa Co.gep)KHT onpe,IjenexxbleKynbTypxble "HHIIIH", rue anxoronb ynorpe6nxeTcx 6onee cso6ouxoH nacTO. B uaHHbIX nourpynnax HHuHBHuyyMbl C yMepexxOKnpe,qpaCnOnO)KeHHOCTbiO MOryT nOUBepraTbcSl pHCKy. TaKHM

06pa30M, MO)KHO O)KH,i(aTb, LITO ;mice B uOBOnbHO "CyXHX" KynbTypaX

MO)KeT 6bITb LiacTb "anKOronHKOB" C HH3KOii Hull yMepeHHOI4npe.gpacnOnO)KeHHOCTbIO, 6narouapsl cynjeCTBOBaHHIO "MOKpbIX

HHIII". Cne,I;OBaTenbHO, B nI060M o6lljecTBe "anKOrOnHKH", cxopeeBCerO, SIBn5I10TC5i ,gOCTaTOLIHO pa3HOpOuHOii MaCCOI-i.

131

4.3 3MI114PN4ECKVIE VICCJ1E,11OBAHNA O6LIJ01B3ANMOCB513111 ME)KAY AJIKOrO11EM N YL1J<EP6OM

4.3.1. H@3KC17@pNM@HTallbHbl@ ,gaHHbl@: o6u4asiH@06X0pNMOCTb OCTOpO)KHOrO OTHOW@HNA

IIpoaHanH3Hp0BaHHble B IlpeAbl,ay111 13X pa3Aenax pe3ynbTaTblnpHBOASIT K O)KHAaHHIO TOI'O, LITO ypOBeHb aJIKOI'OnbHbIX npo6neMHaCeneHHSI, oco6eHHo npo6neM, rAe pHCK TeCHO CBSI3aH C

KOnHLIeCTBOM nOTpe6nSieMOrO anKOrOn51, AOn)KCH 3aBHCeTb OT 06H(er0

ypOBHSI nOTpe6neHHSI anKOronSl cpeAH HaceneHHSI. 3-r0 yTSep)KneHHeHe npHBOAHTCSI B )KeCTKOIi (I)HKCHpOBaHHOii CpOpMe, a KaK OCHOBHOe

CTaTHCTHLIeCKOe npasHno. HHxce MbI paCCMOTpHM 3MnHpHLICCKi3eAOKa3aTenbCTSa 3TOr0 yTSep)KAeHi35l. 1v1bI HaLIHëM C KpaTKOrO 0630paHCKOTOpbIX McTOAOnorHLieCKHX BOnpOCOB, KOTOpble HCO6XOAFIMonOMHi3Tb npH 1-101-16ITKe HpOBepHTb 3Ty rnnOTe3y.

B HCCneAOBaHHSIX COBOKynHOro ypOBHSI B3aHMOCBSi3H Me)KAynoTpe6neHHeM H ypOBHeM npo6neM, B KaLICCTBe AaHHbIX 06b1'-1H0HCHOnb3y1OTC51 11I3()pbl npoAa]ICH Ha Ayuiy HaceneHF3x 143

O(1IIjHânbHbIX i3CTOLIHI3KOB. TaKXCe LIaCTO i3CIIOnb3yeTCSI cpeAHeenOTpe6neHne Ha Kâ)iCAOro B3pOCJIOrO (15 neT H cTapllle). C ApyrOiiCTOpOHbI, B HCCneAOBaHHSiX pacnpeAeneHHSi nOTpe6neHHSI anKOrOnSi,

Tpe3BCHHi3KH 0661,m0 He yLIHTbIBaIOTCSI. TaK KaK Mo)KCT He 6bITbHHKaKON CHn6HOii KOppenSIIwH Me)KAy nOTpe6neHHeM Ha AylllyKa)KAOrO nbiOwerO H pacnpOCTpaHeHHOCTbK) Tpe3BeHHHKOB,

B3a1iMOCBSI3b Me)KAy ypOBHCM npo6neM H nOTpe6neHlieM Ha KaXCAOroB3pOCnOro MO)KCT 6bITb HCCKOnbKO cna6ee n0 cpaBHeHHio C

B3aHMOCBSI3bI0 Me)KAy ypOBHeM npo6neM H nOTpe6neHHeM Ha AyIDyKaHCAOro nbioH.[er0.

BTopaSl np06neMa BbITCKaeT 143 TOro (paKTa, LITO 13 HCKOTOpbIXCTpaHaX He3aperHCTpHpOBaHHOe noTpe6nexxe xBnxeTCx BCCbMa

3HaLIHTenbHblM. 143MeHeHHSi B He3aperHCTpHpOBaHHOM nOTpe6neHHHMOryT eluë cHnbHee OCna6HTb CBSI3b.

KaK 6bUIo oTMeLIeHo paHee, pa3nHiiHble Colu30-AeMOrpaci-HLIeCKHe

rpynnbI MOryT HHOrAa H3MCHSITb CBOe nOTpe6neHHe B pa3nHLIHOIiCTeneHH. CneAOBaTenbHO, TeHAeHmiH B o61ueM noTpe6neHHH HaAyIIIy HaCCneHHSI He BcerAa MOI'yT 6bITb TOLIHbIM HHAHKaTOpOMTeHAeHniHH np06neMHOrO n65iHCTBa B noArpynne. B HAeane, HaM

132

He06XOAHMa ,iZOnOJIHHTenbHâSl HH(DOpMauHSI n0 TOLIH6IM H3MeHeHHSIM

nOTpe6neHHSI B rpynnaX, HO 3TH AaHHble peAKO HMeIOTCSI B HaJIHLLHH.

1Me51 ;ten() C He3KCnepHMCHTanbHblMH AaHHbIMH MO)ICHO

CTOJIKHyTbCSi C BO3MO)KHOCTbIO nOJIyLIeHHSI CTHMynHpOBaHHOIi

KoppensluHH: ABe nepeMeHHble MOryT 6bITb TeCHO CB513aHbl Apyr CApyrOM, IIOTOMy LITO OH14 06e 51BR511OTC51 npOAyKTOM oAHOro H TOTO

)Ke ne)ICaLuerO B OCHOBaHHH McXaHH3Ma. B OCHOBHOM, 0606LueHHble

B3aHMOCB513H MOryT H3yLlaTbC3I n0 AByM pâ3nHLiHbIM THnaM AaHHbIX.

MoxceT 6bITb cAenaHO CpaBHeHHe Me)iCAy HaCeneHHeM pa3nHLIHbIXMeCTHOCTeH B OAHO spew' (3KOJIorHLieCKâSI KoppenSluHSI), HnH MO)KeT

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aHanH3). B3aHMOCB5I3H, OCHOBaHHble Ha 3KOJIOrHLIeCKHX AaHHbIX, noHeKOTOpbIM TeXHHLIeCKHM npHTiHHaM SIBnSI1OTCSI AOCTaTOLIHO

COMHHTenbHbIMH H He 6yAyT paCCMaTpHBaTbCSt B 3TOii rnaBe. r1oAXOA

BpeMeHHbIX cepHfl, KaK MO)KHO O)KHAaTb, AacT 6onee HâAë)KHbleOueHKH, gem 3KOJIOrHLIeCKHIi aHanH3. OCHOBHOH npo6neMoi3BpeMeHHbIX cepHi3 S1B5151eTC5I TOT (taKT, LITO ABe CepHH MOryT HMeTbCXOAHble TeHAeHuHH, XOTSI OHH He 5IBn5I1OTC51 npHLIHHHO

B3aHMOCB5I3aHHbIMH. AHâROrHLIHO, 5IB11eHH51, KOTOpble B AeIiCTBHTenb-

HOCTH 110314THBHO COOTHOCSITCSI, MOryT HHOrAa HMCTb OLIeHb

pa3nHLlHble TeHAeHuHH pâ3BHTHSt H MOryT Aaxce ABHraTbeSi B

npOTHBOnOJIO)KHbIX HanpaBneHHSIX. 11pHLIHHOii 3TOrO 06bI1IH0SIBJISIeTC51 TO, LITO pyre 4)aKTOpbI, KOTOpble BRHSIEOT Ha 3aBHCHMyIo

BeRHLiHHy, He SIBJISIiOTCSI nOCTOSIHHb1MH BO BpeMeHH.

axT, LITO 6OnbHIHHCTBO BHAOB yLuep6a o6naAaloTMHOrO(taKTOpHO1i 3THOROrHeii, npHBOAHT K HeKOTOpbIM Bâ)KHbIM, HOLIaCTO He 3aMeLIaeMbIM nOCneACTBHSIM npH HHTepnpeTauHHo6061ueHHOri B3aHMOCB5I3H MexcAy nOTpe6neHHeM H yluep6oM.Ha6n10AeHHe, LITO ypOBeHb BO3HHKHOBeHHSI Kaxoro-R116o yluep6acTa6HneH HRH noHH)KaeTcSl, B TO spew' KaK nOTpe6nexxenOBbILIIaeTCSI, He yCTpaHSIeT BO3MO)KHOCTH nOAnHHHOTO 11O3HTHBHOTO

COOTHOLIICHHSi MexcAy 3THMH AByMSI BeRHLiHHaMH. OTRHLIaiOIuaSIC51

TeHAeHuHSt MO)KeT 6bITb pe3ynbTaTOM yJIyLILUa10Luero BnHSIHHSI

ApyrHX npHLIHHHbIX (paKTOpOB nOMHMO anKOrOnSI. 143yLIeHHe aBapHli

CO CMepTeRbHbIM HCXOAOM B HOpBerHH npeAOCTaBnSIeT HaM XOpOIIIyIo

HJUIIocTpaljlüo: B TeLIeHHe nepHoAa 1951-80 rr. noTpe6neHHe Ha AyLUyHaCeneHHSI nOLITH yABOHJIOCb, B TO BpeMSI, KaK ypOBeHbHaCHRbCTBeHHbIX CMepTeH 6bIn AOCTaTOLIHO CTa614n13HbIM (Skog

133

1986). 03HagaeT 1113 3TO, 4TO 3Ta 4)opMa cMepTHOCTx He pearxpyeT HaH3MCHeHH5I B nOTpe6neHI3H? Bailee ,I)',eTâJIbHbIii aHânH3 nOKa3an, 4TOypOBeHb CBH3aHHbIX C anKOrOneM HaCHJIbCTBCHHbIX CMepTei4 HaCaMOM Aerie yBenHLIHJICH, HO 3TO yBenH4eHHe 6bino HeNTpani33OBaHO3Ha4HTCnbHbIM CHHNCeHHeM HeC4aCTHbIX cny4aes Ha npOH3BOACTSe(KOTOpble no4TH HHKOrAa He BO3HHKaiOT B HopBerHH no npH4HHenoTpe6neHHx anKOronH). B AaHHOM cny4ae Apyrori ckaKTOp -

npO(iHnaKTHKa HCC4aCTHbIX cny4aes Ha npOH3BOACTBe - npOH3BenBo3AeÎ3cTBHe o6paTHoe BJIHAHHIO noTpe6neHHH. B pe3ynbTaTe BnHSIHHe

anKOronH 6bI110 CKpbITO B o6lueii TeHAeHuHH. 3TOT npHMep Cny)KHTnpCAOCTepe)KeHHeM npOTHB HeOCTOpO)KH6IX yTBep)KAeHHN,

BbIBeAeHHbIX 1-13 aHanH3a TeHjjCHuHFt.

To, 4TO ApyrHe (kaKTOpbI He "paBHbl", Mo)KeT 6bITb HIM He 6bITbIIp06neMOH npH OL[CHKe BJIH)IHHH nOTpe6neHHH anKOronH Ha ypOBeHb

npo6neM. ECnH HCHO11 b33,10TC5I COBpeMeHHble CTaTHCTH4eCKHe

McTOAHKH, TO CHTyauHH He 6yAeT npo6neMaTH4Holi, AO Tex nop noKaHeT HCTHHHbIX KoppenHuHN Me)iCay noTpe6neHHeM H gpyrHMH3THOnOrH4eCKHMH Il3aKTOpaMH, KOTOpble He 6bInH nOJiHOCTbiO

paccMOTpexbl (Box and Jenkins 1976). TeM He Mexee, ec11H Apyrai3THO110rH4eCKHi7 (13aKTop J';eÎdCTBHTenbHO TeCHO CB513aH C noTpe6neHHeM,

TOr,ija OH AOn)KeH 6bITb BHeCeH B MOAenb HRH MbI pHCKyeM nO11y4HTbHCKa)KeHHy10 OueHKy.

Tenepb c Heo6XOAHMOii MeTOAonOrH4CCKOFI OCTOpO)KHOCTbIO H3-

3a Bcero BbILne cKa3aHHOTO, MbI npej[CTaBHM o630p HeCKOnbKHXHCCne,aoBaHH1.1 O6LueH B3aHMOCB513H Me)KAy nOTpe6neHHeM anKOrOnH

H ypoBHeM pa3nH4Hb1x BHAOB yLL[ep6a cpeAH HaCe11eHHH. O63op, BOCHOBHOM, 6a3HpyeTCH Ha CTaTbHX, Ony6nHKOBaHHbIX B

Me)K,ItyHapO,rnibIX )KypHanaX c 1979 rOAa. MbI peluHnH cjtenaTbaKueHT Ha HCCne,aoBaHHAX, KOTOpble yAOBneTBOpHTenbHO

CnpaBHJIHCb C o6CyNC,AeHHbIMH Bbllne MeT0A011oCH4eCKHMH

npo6neMaMH, B TO BpeMH KaK O ,ijpyrHx HccnegoBaHHSIx, ecnH OHHBoo6Lue ynoMHHaIOTCH, rosopHTCA BKpaTue. K co)KaneHHio, AOHCAaBHero BpeMeHH B 3TOH O6naCTH 6bIJIH Ony6nHKOBaH6I TOnbKOHeCKOnbKO McTO,rjOn01-H4eCKH aAeKBaTHbIX HCCnez[oBaHHiï.

KaK y)Ke OTMC4anOCb paHee, B3aHMOCB513b Me)K,gy noTpe6neHHeM

H yLuep6OM HHOrxja Mo)KeT o6naAaTb cTpyKTypoH C BpeMeHHbIMOTCTaBaHHeM. KOrAa 3TO AeNCTBHTenbHO TaK, 3T0 npHHHMaeTCH BOBHHMaHHe B npHBeACHHbIX HH)Ke aHanH3aX.

134

4.3.2 O611051 CMepTHOCTb

CMepTb SIBnHeTCSI O4eBHAHbIM 04eHb Cepbe3H6IM nOCneACTBHeM,KOTOpOe MO)KeT 6bITb pe3ynbTaTOM nOTpe6neHHA anKOronii.IlepexoAA K o6Cy)KAeHHIO B3aHMOCB5I3H Mexcny nOTpe6neHHeMHaCeneHHA H ypOBHeM CMepTHOCTH, He AOn)KeH 6bITb ynylueH H3BHA)/ TOT ItaKT, 4TO 6011bIIIa51 ,I;OnA CB313aHHOTO C anKOrOneM speAa

SIBnAeTCA no XapaxTepy COuHanbHOii, nCIiXOnOrHiieCKOii H CeMeliHOii.O61uas1 CMepTHOCTb, ypOBeHb CMepTHOCTH ABnSIeTCA KnacCnLlecxHM

noxa3aTeneM o61uero COCTOAHHA 3Aoposb51 HaceneHHA. Eë CB513b CnoTpe6nexxeM Ha Aptly HacenexiiA ABnS1eTCA, TaxHM o6pa3oM,0006eHHO HHTepeCHOH, XOTA CTeneHb, B KOTOpOiï CB513aHHa5I C

anKOroneM CMepTHOCTb MO)KeT 6bITb yAOBneTBOpHTenbHbIMnOKâ3aTeneM o6utero cnexTpa MeAHuHHCKHX H COUHanbHblXnpo6neM, KOTOpble npOi3CXOASIT B pe3ynbTaTe noTpe6neHHAanxoronSI, Tpe6yeT BHHMaTenbxoro HCCneAOBaHHA B Ka)iCAOI%I

OTAenbxoH cHTyauHH.

Bce npiiBeneHHble 3AeCb AaHHble - OCHOBaHHble Ha AaHHbIXBpeMeHHbIX cepHÛ 143 IlpyccHH, cI)paxuHH H IIIBeuHH (Norstrom6ynyluHe ny6nHKauH4) - cornacyloTcA MC)Kny C06oi%I H n03BOnAIOTnpeAnono)KHTb, iITO nOB6IHIeHHe B noTpe6neHliH Ha Ayury HacenexHAHa 1 n npHBOnHT K noabIlIIeHHIO cMepTHOCTH cpenH n1oAeH CpeAHHxneT HeMHOrHM 6onee, 4eM Ha 1%. TaKHM o6pa3oM, AocTaTOiixo3Ha4HTenbx0e H3Mexexxe B noTpe6neHHH Mo)KeT He OCTaBHTb nerKOpa3nH4HMOrO Cnena B ypoBHe cMepTHocTH. 3TO ABJISIeTCA

oTpa.)KeHHeM Toro (f3aKTa, 4TO npHBOnAluee K cMepTH noTpe6neHHeanKOTOnA SIBnSIeTCA OAHHM 143 HeCKOnbKHX nyTei4 B Be4HOCTb. TeM He

McHee, Hy)KHO HMeTb B BIiAy, MTO Aa)Ke KOTAa o6mee BnxslHHenoTpe6neHHA sblAenHTb CJIO)KHO, OHO HaBepxslKa LIyBCTByeTCA TaM,rne KoHueHTpxpyeTcA, TO eCTb B CJ1051X HacenexHA, me npesanxpyeT11651HCTBO, H B aJIKOrOJIbHOM CeKTOpe MeAHuHHCKHX cnyxc6. MbITax)Ke AOn)KH6I nOMHHTb, 4TO B HCTOpH4eCKOM nnaHe paAHKanbHbleCABHrH B nOTpe6neHHH Ha Aptly HaCeneHHA He ABnAIOTCSI

He06bI4H6IM ABneHHeM (CM. pa3Aen 6.2) H MOryT 3Ha4HTenbHOCKâ3aTbC51 Ha 061ueH CMepTHOCTH H COCTOAHHH 3AOpOBb51.

He-r BeCKOii npH4HHbI O)KHAaTb, LITO napaMeTp 3(1)(peKTa (atriaB3aHMOCB513H) 6yAeT 3aBHCeTb OT CpeAHerO ypOBHA nOTpe6neHHA HimOT 11HTer1HOH KynbTypbl, B AaHHbIX H HeT HHKaKHX . npH3HaKOB11OAO6HOM 3aBHCHMOCTH. TeM He McHee, OTHOCHTenbHâA Bâ)KHOCTb

anKOrOnA, KaK (kaKTOpa pHCKa - B nnaHe ero OTHOCHTenbHOrO BKnaAa,

135

KaK BbITeKaeT H3 HMeIOnjHXCA AaHHbIX, - ABnAeTCSI rOpa3A0 60nbme4i

B cTpaHaX C BbICOKHM ypOBHeM nOTpe6neHHA n0 CpaBHeHH10 CHa11H51MH C HH3KHM nOTpe6neHHeM.

4.3.3 OTAEJ1bHb1@ 11pN4NHbl CM@pTN

ECnH BMeCTO o6uteH CMepTHOCTH MbI cci)oxycHpyeM BHHMaHHeHa CMepTHOCTH, rue noTpe6neHHe anxoronA ABnACTCA 11pH3HaHHbIM(tiaKTOpOM pHCKa, nepCneKTHBbI yCTaHOBneHHA 0606n.teHHoroBnIdAHHA nOTpe6neHHSi AOnNCHbI 6bITb BbIme. 3T0 npeanOnOnKeHHenOATBepxcAaeTCA B HCCneAOBaHHH Skog (1987), rAe OH axanH3HpyeT6onee orpaHH9eHHy10 KaTeropHlo CMepTHOCTH, KOTOpy10 o6bI9HoCLIHTa1oT CB513axxoi%I C anxoroneM. C1oAa BxojjAT: IjHppo3 neLIeHH,anKOrOnbHbli-i nCHX03, anKOrO11H3M, naHxpeaTHT H pa3nHLIHble BHAbIpaKa BepXHero nHUjeBapNTenbHOro TpaKTa H nop)ICenyjjO-IHON

nCene3bl. BpeMeHHble H3MeHeHHA B 3T011 cI:1opMe CMepTHOCTH 6bInH3HaL1HTenbHO CB513aHbI C Ii3MeHeHHSIMH IIOTpe6neHiiA Ha AymyHaCeneHHSI, H pe3ynbTaTbl n0Ka3bIBanH, LITO ApyrHe cpaKTOpbI

OKa3bIBânH nHmb OrpaHH9eHH0e B03AeIicTBHe. Thorsen (1990) B eroBCeCTOpOHHeM HCCneAOBaHHH, OCHOBaHHOM Ha AaHHbIX H3 AaHHH,n0ny9Hn CX0AHbte BbIBOAbI npH 6onee AeTanbHOM ananH3e(npliMeHAA Arlma-MOAenb). ErO BbIBOAbI COrnaCyIOTCA C BbIBOAaMIi,CAenaHHbIMH AnA HOpBerHH.

OTHOCHTenbHO ApyrHX HpH9HH CMepTH, rAe 3THOJIOrH11 aJIKOr0JI51

BCerO nHmb MHHHManbHa 11n11 MeHee OnpeAeneHHa, 06061I(eHHb1eAOKa3aTenbcTBa MeHee y6eAliTenbHbl. OTHOCHTenbHO paKa H BCerO,9T0 CiOAa BXOAHT, AOCTaTO9HO COMHHTenbHO ONCHAaHHe KaKOIi-nH60

CB5I3H C nOTpe6neHHeM Ha Ayüiy HaCeneHHA, TaK Kai( o6utaA3THO11OrH9eCKa51 BâNCHOCTb ânKOrOnA n0 CpaBHeHHio C ApyrHMHnpH9HHaMH B03HHKHOBeHH5I paKa AOCTaT09HO Mana; npHrIHCbIBaeMbIl-i

eMy BKnaA 6bin oLteHeH TpeMA npOL[eHTaMH (Rothman 1980). boneeTOrO, AnHTenbHblli CKpbITbIN nepxoA C COnyTCTB3/1011113M CHnbHbIMBpeMeHHbIM OTCTaBaHHeM 3aTpyAHAeT OnpeAeneHHe 11106oroBnHAHHA. ECnH BMeCTO 3TOr0 C(110KyCHpOBaTb BHHMaHHe Ha 60neeCneLjH(iH9HbIX Cny9aAX, rAe AOKa3aTenbCTBa B3aHMOCB5I31-1 C

anKOrOneM CHnbHee (HanpHMep, paK nHli[eBOAa) MbI CTOJIKHeMCA Cnpo6néMol-i, BbI3BaHHOi3 He60nbLIIHM KOnH9eCTBOM cMepTeH B

AOIIOJIHeHHe K TpyAHOCTH, CO3AaBaeMOÏi BpeMeHH6IM OTCTaBaHHeM.HH9erO 143 TOrO, 9T0 6bIJI0 3AeCb CKa3aHO, He AOnOKHO 6bITbHHTepnpeTHpOBaHO KaK yMâneHHe Bâ)ICHOCTH ânKOrOJIA KaK (paKTopa

136

pHCKa BO3HHKHOBeHH5I palm Ha ypOBHe HHn11BHnyanbHOr0 aHanH3a(cM. Pa3nen 3.6.1).

KOrna MbI nonXOnHM K 06Cy)KneHHK) CMepTHOCTH B pe3ynbTaTepa3nH1IHbIX cep,IkeiiHbIX 3a60neBaHHI%I, ponb anxoronA BbI3bIBaeT6O11bIHHe CnOpbl, H CCbIJIKH Ha cDyHKuHIO pHCKa J-06pa3HOIi (1)OpMbInpOBOuHpyK)T npoTHBopetHe. OTTOJIOCKH 3THX CnOpOB 6b1nH riceHCCnenOBaHbI B rnaBe 3(Pa3nen 3.5) B OTHOluexxH jjaxxblxHHnHBHnyanbHOrO yposHA. ECM! B3aHMOCB513b J-o6pa3HO1i (loOpMbIAeIiCTBHTenbHa, TO 06LuHiï 3(14)eKT nnA HaceneHHA ,Ijon)KeH

npoBepATbcA aHanH3OM 061xe1i B3aHMOCB513H. B O,I;HOM TaKOM

aHanH3e (Skog 1983) npeAnonaraeTcA HanHHHe 3auIHTHOro 3cf4eKTaânKOronA npH BO3HHKHOBeHHH HHIeMHLIecxoii 6One3HH cepnua yHeKOTOpbIX KaTerOpHli HaCeneHHA C HH3KHM nOTpe6neHHeM, XOTA Bmime CTaTHCTHIIeCKOii 3Ha*-IHMOCTH 3Ta KoppenxuHA HaXOAHTCA Hanpenene. Heo6xonHM 6onee neTanbHbni aHanH3 3THX KpHBbIX, noToro KaK Mo)KeT 6bITb CnenaHO n1o6Oe yBepeHHOe 3axnlotieHHe Hayposxe HaceneHHA.

4.3.4 CMepTHOCTb B pe3yJlbTaTe LiNpp03a

CMepTHOCTb OT uHpp03a ABnAeTCA xnaCCHLIeCKHM HHAHKaTOpOM

nbAHCTBa, H en ynenAeTCSA OrpOMHOe BHHMaHHe B HCCneAOBâHHAX no

anKOrOnIO. CoyHKuHA pHCKa iieTKO yCTaHOBneHa B KOHTpOnbHbIXHCCneAOBaHHAX cJIyiiaes 60ne3H14 (Pe(1Ulgnot et al 1978) H, KaK riceynOMHHanOCb, 6bIJI0 o6Hapy)KeHO, L(TO (IyHKuHA nOT3TH 3KCn0HeHTHa.

3T0 03HaLIaeT, iiTO BnHAHHe Ha pHCK npH nâ.HHOM nOBbIIIICHHHnOTpe6neHHA 3aBHCHT OT ypOBHSI nOTpe6neHH5t, Ha HH3KHX ypOBHAX

pHCK nOBbIIIIaeTCA HeHaMHOrO, B TO spew' KaK Ha BbICOKHX ypOBHAX

noTpe6neHHA er0 pOCT BeCbMa 3HaLIHTeneH. CneAyIOÜwii BbIBOnCOCTOHT B TOM, LITO 6OnbIIIHHCTBO cJIyiiaes o6Hapy)ICHBaeTCA CpeAH3noynOTpe6nsloluxx anKOroneM. AHanH3 BpeMeHHbIX cepHli B

HeCKOnbKHX CTpaHaX (c npHMeHeHHeM ARIMA-MOnenH) noATBepAHJIBbIBOnbI npenbInyII.[HX HCCnenOBâHHH o6 o6üZeii B3aHMOCB513H MexcnynOTpe6neHHeM H uHppo3OM, KOTOpble OCHOBbIBânHCb Ha

HC11Onb30BâHHH 6onee npOCTbIX McTOAOB (Skog 1984; Norstrom1987a,b; Thorsen 1990). B o61ueM, oTSeTHaA peaxuHA 6onee HeMnponopuHOHanbHa, 3a HCKnIOLIeHHeM OiieHb HH3KHX ypOBHeHnOTpe6neHHA, me 6onbulaSl nOnA He CB5I3aHHbIX C anKOTOneMCMepTeH nenaeT OTBeTHyK) peaxuHlo Mexee rH6KO1i. 3ToHanpasneHHe HCCnenOSaHHiï TaKX(e paCIIIHpHna Haute noHHMaxxecbOpMbI BpeMeHHOrO oTCTaBaHHA (CM. 4.4.1). ,r(aHHbMe HCCnenoBaHHIi

137

3neCb nOKa3bIBaIOT, 'ITO 0611>;Hii 3LI(beKT H3MeHeHH51 B noTpe6neHHHHa nyH1y HaceneHHSi Ha CMepTHOCTb OT uHpp03a pacnpenensieTCSI Ha3HaLiHTenbHbIii BpeMeHHOrI nepHon, 6onee RByX necslTHneTHri.IIpH6nH3HTenbHO Oj[Ha nSiTaSI 3c1t1)eKTa 1113O5LBHTC5I cpa3y we, a BnpenenaX 'IeTblpëX neT peanH3yeTcsi nOJIOBHHa 34:(l3eKTa (Skog 1984;Norstrom 1987b).

TeM He Mexee, 6bInH onxcaHbi npHMepbl Cny'IaeB oTKnoxeHHS1(Grant et al 1986; Smart 1988), rie yposeHb CMepTHOCTH OT uHppo3aHe pearliposan, KaK oNCHZ[anocb, Ha H3MexeHH5I B noTpe6neHHH.BO3M0)ICHbI HeCKOnbKO 061,HCHeHHLi. BO-nepBblX, cynA nonpHBeneHHbIM BbIHIe npHMepaM, 3Ha4HTenbHa51 BbITHyTOCTb nexCaLueli

B OCHOBe 41yHKL(HH pHCKa, ienaeT 06LuyIo CBSI3b LIyBCTBI3TenbHOliia)Ke K MHHHManbHbIM H3MeHeHH51M B pacnpeneneHHH nOTpe6neHH5I,0006eHHO Ha nOCnenHeM OTpe3Ke. BO-BTOpbIX, CHnbHOe BpeMeHHOeOTCTaBaHHe 03Ha''aeT. '-ITO HeOiHOpOAHble 1,13MeHeHH5I B noTpe6neHHH

B pa3HbIX BO3paCTHbIX rpynnax 6ynyT OKa3bIBaTb BnH51HLiC Ha 06LnHHpe3ynbTaT.

ApyrHM ckaKTOpOM CMeLUeHH5I MO)KeT 6bITb y9pexCneHHeOpraHH3auHH B3aHMOnOMOLIjH H LHHpOKOrO cneKTpa nporpaMMne'-IeHHA nnSL "anKOronHKOB". 3-rH nporpaMMbl MOI'y'r OKâ3bIBaTbTaKOe BnHSIHHe, 'iTO 3Ha'IHTenbHOe KOnHHeCTBO 3noynOTpe6nSIK)LuHXânKOrOneM no KpaiiHeli Mepe BpCMeHHO COKpaTSIT cBOe nOTpe6neHHe.3TOT Bonpoc 6yneT o6CyxcnaTbcsl no3xce B rnase 9, Pa3nene 9.3.

4.3.5 ,gopoHCrio-TpaHcnopTHbie npoHCweCTBHA

H 3KCnepHMCHTanbHble H 3nHneMHOJ1OrH'-IeCKHe HCCnenOBaHHSL

nOKa3bIBaIOT, 'LTO BoxCneHHe aBTOM0611n5I B HeTpe3BOM COCTOSIHHH

npHBOnHT K nOBbILHeHHOMy pHCKy BO3HHKHOBeHH5I aBapHri (CM. rnaBy

7). Tax KaK nOBbILIICHHe nOTpe6neHHS1 Ha nyLLly HaCeneHHA o3HaqaeTpOCT 'LHCna cnyYaeB BbInHBKH H yBenH'IeHHe nOTpe6neHHSI B KâxCnOMcny'iae, MO)KHO O)KHnaTb, MexCny nOTpe6neHHeM H KOnH'ieCTBOM

nOpOxCHbIX aBapHrl CO CMepTenbHblM HCXOnOM CyLuecTByeT o6Luas1B3aHMOCBSI3b. XOTSI MCTOnOJIOrH'ieCKHe np06neMbl H npo6neMbl CnaHHbIMH o3Ha'IaLOT, 'LTO He Bcerna 3TH OxCHnaHHSL OnpaBnblBaIOTCSI(Skog 1984), B HecxOnbKHX HccnenoBaHHSIx coo6Luanocb o110311THBHbIX pe3ynbTaTaX. HCHOnb3y5I KBa3H-3KCnepHMeHTanbHylOcl)OpMy H naHHble H3 CHIA, Cook (1981) npencTaBnn nOKa3aTenbCTBaB BHne HCraTHBHOLi 31IaCTH'IHOCTH MexCny ueHON Ha anKOTOnb CO,ijHOLï CTOpOHbI, H nOTpe6neHHeM H KOnH'LeCTBOM aBTOKaTaCTpO4) CO

138

CMepTenbHblM HCXOAOM C ApyrOli. gOIIOnHHTenbHble AaHHblenpeRCTaBHn Wagenaar (1984). ARIMA-aHanH3 meMeCSIqHbiXnaHHbIX IIITaTa MHHraH I1oKâ3an 3HaLIHTenbHy10 B3aHMOCB5I3b

Me)Kljy ypOBHeM nOTpe6neHHA H KORHLIeCTBOM CB513aHHbIX C

anKOI'OneM nOpO)KHbIX KaTaCTpO43 (C BpeMeHHbIM OTCTasaHHeM B 1MeCAU). Thorsen (1990) Ha OCHOBe naHHbIX H3 AaHHH nonyLmUI 60neepâ3HOpOAHbie pe3ynbTaTbI. B aHanH3e BpeMCHHbIX CepHii H3MeHeHH5InOCTynHOCTH KpenKHX CHHpTHbIX HaHHTKOB B CeBepHOii Kaponxxe6bIR0 06HapyACeHO, LITO o6u(ee noTpe6ReHHe CnHpTHbIX HanHTKOBnOBbILUaROCb, TaK)Ke KaK H KORHLIeCTBO HOLIHbIX nopo)KHO-TpaHCnOpTHbIX HpOHCUIecTBHIi, rne yLiacTByeT TOnbKO OAHO

TpaHCnOpTHOe CpeACTBO, KnacC KaTaCTpO4), KOTOpble, KaK

nOKâ3bIBaeT npaKTHKa, 04eHb LiaCTO CB5I3aHbI C anKOrOneM (Boise andHolder 1987).

4.3.6 CâMO)/6N1%iCTBB N KpNMNHa11bHO@ HâCNnN@

TORbKO B nOCne,IjHee spew' BO3HHKIIIHIi n0 BHHe anKOrOnACOUHanbHbIN HRH nOBeneHLIeCKHA yulep6 CTan H3yLIaTbCA B

HCCneuosaHHAX 06061I1ëHHOro yposHA. B Haul)/ AHCKyCCHIO 6yAyTBK11IOLIeH6I HCCneAOBaHHA AByX THnOB yuiep6a nono6Horo poAa, aHMeHHO CaMOy6HNCTB H KpHMHHanbHOTO HaCHnH51. 3TH ABa ABneHHA

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aJIKOrORA. I-IOnbITKH CaM0y6HNCTBa H CnyLIaH HaCHRHA B 66ITy MOryT

6bITb Ha3BaHbI B KaLIeCTBe AanbHeiiulHX npHMepos, H anKOrORb, 6e3COMHeHHA, OKa3bIBaeT HeraTHBHbIN 344eKT TaKOrO pOna, KOTOpbIN,HOMHMO BcerO npomero, oTpaxcaeTCA B ABHOii KoppenAuHH MeKr_(yCaMOy6HNCTBaMH, npeCTynHbIM HaCHRHeM H nOTpe6neHHeManKOrOnA.

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139

nepBblM npcABeCTHHKOM CaMoy6Hi%ICTBa. CB513b MexcAy

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CyAA no BCeMy, He HeCyT TaKOIi He0AH03HaT1HOCTH, BCe xce

yKâ3bIBaIOT Ha CB513b Me>KAy anKOrOneM H CaMOy6HiicTBaMH. B AByX

npOBeACHHbIX B CILIA HCCneAOBaHHSIX 6b1na o6HapyxceHa1-103HTHBHa51 B3aHMOCB513b MexcAy COBOKyrIHbIM noTpe6neHHeM HypOBHeM CaMoy6HNCTB KaK BO BpeMeHHOM aHâJIH3e (Wasserman1989), TaK H B OAHOMOMeHTHOM CpaBHeHHH pa3HbIX TeppHTOpHii(Rusk, Gliksman and Brook 1986). Ha ocHOSe ARIMA-axanH3aHaJIHT-IHe no,tio6Hoii B3aHMOCB513H Tax>iCe 6bino noATBepmKAexo AnAcbpaHLiHH (Norstrom 1992), BeHrpHH (Skog and Elekes 1993),HopBerHH H I.IIBenHH (Norstrom 1988c; Rossow 1993) H gaHHH(Skog 1993).

HanHLIHe CB513H Me)K,TZy anxoroneM H HaCHnxeM npeAnonaraeTCSIHa OCHOBe 3KCnepHMeHTanbxbIx AaHHbIX (Gustafson 1986), a Tax)iCeTOrO (paKTa, LITO, no C0o61II;eHHAM, 6onbIIIaA T1aCTb HaCHnbHHKOB6bI11H nbAHbI BO BpeMA COBeputeHHA npeCTynneHHA (Mayfield 1976,Roslund and Larson 1979). AaHHb1e noCneAHHX HCcneAOBaHHFI, TeMHe McHee, He 06313aTenbH0 03HaT3aK)T npHLIHHHb1ii 3(1)(PeKT anKoronA;

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140

LIIBegHH). Bce BbIBOJI6I 6a3HposanHCb Ha ARIMA-aHanH3eAOCTaTOLIHO JLIIHHHbIX BpeMeHHbIX CepHI3. CTaTHCTHTIeCKH 3HaTIHMOe

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141

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142

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COnHanbHyiO nOnHTHKy.

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143

HOBbIHICHHOCO pHcKa. K CI IâCTbiO, HâM He HpICHO Bb16HpâTb i-ITO-TOOZjHO 143 3TOI'O McHIU.

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150

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156

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Lau (1975) Kattata 1949 -1969 -0,03 - 1,65 - 1,45Johnson et Kanaüa 1955 -1971' - 0,22 - 0,50 - 0,91

Oksanen (1974) 1955 -19712 -0,38 - 1,30 - 1,60

Johnson et Kanaüa 1955 -1971' - 0,27 - 0,67 - 1,14

Oksanen (1977) 1955 -71 - 0,33 - 1,78 - 1,77

Quek (1988) Kattaua 1953 -1982 - 0,28 - 0,58 - 0,30

Johnson KaHaga 1956 -1983' - 0,26 Ro- 0,31 - 0,70 /to - 0,88 - 0,45 uoet al. (1992) 1956 -19832 -0,14 - 1,17 0,82

HA

Niskanen (1962) CHIA 1934 -1960 - 0,50 - 1,59 - 2,031934 -1960 - 0,33 - 0,35 - 0,93

Hogarty et Elzinga CILIA 1956 -1959 - 0,89 11A HA

(1972)Simon (1966) CILIA 1955 -1961 I IA }1A - 0,79Comanor & CHIA 1947 -1964' - 0,56 - 0,68 - 0,25Wilson (1974) 1947 -19642 - 1,39 - 0,84 - 0,30Norman (1975) CHIA 1946 -1970 -0,87 IIA II/1Smith (1976) CWA 1970 HA IIA - 1,95Labys (1976) CWA 1954 -1971 1 -lA - 0,4451 -1,656 HA

Lidman (1976) Kantupoptiws 1953 -1975 HA HA 0,02Clements et Selvanathan CWA 1949 -1982 - 0,09 - 0,22 - 0,10(1987)Selvanathan (1991) CHIA 1949-1982 -0,11 - 0,05 -0,11Eecen (1985) F1Huepnanum 1960-1983 0,0 - 0,5 FIA

-

Ta6nMlia 5.1 (llpo11onxcelllle)

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Labys (1976) /EEC Emma 1954 -1971 1111 - 1,14 1111

(1972)Labys (1976) (Ppanutut 1954 -1971 1111 -0,06 IIJILabys (1976) MTannn 1954 -1971 IIJI - 1,00 1111

Labys (1976) 11opTyrannst 1954 -1971 1111 - 0,68 111I;

Labys (1976) Mcnautts 1954 -1971 1111 - 0,37 IIJI

Labys (1976) ßOP[ 1954 -1971 11J - 0,38 1111

Walsh et Walsh (1970) Mpnatuuu 1953 -1967 -0,17 1111 -0,64Prest (1949) Coe ;t.Kop -no 1870 -1938 - 0,66 IIJI - 0,57Wong (1988) CoeJt.Kop -oo 1920 -1938 - 0,25 - 0,99 - 0,51Stone (1945) Coe,a.Kop -uo 1920 -1938 - 0,73 1111 - 0,72Stone (1951) Coejt.Kop -no 1920 -1948 - 0,69 - 1,176 -0,57Walsh (1982) Coe t.Kop -no 1955 -1975 - 0,13 - 0,28 - 0,47Clements et Selvanathan Coen.Kop -no 1955 -1975 - 0,19 - 0,23 - 0,24(1987)McGuinness (1983) Coelt.Kop -oo 1956 -1979 -0,30 -0,17 -0,38Duffy (1983) Coeat.Kop -uo 1963 -1978 II/1 -1,0 -0,77Godfrey (1988) Coeit.Kop -uo 1956 -1980 IIJI -0,76 -1,14 -0,88 -0,98

1956 -1980 1111 -0,91 - 0,56 - 0,99Duffy (1987) Coe,a.Kop -no 1963 -1983 -0,29 -0,77 -0,51Selvanathan (1988) Coe ,a.Kop -no 1955 -1985 - 0,13 - 0,37 - 0,32Jones (1989) Coen.Kop -no 1964 -1983 - 0,27 - 0,77 -0,95

- 0,40 - 0,94 - 0,79Selvanathan (1991) Coen.Kop -no 1955 -1985 -0,13 -0,40 -0,31

Ta6nHua 5.1 (npoRonmexl3e)

AaTop CTpalla rlepnoai flrmo Blum KpenKne11a11r1TKn

Baker et McKay (1990) Coe,q,Kop-Bo 1970 -1986 - 0,88 - 1,37 - 0,94Duffy (1991) CoeA.Kop-Bo 1963 -1983 - 0,09 - 0,75 - 0,86Nyberg (1967) (I) H11/15111)11151 1949 -1962 - 0,49 - 0,83 - 0,133/- 0,954

1949 -19621 0,00 - 0,99 - 0,603/- 1,10'1949 -19622 + 0,01 - 3,28 - 2,003/- 3,654

Salo (1990) (1)nitnxnArtst 1969 -1986 - 0,6 - 1,3 - 1,0Florverak (1979) Ilopaernx 1960 -1974 HJ> - 0,5 - 1,2Malmqvist (1948) W Beurrx 1923 -1939 11Jj - 0,9 - 0,3Bryding et Rosén (1969) W Beunx 1920 -1951 - 1,2 - 1,6 - 0,5Sundström- Ekström IlIBeunx 1931 -1954 I 1 A - 1,6 - 0,3(1962)Fluitfeld et Jorner (1972) W Beunx 1956 -1968 - 3,0' - 0,7 - 1,2Miller et Roberts (1972) ABCrpantlx 1957 -1971 FIJJ - 1,8 FIJjClements et Selvanathan ABCrpannx 1956 -1977 -0,12 - 0,34 - 0,52(1987)Clements et Johnson ABCTpaJlnx 1956 -1977 -0,11 - 0,40 - 0,53(1983)Selvanathan (1991) Ancrpanrtx 1955 -1985 - 0,15 - 0,60 - 0,61Clements et Selvanathan ABCrpantlx 1956 -1986 -0,15 - 0,32 -0,61(1991)Pearce (1986) I-foa.3enauAnx 1966 -1982 -0,15 - 0,35 - 0,32Wette et a! (1993) Hon.3enalunx 1983 -1991 - 1,1 -1,1 - 0,5Partanen (1991) Ketlttx 1963 -19851 - 0,33 IIII I IJ(

1963 -19852 - 1,00 HA IiJ];

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HanHTKH B KaxaAe B 1949-1969 rr., BHHO B HopserHH B 1960-1974 rr,.Kpenxoe nHBO B LLIBeuHH B 1956-1968 rr.

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HeLIyBCTBHTenbHbIM K H3MCHeHHIO ueHbl), pOCT ueH npHBOAHT KOTHOCHTenbHO He60nbHIOMy CHH>iceHHIO cnpoca H K pOCTy AOnHnH'IHOrO AOXOAa, 3aTpa'iHBaeMOrO Ha 3TOT HanHTOK. CHpiceHHe ueHnpHBeAeT K OTHOCHTenbHO He6onbIllOMy pocTy nOTpe6neHHA HCHH>KeHHiO AOnH nHYHOrO AOXOAa, KOTOpbIFI 3aTpa'IHBaeTCA Ha 3TOT

HanHTOK. COrnaCHO Ta6nHue 5.1 TaKOe Cny'-IHJIOCb C BHHOM BO0paHUHH B 1954-1971 rr., nHBOM B I4pnaHAHH B 1953-1967 rr. HKpenKHMH HanHTKaMH B ABCTpanHH B 1956-1977 rr.

14, Haxoxeu, ecnH cnpoc Ha AaHHyIO KaTeropHiO HanHTKOB HMeeTeAHHH4HyI0 3naCTH'iHOCTb OTHOCHTCnbHO ueHbl, pOCT ueH npHBOAHTK CHHxceHHIO noTpe6neHHx B paBHOIi nponopuHH, a gons' AOXOAa,3aTpaLINSaeMaA Ha 3TOT HanHTOK, OCTaeTCA HeH3MeHHOiï. B 06paTHOM

cny'iae, CHH>KeHHe ueH npHBOAHT K 11OB6IHIeHHIO norpe6neHHA BpaBHOii np0nopuHYi H coxpaHeHHIO AOnH, 3aTpa'-IHBaeMO11 Ha 3TOTHaHHTOK, AoxoAa Ha TOM >Ke ypOBHe. 3T0 npH6nH3HTenbH0 TO, IiTOnpOH301.1IJIO C KpenKHMH CnHpTHbIMH HanHTKaMH B (13HHnAHAHH B1969-1986 rr., c BHHOM B I4TanHH B 1954-1971 rr., a Talcxce c nxsoMB KeHHH B 1963-1985 rr.

UnHAHHe H3MeHCHHA WH Ha rOCyAapCTBeHHblli AOXOA 6yAeT3aBHCeTb OT ,IjByX Il)aKTOpOS: CTeneHH 311aCTH'iHOCTH H TOrO, KaKOH

KOMHOHCHT ueHbl Bbl3san H3MeHeHHe. ECnH H3MeHeHHe BbI3BaH03aTpaTaMH Ha npOH3BOACTBO H AOCTaBKy, BnHAHHe Ha

rOCyAapCTBeHHbIIï AOXOA 6yAeT npOHOpuHOHanbHO BnHAHHIO HanOTpe6neHHe. CHTyauHA CTaHOBHTCA 6onee CJ10)KHOIi, KorAa

160

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rOCynapCTBeHHbHi nOXOn na)Ke TOrna, Koma cnpoc ABnAeTCA3111aCTH4HbIM OTHOCHTenbHO LjeHbI H o61uee noTpe6neHHe anKOrOJISI

nanaeT. 1-1pHBenëM KpaliHHii npHMep: nOBbIIHeHHe HaTIOra HaHanHTOK, KOTOpbIÎ-1 n0 3TOrO He o6narancA HanorOM, nOBbICHTrOCynapCTBeHHblii nOXOn, naxce eCnH HanHTOK ABnSIeTCA BbICOKO-3naCTHYHbIM OTHOCHTenbHO LZeHbI, H 6onee BbICOKHN ypOBCHb LjeHbl

npHBenëT K CHnbHOMy cOKpaII(eHHio nOTpe6neHHA. TOnbKO B

CHTyaLjHAX, KOrna ypOBeHb HanOra rice nOCTaTOIiHO BbICOK,

nOnOJIHHTenbHblFi HâTIOr MO)KeT COKpaTHTb nOXOn npH naneHHHnOTpe6neHHA.

KOrna MbI rOBOpHM o6 OTHOCHTenbHO MâTIeHbKOM HnH CHnbHOM

BnHAHHH L[eHbI Ha noTpe6neHHe anKOronA, MbI, KOHe'-IHO, HMeeM BBHny ynenbHOe H3MeHeHHe LjeHbl. CnenOBaTenbHO, naxce B TOMCnyllae, 'corna CnpOC ABnACTCA He311aCTHIiHbIM OTHOCHTenbHO LeHbI,

60nbLH0e panHKanbHOe H3MeHeHHe L(eHbI npOH3BenëT 60nbLLIHil34)C1"eKT Ha noTpe6neHlie, item nHIIIb He6o11b11I0e H3MeHeHHe uexbl Bcny'iae, 'corna CnpoC Ha aTIKOrOnb ABnSICTCA 31IaCTH4HbIM

OTHOCHTenbHO L[eHbl. CTeneHb H3MeHeHH5I L(eHbl, TatoKe KaK

COOTBeTCTByIOIi[aA CTeneHb 3naCTHIiHOCTH, nOn)KHbI, TaKHM 06pa30M,

6bITb y'iTeHbl npH paC4eTe BnHSIHHA I.IeHbl Ha nOTpe6neHHe. MbIpaCCMOTpHM BOnpOC O panHKanbHblX H3MCHeHHAX HH)Ke B pa3nene5.2.4.

BnHAHHe H3MeHeHHÎi B L(eHe no npoLHeCTBHH HexOTOporoBpeMeHH mowe-r 6bITb CHnbHee, '-ieM HX HeMenneHHbIN 34)(1)eKT(Ornstein & Levy, 1983). l'1CCnenOBaHHA, npOBeneHHble B KaHane(Johnson & Oksanen, 1977), CHIA (Comanor & Wilson,1974) HKeHHH (Partanen, 1991), noxa3blsaloT, KpaTKOCpo'IxaA3naCTH'{HOCTb L[eH o6nanaeT MexbLHeÎ-i a6conioTHoFi BenH'IHHOIi nocpaBHeHHIo C Hx nonrospeMexxoÎd 3nacTHIIHOCTb10.

5.2.2 CHryagNN, KOTOpbI@ MOI]/T 6bITb CB113aHbI Cpa3J1NyHbIMU1 BapHaHTaMN 3J1aCTN4HOCTli Ii@H

r1pHBeneHHOe BbIIIIe o6CyACneHHe nOKâ3bIBaeT nOne3HOCTb

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nOTpe6neHHA. Ho, KaK Mbl yA(e nonlIepKHBânH, naHHble Taxxcen0Ka3bIBaK)T, 'ITO BenH'IHHbI 3naCTH'IHOCTH He SIBnAIOTCA

161

yHHBepCanbHblMH. Ha6nlOAaeM61e OTn144145I LIaCTHLIHO 06yCnOBneHblHpHMeHeHHeM pa3nHT-IHbIX McTOAi3K H pa31113i4HbIM KaLIeCTBOM

AâHHbIX. HeCOOTBeTCTBHSi TaK)Ke BO3HHKaIOT H3-3a pâ3nHLIHSI

COuHâJIbHbIX, KynbTypHbIX H 3KOHOMH1ICCKHX yCJIOBH1i, 6bITyiOIuHX B

pa3nHLIHbIX perHOHaX B pa3nHLiHble I7epHO,IjbI BpeMeHH.

B aHrnOS13bILIHbIX cTpaHax, AâHHb1e 06bILIHO 1-10Ka3blBaiOT, LITOCHpOC Ha I7HBO 51Bn5leTC51 MeHee 311aCTHLIHbIM OTHOCHTenbHO ueHbl,

LIeM CITpOC Ha MHO H KpeIIKHe CIIHpTHble HaIIHTKa. B pe3ynbTaTeAeTanbHOli OueHKH ABaAUaTH HCCne,EtoBaHHii Ornstein H Levy (1983)HpHHInH K BbIBOAy, LiTO HaH60nee TOLIHa51 OueHKa 3naCTHLIHOCTH twit

Ha IIHBO, BHHO H KpeIIKHe CIIHpTHble HaIIHTKH B COeAHHëHHbIXLLITaTaX (H KaHaAe) 3TO -0.3, -1.0 H -1.5 COOTBeTCTBeHHO. B CBOCMo63ope HeCKOnbKHX HOCneAHHX HCCne,IIOBaHH1i cnpoca Ha anKOOOnb BBenHxo6pHTaHHH Godfrey (1989, 1990) Taxxce Hoxa3ana, LiTO cnpocHa HHBO B BenHK06p14TaHHH, B OCHOBHOM, SIBn51eTC5I He3naCTHLIH6IM

OTHOCHTenbHO ueHbl. C ApyrOlil CTOpoHbl, CIIpoC Ha BHHO H KpeIIKHeC1IHpTHble Ha1IHTKH 6bin 601Iee LiyBCTBHTenbHbIM K ueHe. KOHTpaCTOM

3TOMy Cny>KaT HCCneAOBaHHSI, KOTOpble HOKa3bIBaIOT, LITO cnpoc HaBHHO MO)KeT 6bITb OTHOCHTCn6HO HeLIyBCTBHTenbHblM K ueHe BOaopaauHH H McnaHHH (Ta6nHua 5.1).

OAHHM H3 CII00060B HOHHMaHaSI OCHOBbI 3THX OTnHLIHIi

5IB1151eTC51 aHaJIH3 HOTpe6HTeneli ânKO00nbHbIX HaIIHTKOB. 3AeCb MbIAOn)KHbI yLIeCTb uenblli pig yCTaHOBnCHHbIX KynbTypOii pâ3nHLIHbIX3HaL1eHHIi, KOTOpble HpHAalOTC51 HOTpe6neHHlO anK00onSi, HaHpHMep,

o1165lHeHHe, HaHHTOK AnSt yTOneHaSI )Ka)KAbI, COCTaBHaSI LIaCTb eAbl,

nCKapCTBO HnH CpeACTBO OTAOXHyTb H pa3BneLIbC5i. C 3TOIï TOLIKH

3peHHSI COBepH1eHH0 HeyAHBHTenbHO, LITO CHpOC Ha anKOrOnbHbleHaHHTKH MO)KeT B pa3nH9H6IX CTpaHaX H KynbTypaX H B pa3nHLlHbleHepHOAbI BpeMeHH OLieHb Ho-pa3HOMy pearHpoBaTb Ha AaHHOeH3MeHeHHe ueHb1. 06135ICHeHHe BenHLIHHbI 311aCTHLIHOCTH, TaKHMo6pa30M, Tpe6yeT HOJIHOI'O HOHHMaHHSI HpHBbILIeK HOTpe6neHHSI BAaHHOM 06ineCTBe H Ha AaHHOM OTpe3Ke BpeMeHH.

BenHLIHHa 3naCTHLIHOCTH MO)KeT TaKXCe McH5IT6CSI B 3aBHCHMOCTH

OT ypOBHSi uCH Ha anKOrOnbHble HaHHTKa. rlpH OilpeAeneHHbIXo6CTOSITenbCTBaX BenHLIHHa 3naCTHLIHOCTH MO)KeT HOHH)KaTbC51 rlpH

CHH)KeHHH Hen H rIOBbI111aTbC1I ripa HX yBCnHLIeHHH. B LLIBeuHH HOCne

OTMeHbi B 1955 rOAy KapTOLIHOa CHCTeMbI Ha HOKyHKy KpeHKHXCIIHpTHbIX HaHHTKOB HpOH3OLHn0 pe3KOe HOBbIHIeHHe ueHbl HaCHHpTHble HaHHTKH. KaK CneACTBHe 3T000 Ha6niOAanOCb rlOB6IIHeHHe

162

a6C0nloTHOII BenHLIHHbI 3naCTHLIHOCTH ilex Ha KpenKHe CnHpTHbleHanHTKH (Huifeldt & Jorner,1972). 3TO MOTJIO 6bITb o6ycnosnexoTeM, LITO KapTOLIHaSI CHCTeMa CAep>KHBaeT BnHSIHHe H3MeHeHH5I LjeH

Ha nOTpe6neHlie. IIpHMep 1lIBeLtHH, TaKHM 06pa30M, HnniOCTplipyeTB3aHMOAei3CTBHe LteHbl H 3aKOHOAaTenbHbIX OrpaHHLIeHHi3 AOCTynHOCTH

anKOronSi.

$enHLIHHa 31IaCTHLIHOCTH MO>KeT TaK>Ke MeH5ITbC51 BCneJ.jCTBHe

pocra H 611arocOCTOSiHH5I H H3MeHeHHIi COItHanbHOrO H o6LLteCTBeHHOrO

cTaTyca anKOI'onbHblX HanHTKOB. B C1HHn5IHAHH a6COJI1OTHa5I

BenHi-II3Ha 351aCTiiLIHOCTH IjCHbI XI5I o6LI[ero nOTpe6neHlisl anKOronSl

nOCTO5IHH0 nOHH>KanaCb Me>ICJty 1955 H 1980 rOAaMH C -0,93 Ao -0,70(Ahtola et al 1986). B TeLIeHHe 3TOrO nepiiOAa pOCT 6narOCOCTOSIHHSIH OCna6neHiie KOHTpOnSI 3HaLIHTenbHO nOBbICHnH AOCTynHOCTb

anKOrOJIA. llOTpe6neHHe anKOrOnSI BbIpOCJIO C McHee 2 nHTpOB HaAyLHy HaceneHlisl B rOA B cepeAliHe 50-x rOAOB AO OKOJIO 6,5 n KHammy 1980 r. Beni3LliiHa 3naCTHLIHOCTF3 LteH HMena TeHAeHL1H10 KCHIi)KeHHIO 110 Mepe npespaLl.teHliSi anKOTOnSI B ToBap e>KeAHeBHOrOcnpoca.

5.2.3 3KOHOMNKa [email protected]@HNfA

TaK KaK BCe anKOTOnbHble HanHTKH COAep>KaT 3TaHOn, MO>KHOO>KHAaTb, LITO OHH H0TeHL1IiânbH0 MOryT 3aMCILtaTb Apyr Apyra. HoTaK>Ke OLIeBHAHO, LITO anK01-011bHble HaHHTKH MOryT 3aMeLltaTb H

pyre TOBapbl H, B CBOIO OLlepe,ijb, 3aMeHtaTbCSI HMH. 3TO 1-103BOJI5IeT

npeAnOJIO>KHTb, LITO Ha ypOBeHb nOTpe6neHHSI ânKOrOnsI H CTpyKTypy

er0 noTpe6neHHSI MOryT nOBnH5ITb OTHOCHTenbHble LteHbl Ha 3THHanHTKH (no OTHOIileHHIO K ApyrHM TOBapaM).

ECRU LteHa OAHON KaTeropHH HanHTKOB nOBbIIDaeTCSI,

noTpe6HTenH MoryT HCKaTb HM MeHee Aoporylo He 3anpeLL[eHHyio3axoxoM 3aMeHy. HanpHMep, ecnH LteHa Ha KpenKHe CHHpTHbleHanHTKH nOBbILIIaeTCSI, Cnpoc Ha BHHO HnH nHBO HJIH Ha TO H Apyroe

Mo>KeT sblpaCTH. B HecxonbKHX HCCneAOBaHHSIX 6bina pa3pa6oTaxaMeTOAHKa OLteHKH 3naCTHLIHOCTH B3aHMOCB5I3aHHbIX 'tell, TO eCTb

OLtCHKH H3MeHeHH5I cnpoca Ha OAHy KaTeropHiO anKOTOnbHbIXHanHTKOB, BbI3BaHHOe H3MeHeHHeM LteHbI Ha KaKylo-nH60 ApyryioKaTCrOpHIO anKOTOnbHbIX HanHTKOS (Niskanen, 1962; Nyberg 1967;Walsh and Walsh, 1970; Huitfeldt and Jorner, 1972; Jonson andOksanen, 1974; Lau, 1975; Lidman, 1976; Jonson and Oksanen, 1977;Ornstein, 1980; Godfrey 1986). Iloxa3axo, LITO oLtenxa 3nacTHLIHOCTH

163

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KaK H 3J1aCTH4HOCTb IjeH, 3JIaCTH4HOCTb B3aiiMOCB513aHHbIX IJ;eH

pa3JIHLIHbIX BH,IjOB aJIKOrOJIA ABJIAeTCA He HeOTbeMJIeMbIM aTpH6yTOM

aJIKOTOJIbHbIX HanHTKOB, a OTpaxCeHHBM npeBanHpyK)njHX npHBblLieKjjaHHOI-i KyJibTypbI B nOTpe6JIeHHH aJIKOrOJIA. B 06njeCTBe, rAeKpeIIKHe CnHpTHble HanHTKH H nHBO nOTpe6JI5IOTCA 3a OAHHMCTOJIOM, nOBbIIneHHe IjeH Ha KpenKHe CnFipTHble HaniiTKH MOxCeT,HanpHMep, CH143HTb noTpe6neHHe 060IiX KâTerOpiil%I Hani-ITKOB. XOTA3aMenjeHHe HepeAKO BCTpeLIaeTCA, 6bIJIO 6bI HeBepHbIMnpe,gnOJlaraTb, LiTO aJIKOrOJIbHble HanHTKIi BcerAa 6y,3yT 3aMeüjaTbApyr Apyra.

B HeKOTOpbIX HCCJIeAOBaHHAX TaKxCe Ha6JIlOAâJIOCb, LITO

MHOrOnbiOnjHe npeAnOLIHTa10T CaMbli%I AeIIIeBbIN npOAyKT H3 Ka)iCAOii

KaTerOpHH aJIKOrOJIbHbIX HanHTKOB. IIpH TaKHX 06CTOATeJIbCTBaX3aMeIljeHi-ie pa3JI134HbIX THnOB HanHTKOB OnpeAeJIAeTCSI He CTOJIbKOii3MeHeHHeM CpeAHe{I LjeHbl Ha KaxCAy1O KaTerOpiiO HanHTKOB,CKOJIbKO Ii3MeHeHIieM IIeHbl CaMOrO AeIneBOro HanHTKa B KaxCAoiïKaTerOpHH. TaKiiM )Ke 06pa30M, COOTBeTCTBeHHaA L[eHa aJIKOrOJIA Bpa3JIH4HbIX KaTerOpiiAX 6yAeT BJIHATb Ha TO, KaKaA KaTerOpldA 6yAeT3aMeCTHTeJIeM. HanpHMep, BO3MO)KHO, LITO nOBbIIIIeHHe IjeH HaKpenKHe CnHpTHble HanHTK17 ABHHeT nOTpe6JIeHHe C KaTeropliliKpenKHX CnHpTHbIX HanHTKOB B HeKOTOpbIX cTpaHaX Ha nHBO, BApyrHx cTpaHax Ha BHHO HJIIi AaxCe 6yAeT HMeTb pa3JIHLIHblenOCJIeACTBIiSi B OAHOii H TOi3 xce cTpaHe B pa3JIHLIHbie nepNOAbIBpeMeHH.

Bce HCCrIeAOBaHHA 3JIacTHLIHOCTH IjeH 6a3HpyioTCA HaO(tHIjHâJIbHbIX AaHHbIX nO npoAaxce aJIKOrOJIA H He yLIHTbIBaIOTHedHKCHpyeMble HCTOLIHHKH nOTpe6JIeHHSI, TaKHe KaK AOMaIIIHee143rOTOBJIeHHe HJIH KOHTpa6aHAHaS( ToprOBJIA. Pa3pa6aTbIBaAnOJIHTIiKy HâJIOrOO6JIOxCeHIiA aJIKOrOJiA Heo6XOAHMO TnjaTeJIbHOKOHTpOJ1HpOBaTb nOTeHI.jHâJIbHble 3(1)(1)eKTbI 3THX THIIOB nOTpe6JleHHA.

06CyxCAaA pyre TOBapbl B KaLieCTBe 3aMeHHTeJIA aJiKOrOJIA, MbIAOJI)ICHbI 3aMeTHTb, LiTO npOljeCC 3aMeIIjeHHA MOxCeT npHBecTH KaK K

6onee, TaK H K Mexee 3AOpOBbIM npHBbILIKaM. r10BbIItIeHHe L(eH HaBHHO, HanpHMep, MoxceT npHBecTH K 3aMenjeHHlo ero MexeeKpenKHMH HanHTKaMH, K yBeJIHLieHHiO AOMaIIIHero H3rOTOBJICHHA

164

BHHa HJIH K noTpe6neHxlo OnaCHOrO Heneranbxoro anKoronSl. Ha3aMeLLjeHHe MO)KHO nOBnHSITb C nOMOLLIbiO KOHTpOnSI, HaLieneHHOrO Ha

Te HaHHTKH, KOTOpble, BepOS1THO, 6yAyT nonynxpHbl cpeAHnOTpe6HTeneN. TeM He McHee, ecnH LjeHbl Ha neranbHOnpOH3BOj(HMbIIi anKOrOnb 6yAyT OCTaBaTbCSI TMH p(a)ceCHH)KaTbCSi no npNLINHe OnaceHHA BO3MO)KHOI'O HX 3aMeIijeHHSIHeneranbHblM anKOroneM, nary6HOe BO3AeriCTBNe neranbHOrOanKOrOnSI MO)KeT npeBbICHTb BbI3bIBa1OLLjHe OnaCeHHSI yrpo3bI,06yCnaBnNSaeMble HeKOHAHLjHOHHbIM anKOroneM.

5.2.4 Pe3KNe Kone6aHNSi HanoroB: acjxpeEcrpa,gNKanbHoro 113MeHeHNS1 geH Ha noTpe6neHNe anKoronH

B 60nbLIIHHCTBe csoeM, 3KOxoMeTpHLIecKHe HCCne,14OBaHHSI

HCnonb3ylOT B xaLIeCTBe MaTepHana He6onbLllHe H3MCxeHHSI L[eH HaanKOronb. KJIaCCHi-ieCKHN npHMep pap;HKanbHOrO H3MeHeHFISI 'texAaeT gaHHSI. 143-3a HeXBaTKH npOAyKTOB BO BpeMSI HepBOIi MNpOBOIi

BONHbI ueHa BOAKN BgaHHH 6bina nOBbILNeHa 60nee LIeM B 10 pa3, BTO BpeMSI KaK LjeHa misa 6b1na yABoexa. 3TH peLNNTenbHble MepblCOxpaTHJ1N noTpe6neHNe anKOrOnSI Ha Ayury HaceneHHSI Ha TpHLIeTBepTH: c 6,7 po 1,6 n 3a Asa roAa. He TOnbxO o6LLjee noTpe6neHHe1,13MeHHJIOCb, HO KOnNLieCTBO 3aIIJHKCHpOBaHHbIX cnyilaes 6enOlirOpSILIKH CHH3HJIOCb AO OAHOIi TpNHaALjaTON, CMepTHOCTb B

pe3ynbTaTe "XpOHHLIeCKOrO anKoronH3Ma" CHN3HnaCb AO OAHOIiH1ecToli OT npeAblAywero ypoBHSI (Bruun et al 1975).

ApyrNe AOCTynHble npNMepbl KpynHOro N3MeHeHH51 tell HMe1oT He

TaKON MacLHTa6, HO 3aTO npOHCXOAHJIN HeAaBHo. HanpHMep, B 11lBeLjHH

B 1957-1958 rr. peanbHaSl L[eHa Ha KpenKNe HanNTKH nOAHSLJIacb 60neeitem Ha 30%. 3r0 npNBenO K CHH)KeHHK) HX nOTpe6neHNSI C nOLITH 0,8 SI

Ha pyltry HaceneHHSI B meCSiLj B 1956 ropy Ao 0,6 n s 1958 ropy:cHHxceHHe Ha OAHy LIeTBepTb (Huitfeldt & Jorner, 1972).

5.2.5 6y,gyT Jill MHOfonbFOI1pNe NnN 3aBNC4lMble OTanKOronA nO,gBepraTbCA BnNAHNFO N3MeHeHNfI geH?

B 3KOHOMeTpH1IeCKHX NCCJIeAOBaHNSIX, OCHOBaHHbIX HaBpeMeHHbIX cepHSlx, CTeneHb 3naCTHLIHOCTH L(eH oTpaxcaeTyCpeAHeHHy1O peaKLjNIo HaCeneHNSI Ha H3MeHeHNe LjeHbl. XOTSI

MO)KHO CAenaTb 3aiUIK)LIeHNe, LITO nOBbILNeHHe COKpaTHT

noTpe6neHHe, 3TOT BHA HCCneAOBaHHIi He MO)KeT cam n0 ce6eOnpeAenNTb KTO HMeHHO COKpaLqaeT nOTpe6neHNe H HaCKOnbKO. KaK

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B 6onee nO3AHeM NCCneAOBaHNN 3a6acTOBKN 1972 roua BCDNHJIAHANN 6bIJl0 06Hapy)KeHo, LITO B Te4eHNe Masi 1972 r. o6njNilypOBeHb npouaxcN anKOrOJISI COKpaTNJICSI Ha 30%. TaKoe xce

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HaN6onee O4eBNAHbIM 3(14eKTOM 9-HeuenbH0N 3a6aCTOBKHHOpBe)KCxO41 MoHOnonNN Ha BNHa H penne HanNTKH B 1978 r.6bInO AOCTaTO4HO 6bICTpOe npNcnoco6neHNe K HOBbIM yCJIOBNAMnpeAnO)KeHNSI. r10Bb1LNeHNe nOTpe6neHNSI nNSa, MaCTHbIFI NMIIOpTaJIKOrOJIA H AOMaNIHee 1,131-OTOBneHNe CTanH HaN60nee Ba)KHbIMNNCTO4HNKaMN 3aMeLLjeHNM, Hap51Ay C NCnOnb3OBaHHeM AOMaLnHNX

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179

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180

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pe3Koe COKpanjeHHe J(OCTynHOCTH B p03HH'iHOFi TOprOBne, ypOBeHbanKOrOnbHbIX npo6neM CHH)KaeTCA, H KorJJa J1OCTyHHOCTb pe3K0nOBbIHIaeTCA HJIH BO3BpaüjaeTCA K npe)KHeMy ypOBHIO, npO6neMbI

181

yCHnHBaiOTCA. 3Aecb MbI HMeeM nen0 C KpaNHHMH cnrIaAMH, HO OH14rOBOpAT HaM o6 06Hje1ï TeHAeHLJHH.

6.3 B11I4SIHI1E 3K011OrI14ECKIIX MEP: AAHHbIE14CCflEAOBAHI4V1

1'ibIJIO npOBeneHO 60nb111oe KOnHLIeCTSO HCCJIeAOBaHHiï noH3yLIeHHiO OCHOBHOR npennocbinKH Toro, LITO OrpaHHileHHeAOCTynHOCTH anKOTOnA MO)KeT npOH3BeCTH 3HaLIHTenbHbli-I 34)(1)eKT Ha

ero noTpe6neHHe H cBA3aHHble C 3THM npo6neMbl. 3THHCCneAOBaHHA, B KOTOpbIX U3yilanaCb AOCTynHOCTb anKOTOnA,

06bI4HO 06Hapy)KHBâJIH, LITO KOrAa aJIKOTOnb MeHee AOCTyneH, MeHeeyuo6eH B npHo6peTeHHH HnH MeHee nplieMneM B 06u.JeCTSe,noTpe6neHHe H npo6neMbl, CB513aHHble C HUM, coxpauualoTCA. 3THHCCneAOBaHHA 6bIBaiOT AByX THnOB: Te, KOTOpble H3yTia1OT

OrpaHHT-IeHHSi o6ute13 AOCTynHOCTH H Te, KOTOpble HCCneAyIOT

OTAenbHble Mepbi anKOronbHOii nonHTHKH B IIJIaHe FIX oco6oroB03neNCTB1451. 1'13yiieHHe OnpeneneHHblx CTpaTerHN KOHTpOnA

COCTaBnAIOT OCHOBHyiO TiaCTb HCCneAOBaHHIi.

1'ibin0 nposenexo OTHOCHTenbH0 He6onbluoe KOnUi-IeCTBO

CpaBHHTenbHbIX HCCnenOBaHHii, rAe H3ylianHCb pa3JiHTlHA MexcnyKynbTypaMH HO THny Mep perynHpOBaHHA (HanpHMep, MOHOUOnHA noCpaBHeHHIO C CHCTeMOÎ-i nHLJeH3Up0BaHHA), HO TiaCTHiiHO H3-3apa311 141IHb1X 3I14eKTOB BpeMeHHOTO OTCTaBaHHA TaKHe HCCneAOBaHUA

OKâ3anHCb He B COCTOAHHH aAeKBaTHO 01.JeHHTb peanbHOe BnHAHHe

Mep perynUpOBaHHA Ha noTpe6neHHe aJIKOTOnA H CBA3aHHble C 3THMnp06neMb1. B naHHOM o63ope HCHOnb3y1OTC51 TOnbKO AaHHblenonrOBpeMeHHbIX HCcnenosaHHFi, TaK KaK OHH 1103BOJI5ifOT 6oneeyBepeHHO BbIABnATb npHiiHHHble CB113H. 0630pbI COOTBeTCTBÿiOIi[HXHccnenosaxHi3 MO)KHO Harm! B Smith (1988d), Osterberg(1991,1993), Gruenewald (1991) H Holder (1987, 1991).

6.3.1 "CyXOH 3aKOH"

KOrna B HexOTOpbix cTpaxax B Hai-lane 20 CTOneTHSi 6b1n BBeneH11OJIHbI1i 3anpeT Ha anKOTOnb OH 6bIJI B KOHne KOHLJOB OTMeHeH H3-3a

OTCyTCTBHA O6HJeCTBeHHOii IIOA,nep)KKH H CornaCHA. COBpeMeHHbI1ï

npHMep "CyXOTO 3aKOHa" HMen McCTO B 1978 F. Ha THXO0KeaHCKHXocTposax MoeH B Tpyxe B cl?enepaTHBHOM rocynapcTSe

182

MHKpOHe3HH, KOTOpblii 6bin BBeJjeH B pe3ynbTaTe rOCyJjapCTBeHHOTO

pecl3epeHAyMa. IIpH4HHOiI pecl)epeHJjyma cTana nonHTHVeCKax

aKTHBHOCTb TpyKCKHX )KeHHjHH, KOTOpbIX BOJIHOBanO nbSIHCTBO H

HaCHnHe B 06n.jeCTBeHHbIX MeCTaX, oCO6eHHO CpeJjH MOJIOJjbIX

My)K4HH (Marshall and Marshall, 1990). 1lb5IHCTBO B 06HjeCTBeHHbIXMeOTaX 6bIJIo 3aMenjeHO 11bS1HCTBOM B OTJjenbHbIX rpynnaX, KOTOpOe

npOHCx0J1I1nO B 60nee H301114pOBaHHbIX 3OHaX, B "KycTaX".O61IjeCTBeHHaSI noagep>KKa 3anpeTa ocTasanacb CHnbHOil, H cyxoil3aKOH pacnpocTpaHHncx Ha HeCKOnbKO Jjpyrxx OCTpOBOB. TpHHOnbITKH OTMeHHTb 3anpeT nOTepnenH HeyJjar-Iy. McCTHblii 3anpeT,TaKHM O6pa3OM, 51s1151eTC51 )1CH3HeCn0C06HbIM BapHaHTOM gagHe60nbnlor0 06HjecrBa (oco6eHHo JIJISI OCTpoBHOrO H H30nHpOBaHHOrOo6njecTBa), rJje OH MO)KeT npHBeCTH K 1-1O3HTHBHbIM H nOnynSipHbIM

pe3ynbTaTaM.

B nepHOgj noJIHTHLIeCKHX BonHeHHÎ1 B r10nbII1e B Hai-lane 1980-xBpeMeHHbllti 3anpeT 6bin BBeJjeH B 1lJ(aHbCKe B asryCTe 1980 r., Bpe3ynbTaTe KOTOpOrO Ha6nIOJjanOCb CHH)KeHHe KOnH4eCTBa

nonaJjaHHil B BbITpe3BHTenb (Bielewicz and Moskalewicz 1982).3anpeT H0nb30BanCSI nOJIHOIi noJjgjep)KKO1i HaceneHHSI, TaK KaK 6binBBeJjeH BO BpeMS1 noJIHTH4eCKOii 3a6aCTOBKH 14 pacCMaTpHBanCA, KaK

peckopmaTopcxaa Mepa.

Bo MHOrHX cTpaHaX, rJje JjOMHHHpyeT HcnaM, "CyXoli 3aKOH"coxpaxsleTC51, B TaKHX KaK CaygjoBCxasl ApasH51 H HpaH. 3anpeJgenaMH HCnaMCKHx CTpaH, nonHTHLiecKHe nHgjepbl BpAgj nHgjyMalOT O nOJIHOM 3anpeTe anKOronSl. 3anpeT Mo)KeT

COnpOBO)KJjaTbCA 3HaiIHTenbH61M nOBbIIlleHHeM HeneranbHOrO11pOH3BOJjCTBa H TOprOBnH anKOrOneM. TeM He McHee, C TOLIKH 3peHH51

O61.11,eCTBeHHOr0 3J1OpOBb51 H 6narOCOCTO5IHH3I, "CyXOiI 3aKOH" HeMO)KeT pacCMaTpHBaTbC51, KaK a6COnIOTHaS1 HeyJja4a. HanpHMep, BOBpeM51 "CyXOrO 3aKOHa" B AMepHKe ypoBCHb CMepTHOCTH B

pe3ynbTaTe LjHppo3a CHH3HJICSI 1-104TH Ha 50% (C 13,4 go 7,3 Ha100000), TO )Ke Cny4HJIOCb H C ypOBHeM anKOrOnbHbIX npo6neM(Warburton, 1932; Clark,1976; Prendergast, 1987). Bailee Toro, HeMO)KeT 6bITb COMHeHHIi, 4TO B Te4eHHH nepBblX HeCKOnbKHX neT"cyxoro 3aKOHa" B KaHaJje, (1)HHnSIHJjHH H CHIA Bee noKa3aTenH nonoTpe6neHHIO anKOrOnSI H aJIKOrOnbHbIM np06neMaM JjOCTHrnHCaMOrO HH3KOrO ypOBHSI, item B KaKOr1-J11460 HHON nepHogjBpeMeHH,nO KOTOpOMy HMeIOTCSI COOTBeTCTByIOIIjHe JjaHHble (Bruun

et al 1975).

183

6.3.2 MOHOnonNfl

OAHa 143 Hax60nee x3BeCTHbIX (tiOpM BO3AeNCTBxR

npaBxTenbCTBa Ha AOCTynHOCTb ânKOrOnR - 3T0 CO3AaHHe

rOCy,EtapCTBeHHOIi MOHOII01111H Ha pO3H1411Hyl0 npoAaxcy. PonbrOCyAapCTBeHHOii MOHOIIOnxx, KaK npRMOro abIpâxceHHR

rOCyAapCTBeHHOIi aJIKOrOnbHOii IIOnxTHKH o6cyxcAanacb AOBOnbHO4acTo (RoxnaA KoxcPepexuxx 1987 roAa, Kortteinen 1989). BOTHeCKOnbKO npxCyLuxX MOHOnOJIxx XapaKTepxcTHK, KOTOpble BnIiRiOTHa noTpe6nexxe. .TI1o6aR MOHOnOnxR no CBOeN CyTx xcKnlo4aeTKOHKypeHuxiO Ha ânKOr0116HOM pblHKe. Ilpx MOHOnOJIHx pO3Hx4HOi3TOprOBnH, KOrAa uenblO 51BJ151eTC51 cOKpalljeHxe nOTpe6neHxRanKOrOJ151, cnpoc He MOxceT CTi3MynHpOBaTb nOBbILIJeHxeAOCTynHOCTx H yA06CTBa 4epe3 AOIIOJIHHTenbHble 4aCTHblexCTO4HIIKx anKOrOnR. Tatum 06pa30M, npx MOHOIIOnHx pOCT 41,1cnaT04eK pO3Hx4HO1i TOM-OW-11i He CTNMynxpyeTCR 4epe3 nOBbILIIeHxecnpoca (xnx oxcxAaeMoit npx6binH) TaK, KaK 3T0 6bI110 661 B06CTaHOBKe npxsaTx3auHx lull OTKpbITOrO pblHKa. ECnx B yCJIOBxRXCB060AHOr0 pblHKa cnpoc yBenH4xBaeTCR, a ace Apyrxe yCJIOBNROCTaiOTCR pasH6lMx, KOnx9eCTBO TO4eK npoAaxcH anKOrOJIR HJIH

npeAJIwiCeHxe yBenx4aTCR. POCT cnpoca Ha anKOrOnb (ecnxn03BOJIRIOT npaBl-IJIa perynxpOSaHHR) MOxCeT ysen1-1414Tb 4acblnpoAaxcx, A06aBiiTb xCIIOnb30BaHxe KpeAHTHbIX KapTO4eK H npOAaxCyanxoronR BMecTe C ApyrHMx ToBapaMx, TaxxMx KaK nxlua,nexapcTSa, 6eH3HH, HO ecnx rocyAapcTSeHHaR MOHOIIOnHR He3axHTepeCOSaHa B pa3B14T1411 pbIH04HbIX CM, TOrAa 3TH pbIH04HbleMeXâHH3MbI He 6yAyT nOAKJliO4aTbCR. I-Io3TOMy OTMeHa MOHOnOnxxnpeAOCTasnReT BO3MOxCHOCTb x3y4xT6 H3MeHeHxR

AOCTynHOCTx ânKOrOnR. r1pNBaTx3auxR TOprOSnx O6bI4HO npxBOAHTK 60nbIlleMy KOJIx4eCTBy TO9eK TOprOBnH Ha BbIHOC, K paCLnxpeHxlO4aCOa npOAaxCx, a TaKxCe 4aCTO K 60nee HH3KHM ueHaM B pe3ynbTaTeKOHKypeHuHH (Holder, 1988).

IibIJlO nOKa3aH0, 4TO BNHO, KaK HanHTOK, KOTOpbIN CTaHOBHTCRBCe 601lee norlynRpHbIM B He 1113Ox3BOARLI(xX BHHO CTpaHaX, RBnReTCSI

4yBCTB1,1TenbH6IM K (tiOpMe AOCTynHOCTx B pO3HH4HOx TOprOBne.Koma OTKpbIBaiOTCR BHHHble Mara3xHbl xJlx OTMeHReTCR MOHOIIOnxRHa TOprOBnIO BHHOM, nOTpe6neHxe BIiHa yBenH4xBaeTCR. C 1970 r.HeCKOnbKO LIITaTOB CHIA H 11pOBHHuxS1 KBe6eK B KaHaAe OTMeHxnH

rOCyAapCTBeHHyIO MOHOnOJIHIO Ha npOAaxCy 066I4HO1-0 H KpenneHOTO

BHHa. McDonald (1986) o6Hapyxcxn, 4TO nposeAexxe npxsaTH3auHx

184

BHHHOi%I ToproBnH B ulTaTax Ati,lIaXO, M3i3H, BF[p,IpKHHHA H

BaIIIHHiTOH (CHIA) nOBbICHJIO nOTpe6neHHe BHHa B 3-x H3 4-xuITaTOB, B TO spew', KaK Smart (1986) npHÜten K BbIBOJjy, LITO TaKorOxce pOJta 11H6epanH3HuIi51 B IIpOBHHuHH KBe6eK He npHBena HH KKaKHM H3MeHeHH51M. bOnee HegaBHHe HCCne,I1OBaHH31 OTMCHM

noJxo6HOti MOHOHOnHH a 1985 r. B AtiOBe H B 1981 r. B 3anauxotiBHpJpKHHHH BbI5IBHJIH nOBbIUIeHHe nOTpe6neHHA BHHa, a TaK)Keo61uero noTpe6neHHA anxoronA (Wagenaar and Holder, 1991a).Mulford, et al (1992) coo6luaeT o npoTHSOpeLIHBbtx ,Itauxb[X TOnbxOXIA AHOabl, Ho Wagenaar H Holder (1993) nOTIHAnH HexoTOpbleMcTOgonorHLtecKHe npo6neMbl 3TOrO HCCne,aOBaHHA, BKJIIOLIaA

H3MeHeHHe HCTOLIHHKOB J1aHHbIX BO BpeMA npHBaTH3auHH BHHHOti

TOprOBJIt

gpyraA cl)opMa pO3HHLIHOIi MOHOnOnHH, cyueCTSOaaBHIaA BCHIA - 3T0 MOH000nHA Ha KpenKHe CnHpTHble HanHTKH. AIiOBa B1987 r. CTana nepBblM IuTaTOM CHIA, rJje 6bina OTMeHeHaMOHOUOnHA Ha KpenKHe CUHpTHble HanHTKH nocne OTMeHbI CyXOrO3aKOHa B CHIA. 3TO HOBbICHJIO o6Luee nOTpe6neHHe a6contoTHOroaJIKOrOnA, BKJIIOLIaA nOBbIQIeHHe Ha 9,5% npoJ[axcH KpenKHX

CHHpTHbIX HanHTKOB, OTCyTCTBHe H3MeHeHHIi B nOTpe6neHHH nHBa H

noHHxceHHe Ha 13,7% npoJtaxcH BHHa, KoTOpaA 6b[naJjeMOHOHOnH30BaHa JjByMA rOJ[aMH paHee. HHKaKHX H3MeHeHHÎ-t BnpoRaxce CnHpTHOrO He 6bIJIo o6Hapyxcexo HH B OAHOM LuTaTe,rpaHHVaIueM c Aliosoli (Holder and Wagenaar, 1990).

OJIHa 143 (1)OpM H3MeHeHHFI JtOCTynHOCTH anKOronA npHp03HHLIHOIi MOHOHOnHH - 3TO BBegeHHe caMOo6CnymKHBaHHA B

Mara3HHaX, rge paHbule 6bina BO3MO)KHa nHLUb TOprOBnA LIepe3npHnaBOK. B TaKOti CHTyauHH nOKynaTenb MO)ICeT paCCMOTpeTb BeeanKOrOnbHble npOJjyKTbl H Bbl6paTb HX npAMO C nOJIKH. Smart (1974)CpaBHHn CaMOO6Cny)KHBaHHe H ToproBntO C npoJjaBI.tOM B nHKepo-BOJtOLiHbIX Mara3HHaX TOpOHTO, KaHaga. HpH CaM006Cny)KHBaHHHnpHCyTCTByeT 60nbLUe noKynaTene}i H OHH, no JtaHHbIM Ha6nIOJ4eHHIi,nOKynaIOT 6onbLUe, item nOKynaTenH Llepe3 npOJjaaua. HpH onpoce -KnHeHTypa nepsoro Mara3HHa Lialue coo6Luana oHe3annaHHpOBaHHbIX HMI "HMnynbCHBHbIX noKynKaX" H Te, KTO TaKnocTynan, Talolce coo6LuanH o pocTe csoero noTpe6neHHA anlcoronA3a npeJiblJryulyto He,genlo (Smart 1974). Skog (1991) HceneJioBan3TOT 3c14eKT npH npOJ(a)Ke Kpenlcoro nHBa (6onee 3,5% anKOTOnA nosecy) B 8 MOHOHOnbHbIX Mara3HHax LIIBeuHH B 1980 F. OH

185

o6HapyxcHn CTaTHCTHLIeCKH 3HanHMOe yBenHVeHHe npO,qaxcH TOnbKOB 2-x 113 8 Mara3HHOB, rAe 6bIno BBe,r);eHO caMoo6cny>KHSaHHe.

Nordlund (1981) HccneAoBan 3c14eKT coxpaiueHHSi ceTH TOHeKnpoAaxcH niisa Ha o6uiee noTpe6nexxe B ,ziByx ropoAax HopserHH,KoTOpoe BO3HHKJIO B pe3ynbTaTe orpaxHLIeHHSI npo,ija)xH nHBa BHeCKOnbKHX CneL[HäJiH3HpOBaHHbIX nHBHbIX Mara3HHaX. 3Ta TaKHa3bIBaeMaSl "MOHOHOnHSi Ha nHBO" npHBena K naz[eHHiO npoga)KHnHBa, HO 'iaCTb 3T0rO coxpaLuexxa 6bina 3aMeuieHa nOBbIHIeHHeMnpOna)KH BHHa H KpenKHX CHHpTHbIX HanHTKOB.

MOHOnOnHH, KOTOpble ,geiiCTByiOT CeFi4aC, B KOHIje 20 BeKa,MOI'y'r HHOrRa MeHSITb CBOH nepBOHa'IanbHble npHOpHTeTbI -

KOHTpOnb H CHH)IceHHe nOTpe6neHHSI, H CTaHOBSITCSI 6oneeKOMMepneCKH OpHeHTHpOBaHHbIMH. l'1HOrga OHH BbIHy)K,IkeHbI

OTBe'-IaTb Ha CnpOC nOTpe6HTene'i H OTKpbIBaIOT TOr-IKH, 1-1TO6bI

nOBbICHTb y,qO6CTBa junA nOKynaTene'i. B TaKOM Cny'Iae OHH He MOI'y'rCOKpaTHTb CeTb TO'-IeK npoga)KH anxoronSi. TeM He Mexee, C11CTMMOHOHOnHH 5IB115IeTC51 rH6KHM HHCTpyMeHTOM, KOTOpbIM MO)KHOyCneLHHO OnepHpOBâTb B HHTepecaX O6LLteCTBeHHOrO

3ApaBOOXpaHeHHSI. IlOCTaBHB Ha nepsoe McCTO BMeCTO KOMMep1(HH3ROpOBbe, OHH MOryT 06y3AaTb CHnbI KOHKypeHI[HH pblHKa, KOTOpbleB npOTHBHOM cnyLlae npHBegyT K nOBbIIileHHK) npOga)KH ânKOrOnSI.

6.3.3 PauHoHHpoBaHHe anKoronA

O,rjHHM H3 nO,IjXO,IZOB, OrpaHHYFiBaK)LIuHX nepCOHanbHblli ,uOCTyn

K aJIKOrOnIO, 5IBnSIeTCS1 panHOHHpOBaHHe, KaK ânbTepHaTHBa 3anpeTy.IIpH TaxOii cHCTeMe JIJISI Bcex rpa)Kj[aH onpegenSleTcx (iHKCHpOBaHHasiHOpMa anKOronSl, KOTOpyiO OHH MOryT KynHTb. PaiJ;HOHHpOBaHHe,TaKHM 06pa30M, - 3TO KOHTpOnb BO3MO)KHOCTH npH06peCTH CTOnbKO

ânKOIOnSi, CKOnbKO KaxcgbII7 XO'ieT KynHTb. PanHOHHpOBaHHe, KaKMHHHMyM, nOBbIHIaeT neHbI Ha gOHOJIHHTenbHble nOKynKH JjJISI TeX,KTO XOLIeT npHO6peCTH aJIKOrOnb CBepX HOpMbI.

1-lOg06HâSi CHCTM paLjHOHHpOBaHHSi 6bLna BBegeHa B CTOKronbMe

B 1914 F. H BO BCeii CTpaHe B 1920 r., Ha3Baxxax n0 HMeHH Bpana,KOTOpblii pa3pa6oTan cxeMy, CHCTM bpaTra onpeAenxna, tiTO

Ka)Kgblii rpa)fCnaHHH CTapuIe 20 neT MO)KeT npHO6peCTH enceMeCSiLIHO1, 2, 3 HnH 4 n anKOrOnbHbIX HanHTKOB. 14H,iIHBH,rjyanbHaSI HOpMaonpegensinaCb no CeMeiiHOMy H COLjHanbHOMy cTaTycy. 3Ta CHCTM6bina oTMexexa B 1955 r. Norstrom (1987) o6HapyxcHn,'ITO BcneA 3aOTMexoii cHCTeMbI paL[HOHHposaHHSI nOCnegOSanO 4-x KpaTHOe

186

nosbllneHHe yposxx unppo3a nenenH. Lenke (1990) o6Hapyxcnn, LiToHOCne OTMeHbI CHCTeMbI paijnOHHpOBâHHSI B IIIBeL(HH Ha6nIOaanoCb8% nOBbIIIIeHHe KOnnLieCTBa npeCTynHbIX HanaAeHHIi. OAHO 14306735ICHeH14N 3THX BbIBOAOB COCTOHT B TOM, LITO OTMH CnCTeMbI

paUnonnposaHHSi npHBena K nepepacnpeAeneHHlo noTpe6neHH5ianKOronsl. Tax KaK paL[nOHnpOBaHHe 6bIno HaLjenexo Ha

3nOynOTpe6n5noLi[nX anxoroneM, 3TH nK)An 6bIRH BbIHy)KAeHbI

HCHO11b30BaTb peCTOpaHbI, KaK HCTOiiHHKH anKOrOnsi, rAe OH

noAasancsl C 3aKyCKOIi, H IjeHbl 6bIRn BbILUe. B HpOTIiBHOM cnyqaeOHn AOn)KHbI 6b1nH jjopor0 HRaTHTb 3a HeneranbHblii aJIKOronb. 3TOTnpoLjeCC 3aBepIIIHRCSI OTMeHOii paLjnOHnpOBaHHSi.

B I'peHnaHAiii3 B am-ye-re 1979 T. 6bina yCTanosnena CHCTMpauiiOHHpOBaHHSI, KOTOpaSi onpeAenSina, HTO KaxcAblli *lenoseKCTapLne 18 nCT MO)KCT e)KeMeCSILIHO nonyllHTb JIHCT 143 72 KynOHOS.

Pa3n144Hble THHbI anKOrOnbHbIX HaHFITKOB Tpe6oBann pa3nntiHOrolincRa KynOHOB. HanpnMep, Ha nFIBO Tpe60Bancsl OAHH KynoH, HO TpHi-IeTBepTn nHTpa KpenKliX CHNpTHbIX HaHHTKOS Mo)KHO 6bI110 KynHTb,

nMesl 24 xynoxa. Schechter (1986) o6HapyxcHn, '-ITO o61ueenoTpe6neHFIe anKOronSI ynano TaK )Ke, xax nOTpe6neHHe AoMa HKonHLIecTBO cnyi-IaeB oTCyTCTBHSI 3a6oTbI O AeTSiX. CHCTeMa 6binaoTMeneHa B anpene 1982 r. iIaCTN4H0 n3-3a BbIpOCIIIerO ilepxoropblHKa no npoAaXCe KyHOHOB H TaK)Ke H3-3a cnyiIaes OTpaBneHHSIanKoroneM, 143rOTOBReHHbIM B AOMaIHHHX yCROBHSIX. B pe3ynbTaTenoTpe6neHne anKOrOnSi HOACK04nR0 Ha 60%, a BMeCTe C HHM060CTpHJIHCb CB513aHHble C 3THM npo6neMbl. KOnFILIeCTBO cnymaeBOKâ3aHi15I Cp011H0N HOMOIun pe3K0 BO3p0CJI0 (Schechter, 1986).

6.3.4 ÎÎl10THOCTb paCIlOJ10NC@HNA T04@K I1pOAaNCiA

alIKOfOlIA

KoHTponb LIHCna TO'-IeK npoAa)KH anKOrOnsl H MecT HXpacnOnOxceHnsi npHMenSIncSI BO MHOrHx cTpaHax, BKnIOLIaSI

orpaHntieHHSI no pacnonoxceHHio AaHHbIX ToLIeK BO3ne IiIKOn HRHMecT pa60TbI. PaHHHe HCCneAOBaHHSI TaKHX Mep nOKa3ânn, LITO 3TOTCpaKTOp OKa3bIBaeT He60nbIIIOe BRH5IHne Ha noTpe6neHHe. Ornstein HHanssens (1985) o6HapyxcHnH, tITO HROTHOCTb Toilet( npOAa)Kn

onpeAenSleTcsi TOnbKO cnpocoM. TeM He Menee, 6onee HeAaBHHeHCCne,iIOSaHH5I, rAe HC11011b3OBanncb BHAbI MHOrOBapHaHTHOii

3KOHOMeTp144eCKOii TeXHHKn, BKniOLIaSI 110AXOA 06-13eAHHeHHOr0

Me)KcepnanbHOrO aHanH3a, nOKa3anH, LiTO reOrpagHLIeCxaSl

187

11J1OTHOCTb BCe xce OKâ3bIBaeT 3Ha4HTCJ1bHOe BJIHAHHe Ha nponaxcyaJiKOI'OJ151, H Mbl CyMMHpyeM 3TH naHHble mince.

B OpHO{i rpynne HCCJIenOBâHHI%I npH aHâJ1H3e BpeMeHHb1X CepHNy4HTbIBâJIHCb nepeMeHHble pblHKa (McGuinnes, 1983; Walsh, 1982)H npeACTaBJ1eHHb1e naHHble no (1)H3H4eCKON .gOCTynHOCTH aJ1KOTOJ151 H

ero nOTpe6JIeHHIO H3 BpeMCHHbiX CepHN (Wilkinson, 1987). 3THHCCJienOBaHHA, HCIIOJ1b30BâBWHe naHHble 143 BeJ114K06pHTaHHH,

n03BOJ15I10T npeAnOJIoxCHTb, 4TO nOCTynHOCTb, H3MepAeMâA 11J1OTHOCTb1O

pacnOnOxceHHA TO4eK npOAaxcH, MO)KeT 6bITb B3aHMOCBA3aHa cnOTpe6JleHHeM, HO 3T0 TOJIKOBaHHe OCpaHH4eHO KpaTKOCTb10

H3y4eHHbIX CepH11 (He 6onee 25 JIeT).

Godfrey (1988) aHaJ1H3HpOBâJIa naHHble no npOnaxce aJIKOrOJ1A HnoKa3aTeJiH nOCTynHOCTH aJ1KOI'oJ1A B BeJIHK06pHTaHHH. 14CnOJIb3yAnaHHble BpeMeHHbIX CepHN H Bo3BpaTHOe MOnenHpOBaHHe, oHanOJIy4HJla nOKa3aTeJIbcTBa TOI'O, 4TO KOJ1H4eCTBO TO4eK nponaxcH3aBHCHT OT 06beMa p03HH4HON TOpI'OBJ1H KpeIIKHMH CI1HpTHbIMHHanHTKaMH, BHHOM H nHBOM. KpoMe Toro, nJ1OTHOCTb pacnoJlwKeHHA

T04eK npOnaxCH BJ1HAeT Ha nOTpe6JleHHe nHBa H npennOJlai'aeTCA, 4TOnoTpe6JIeHHe nHBa paCTeT C yBeJ1H4eHHeM ero nOCTynHOCTH.

LehtOnen (1978) aHaJIH3HpOBaJi CnpoC Ha aJ1KOI'OJ1bHble HanHTKHnpH nponaxce Ha pa3JIHB B OHHJ1AHA(iH. B nOnOJIHeHHe K 3J1aCTH4HOCTH

I(eH H noxona, OH OIleH1-1BâJ1 3JIaCTH4HOCTb (paKTOpOB npenJIomKeHHA.

1_lOJ1oBHHa nOBbIWeHHA npona>KH aJIKOI'OJ151 Ha pa3J1HB C 1962 no 1977 IT'.

06bACHAJ1aCb yBeJ1H4eHHeM KOJ1H4eCTBa peCTOpaHOB (Lehtonen 1978;Mäkelä et al 1981). IIOJIHTHKa OI'paHH4eHHA, TaKHM o6pa3OM, montaCnepxCâTb CnpoC Ha aJ1K00011b Ha nJIHTeJIbHOe BpeMA, HO 3T0 HaW110cBoe OTpaxCeHHe B paCWHpeHHH npOnyCKH01%1 CH0006HOCTH pecTopaHoB.

B CBOeM HCCJIenOBaHHH, OCHOBaHHOM Ha OTHOCHTeJ1bHO

60JIbWOM KOJ1H4eCTBe naHHbIX 143 50 WTaTOB CllIA 3a 5 JIeT,

Wilkinson (1987) H3y4aJI B3aHMOCBA3b Mexcny KOJ1H4eCTBOM TO4eKnponaxcH, 06beMOM nponaxcH aJIKOI'OJ1A H BOwneHHeM B HeTpe3BOMCOCTOAHHH. B pe3yJlbTaTe OH O6HapyxCHJ1 He6oJlbWylo, HO 3Ha4HMy10

B3a11MOCB513b Mexcny 3THMH nepeMeHHbIMH. Gruenewald, et al. (1993)npoBOnHJlH aHâJ1H3 npenCTaBHTeJIbHbiX BpeMeHHb1X cepHNnoTpe6JieHHA aJIKOI'OJ151 H T04eK npOnaxcH no THnaM HanHTKOB (BHHOH KpenKHe CHHpTHble HanHTKH) no 50 I11TTM C111Ei 1975-1984 COnOB.arIA npOBeneHHA 1-1OJ1HON OI1eHK14 3J1aCT144HOCTH nHBa, 6a3a naHHbIXn0 BpeMeHHbIM CepHAM 6blJla HenOCTaTo4Ha. 1-1onX0n,

HC11OJIb30BaHHbIN 3THMH aBTOpaMH, BKJ1104aJ1 B Ce651 aHâJIH3 I(eHbl

188

HanHTKOB H gOXOlja coBMeCTHO C pAgoM COLjHO-J.jeMOrpaciHYeCKHX

nepeMeHHbIX, KOTOpble, KaK npeRnonaraeTcM, BnHMiOT Ha

noTpe6neHHe. AHan143 rlposOljHnCM Ha OTHOCHTeJ1bH0 60n13uI0MHa6ope ,IjaHHbIX 113 BpeMeHHbIX CepHii. B pe3ynbTaTe 6bInH nOny'ieHblBenH9HHbI 3naCTH'IHOCTH npOJjâ)ICH anxoronsl OTHOCHTenbHO

nnOTHOCTH TO'IeK npO,TZâ>KH OT 0,1 40 0,3 4451 KpenKHX C11HpTHb1X

HanHTKOB H 0.4 j4JISI BHHa: BenHLIHHa 311aCTH'IHOCTH 0,1, HanpHMep, B

3TOM KOHTCKCTe 03Ha'IaeT, LITO 10% nOBbIIUeHHe IIJIOTHOCTH TOLIeK

npOAaxcH npHBeAeT K 1% nOBbILLIeHHiO nOTpe6neHHM. 3Ta1-103HTHBHa51 3naCT14LIHOCTb COOTBeTCTByeT TOIi, '1TO 6bIna BbIMBneHa

Watts H Rabow (1983) H TaK)Ice nOKâ3bIBana nOBbllIleHHe o6hemanpOjjâ)ICH anKOTO5151 C nOBbILUeHHeM ,IjOCTynHOCTH anKOrOnSI.

6.3.5 AOCT)/IIHOCTb B PO3HN4HON TOprOBn@ OT,g@JIbHbIXHâIINTKOB

OrpaHH'{eHHM no ,IjOCTynHOCTH OT4enbHblX HanHTKOB BBO414J1HC6

BpeMSI OT 'apemen'," B HeKOTOpbIX CTpaHaX. Kuusi (1957) nOKa3an, 9T0OTKpbITHe rOCyjjapCTBeHHbIX Mara3HHOS no npoAaxce anxoronM,npe,ljJlaraloujHX InHpOKHii Bb160p anKOTO116HbIX HanHTKOB B

npOMbILIIneHHbIX paNOHaX, nOBbICHJIO nOTpe6neHHe ARA My)iC'iHH Ha40% H AIM )ICeHLIjHH Ha 15-19%. Amundsen (1967) o6HapywHn, 'ITOOTKpbITHe TO'IeK npoRaxcH BI4Ha B HOToZjeHe, B HopBerHH B 1961 r.nOBbICHJIO noTpe6neHHe BHHa, B TO BpeMM, KaK noTpe6neHHe KpenKHX

CHHpTHbIX HanHTKOB H HeneranbHOrO anKOrOnM 1-1OH1431i1IOCb

He Ham HOTO. Nordlund (1974) 3aKn1o'IaeT, 9TO 6eCKOHTponbH0eOTKpbITHe CneLjHanH3HpOBaHHbIX TO'IeK npo,ija)ECH B HOTO4eHe,3nBepyMe H AnecyHAe He 6611I0 CBM3aHO C H3MeHeHHeM ypOBHMO6LLjerO noTpe6nenHM, Ho 3TO HccneZjosaHHe 6binO 06beKToMMeTO,qOJIOrH'IeCKOii KpHTHKH 143-3a HCIIOnb30BaHH51 TOnbKO ZjaHHbIX

H3 onpocon HaCeneHHM, rAe 'IenoBeK Cam COo6ujaeT o ce6e(Ahlstrom-Laakso, 1975).

AOCTynHOCTb HanHTKa MoMCeT TaIUKe 6bITb npejjMeTOM pe3KHXH3MeHeHH1-1 B pe3ynbTaTe jjeiiCTBHii npaBHTenbCTBa, TaKHX KaKBBeAeHHe Will OTMeHa 3anpeTa Ha onpe1jeneHHblli THn HanHTKa.14cnaH4HM 6b1na nepBOil cTpaxoli B EBpone, r,qe B 1912 r. 6binoBBe,CjeH nOJ1HbIN 3anpeT Ha ânKOTOnb. 1-103)Ke BHHO H KpenKHeCHHpTHble HanHTKH 6bI51H neranH3HpOBaHbI, HO nHBO 6bIJ10

3anpeujexo go 1 MapTa 1989 r. Olafsdottir (1990) npeAcTaBnMeTpe3ynbTaTbI OTMeHbI 3TOT0 3anpeTa Ha OjHy CpopMy AOCTyHHOCTHanKoronM 'iepe3 nepBble 12 MecMljeB. OnpoCbI, npOBejjeHHble go H

189

nocne H3MeHeHFi51 AOCTynHOCTH nHBa o6Hapy)KFinH, LrTO nHBO 6bIJI0A06aBneHO K o6ujeMy noTpe6neHHio anxOronA My)KLIi3HaMFi, HO3aMeHHJIO BHHO H KpenKHe CnHpTHble HanHTKH y )KeHIIHiH. IIpHonpoce 6bin 06HapyACeH OTHOCHTenbHO He6onbUIO11 3IInbeKT 3TOr0H3MeHeHH51 Ha nOTpe6neHHe KpenKHX HanHTKOB, O KOTOpOM nIOAHC006UjanH CaMH. l-loBbIUleHiie noTpe6neHliA nHBa 6bIJI0 3HaLIHTenbHb1M

H yBenHLiHJIO o6U1HIi O6bëM TOprOBnH anKOrOneM Ha O.i(Hy LIeTBepTb B1989 r. H Ha oAHy nATylo B 1990 r. no cpasneHHio c o6uiHM o6beMoMnpoAaACFI anxoronA B 1988 r.

B(DHHJIAHAHH nponaxca nHBa CpeAHeli KpenocTii BO BcexnpO,IjyKTOBbIX Mara3HHaX H Ka(1)e HaLIanaCb B 1969 r., KâK LiaCTbo6üjer0 nepeCMOTpa anKOrOnbHOrO 3aKOHOAaTenbCTBa, XOTA AO 3TOr0nHBO yACe 6bIJ10 B npOAâACe B TeLieHHe 20 neT B rOCynapCTBeHHbIXCneuFianH3HpOBaHHbIX Mara3FiHaX H pecTopaHax (Osterberg 1991).3aperHCTpnpoBaHHOe nOTpe6neHHe anKOrOJIA nOBbICHJIOCb B 1969 r.Ha 46%, H 3TO npOH30IIIJIO nOnHOCTbIO 143-3a nOBbIUleHHA nOTpe6neHHA

nHBa cpenxeli KpenocTx. Mäkelä (1970) c,rjenan BbIBO.zt, LITO

KOJIHLieCTBO CnyLiaeB BbInHBKH, KorAa ypOBeHb anKOrOJIA B KpOBI3AOCTFiraeT 100 Mr % nOBbICHJIOCb Ha 25% Ha CnenyiOluHli rOn nocneH3MeHeHFiIi H Ha6nlOnanOCb 3HaLIHTenbHOe yBenHLieHHe KOnHLieCTBa3noynOTpe6nSIEOILjHX anKOroneM TaK Ace, KaK H nOBbIUIeHHe 06LL[er0noTpe6neHHA (Bruun, et al., 1975).

B 3KcnepHMeHTe, KOTOpbIFi npOBO,I[HJICA KOMHTeTOM 111Be1(NH no

anKOronlo KpenKOe nnBO (6onee 3,6% anKOronA no Becy) HaLIanHnponaBaTb B racrpoxomlax H B 6apax B AByx oxpyrax B 1967 rony.3xenepHMeHT 6bin npexpau(eH B 1968 rOny Ha IueCTb MecAljeB paHee,LieM npe,iZnonaranocb nepBOHaLIanbHO, TaK KaK OH npHBen K

Cepbe3HbIM nOCnenCTBHAM. B oxpyrax, rne npOBOAHnCA

3KCnepHMeHT, OLieHb pe3K0 yBenHLIFinOCb nOTpe6neHHe KpenKOrOnHBa, a nOTpe6neHHe nHBa cpeAxefi KpenOCTH yMeHbIIIHJIOCb, npH3TOM He Ha6JIIOAanOCb HHKaKHX H3MeHeHHiâ B nOTpe6neHHH BHHa HKpenKHX CnIipTH6IX HanHTKOB. iIFiCTbIii 3(141eKT, npOH3BeneHHblii Hao6Hiee noTpe6neHHe anKoronA 6bin ouexeH B 5% (Osterberg 1991).Yposexb xynHraxcKHx HananeHHli nOBbICHJICSi Ha 32% (Lenke 1990).OAF a Bo3paCTHâSI rpynna "H3BneKJIa npeHMynjecTSo" 143 H3MeHeHH5IAOCTynHOCTH nHBa - 3TO rpynna 15-17-neTHHx. Lenke (1990)o6Hapy)KHn, LITO HMexxo B 3TOii Bo3pacTHOii rpynne 6onbule BceroyBenHLiHJICA ypOBeHb HaCHnbCTBeHHbIX npeCTynneHHii. 3KCnepHMeHT

6bin npepnaH B HIOne 1968 r. B OTBeT Ha Acano6bl rpaxcAaH H

190

COO6theHHSI o 9pe3MepxoM H HenpxeMneMOM ypoBHe nOTpe6neHHSIKpenxoro nxsa, oco6exxo MOJIORbIMH nIO,I1bMH (GovernmentCommission on Alcohol Policy, 1974, and Lenke 1990).

lloslBneHHe misa cpeAHeii xpenocTH (3,6% anxoronSl no Becy) B111BeuHH AanO AOIIOJIHHTenbHble ,I(aHHble O pe3ynbTaTaX H3MeHeHH5I

cpopMbl AOCTynnoCTH aJixoronsl. Novai H Nilsson (1984)o6HapyxcxnH, Lrro o6luee noTpe6nenHe anxoronsl B ll1BeuHH 6bino Ha15% Bbllue, B nepHoA MexcAy 1965 H 1977 rr., xor,ga nHBo cpeAHeiiKpenOCTH MO)KHO 6bIJI0 KynHTb B CynepMapKeTaX, a He TOnbKO BrOCyAapCTBeHHbIX CneuHânH3HpOBSHHbIX Mara3HHaX. r1OCne OTMeHbInpoAa)KH nHBa CpeAHeii KpenOCTH B 1977 r. KOnHiieCTBO 06BHHeHHH B

HaCHnbCTBeHHbIX npecTynJIeHHAX, CpeAH AaHHOii Bo3paCTHOii rpynnbI

yMeHbuIHJIOCb, KaK H. KOnHiIeCTBO XynHraHCKHX HanaAeHHIi cpeAHBceX BO3paCTOB.

11OBbILLIeHHe AOCTynHOCTH anKorOnSI B pO3HHTIHOIi ToprOBne KaK

Ha BbIHOC, TaK H AnSI nOTpe6neHHSI Ha MeCTe, KaK BbISICHHJIOCb,nooujpSleT nOTpe6neHHe. HanpHMep, BBeAeHHe npOAa)KH KpenKHXCnHpTHbIX HanHTKOB nOCeTHTenSIM B 6apax, na6ax H pecTopaxaxCeBepHOii KapOnHHbI B nepBblii pa3 nocne OTMeHbI "cyxoro 3aKOHa"nOBbICHJIO O6u.[ee noTpe6neHHe anxoronSl Ha 6,8%, a KOnHtIeCTBOAOpO)KHbIX aBapHil, BO3HHKIiIHX no BHHe anKOrOnsi - Ha 16-24%(Holder and Blose, 1987; Blose and Holder, 1987). 3To 6binoHeyAHBHTenbxo, TaK KaK 3Ha4HTenbx0e LIHCnO BoAHTeneI3 CeBepHOiiAMepHKH C yXyAüleHHoii peaKuHeii H3-3a BnHSIHHSI anKOrOnsl

nOceujaK)T TaKHe 3aBeAeHHSI, HCIIOnb3ySl aBTOM0611JI14. O TeX wepe3ynbTaTax coo61uaeT Hoadley et al (1984).

6.3.6 PerynHpoBaHrie ankoronbHbix HanNTKOB BCOOTBeTCTBNN C NX KperIOCTbFo

Bcë 6Onbulylo nolIynSIpHOCTb BO MHOrHx cTpaxax npIio6peTaeTp03HHLIHaSI TOproBJIA HanHTKaMH, KOTOpble Ha BHA H BKyC CXO)KH C

anKOrOnbHbIMH HO coAep)KaHHe anKOrOnSI B KOTOpbIX OTHOCHTenbHOHH3KOe (MeHbLUe, LIeM 2% anKOrOnsi no 0fteMy) HIM OH oTCyTCTByeTcOBCeM. r1peAHa3HaLIeHHe 3THX HanHTKOB COCTOHT B TOM, 11T06bICOCTaBHTb npHBneKaTenbHyK) anbTepHaTHBy Avia nbIOmerO, npHKOTOpOii npxcyTCTByeT n14I1Ib He6onbluaSl HRH Hynesasl CTeneHbpHCKa BO3HHKHOBeHH5I anKOrOnbHbIX npO6neM.

Skog (1988) ananH3HpOBan 3(1)(1)eKT noslsneHHSI nHBa HH3KOiiKPflOCTM B HopserHH B MapTe 1985 T. H o6HapyxcHJl 11O3HTHBHy1O, HO

191

CTaTNCTNMeCKN He3HaMHTenbHyLO BenNMNHy 3aMeL1[eHNSI.

KOHTpOnNpyeMblli 3KCnepNMeHT Denney (1993) no NCHO11b30BBHNIOaHrnNÎdCKOrO nNSa C HN3KNM CO,i[ep)KaHNeM anKOTOnSi H .narepa(0,5%-1,2% no 0fteMy) nOKa3an, MTO 4enOBeK He Mo)KeT jjOCTNrHyTbCTeneHN OnbSIHeHNSI C cOAepxcaHNeM anKOTOnSI B KpOBN (CAK) 80 Mr%

(neranbHOrO npeAena AJISi BO)CAeHNSL B BenNK06pNTaHNH), noTpe6naxnNBO C H143KNM COAep)KaHNeM anKOTOnSI. TaKHM o6pa30M, HanNLINe B

npoAaxce HanHTKOB C HH3KHM coRep)KaHNeM anKOTOnSI, BepO5ITH0,MO)KeT npN onpeAeneHHblx o6cTOSiTenbcTBax BHeCTN CBOIï sKnaA BcTpaTerN10 npOC121NnaKTNKH.

11O1IBneHNe TaKNX anbTepHaTNBHbIX HanNTKOB moulanOOLupSIeTCSI 6onee H113KNMN HanoraMN, H, TaKHM O6pa3OM, 6oneeH113KON L1eHOi3. MonCHO TaLoLCe CAenaTb NX 6onee AOCTynHbIMN,TOprySl HMN B '-IaCTHbIX Mara3NHaX (ecnN CyLueCTByeT MOHOHOnNArocy,qapcTBa) HAN KOHTponNpySI NX He B paBHOti cTeneHN C

HanNTKaMN, NMeIOLuNMN 6onbulee coAepxcaHLle anxoronx. HanpNMep,B 1.1.lseLjNN B 1992 T. 6bIJIN yCTaHOBneHbl ueHbI Ha anKOTOnbHbleHanNTKN TaKNM 06pa30M, MTO L[eHa HanNTKa C 6011bL11NM

COAep)KaHNeM anKOTOJISI 6b1na B6IIIIe, '{em LjeHa HanHTKa C H113KNMCOAepnCaHNeM anKOTOnSI H3 paC'ieTa ueHbl 3a rpaMM anKOTOnSI. BoMHOrNX CTpaHaX neranbHo AonyCTNMbIFi BO3paCT nOKynKN nNSa HBNHa MeHbLNe, '-IeM An51 nOKynKN KpenKNX CnNpTHbIX HanNTKOB(Brazeau et al 1993).

6.3.7 4acbl H ,gHH npoAa)lcN

FiOnbLIINHCTBO NCCneAOBaHN4i 133MeHeHN51 'iacOB npoAa)ICN NnNAHeH pa6oTbl TOprOBbIX TO'{eK nOKa3anO, 'ITO nOBbIIlleHNenOTpe6neHNSI cB513aHO c paCLUltipeHNeM 'iacOS npOAa)KN, a CHN)KeHNenOTpe6neHNSI - C COKpaLIjeHIieM HeKOTOpbIX AHeH pa6OTbI TOprOBbIXTOMeK.

T-laCbI N AHN npo,naxcH 6bInN 06beKTaMN CepNN NCCneAoBaHNFi,

npoBeAexxblx Smith (1987, 1988a, 1988b, 1988c) no uenon-Iy pSl,gyn0A06HbIX N3MeHeHNFI, KOTOpble npOBOANnNCb B pâ3nN'IHbIX ropoAaXH ulTaTax ABCTpanNN (cM. TaK)LCe Lind and Herbert, 1982). Talolce6bino ony6n4xosaxo OHO onNCaTenbxoe HceneAoBaxxe ysenNMeHN51LIacoB pa6oTbl na6os H roCTNHNL1 B 1.1lOTnaHANN (Bruce, 1980). XOTSI3T14 NCCneAOBaHNSI 06naAaK)T HeKOTOpbIMN McTOAOnOTNMeCKNMH

HeAOCTaTKaMN, OHM no KpaÎ-LHe}L Mepe, npe,I);ocTasnxloT AâHHble

192

onxcaTenbxoro xapaKTepa no BnMAHMIO nO,Ij06HbIX i33MeHeHi3i4 HaypOBeHb ânKOTOnbHbIX npO6neM.

Olsson H Wikstrom (1982) Hccne,goBanH 3cpcDeKT

3KCnepIiMCHTanbHOl'O 3aKpbITM5I nliKepO-BOAOTIHbIX Marâ3MHOB n0

cy66oTaM B 1.11BeuHH. OHM o6HapymKMnM yMeHbffieHlie KOnii*-IeCTBaapecToB 3a nbAHCTBO Ha 10%, a TaIUKe yMexbAIexi3e KonMiIecTBaXynxraxcKMx HanaAeHMil, KaK Ha ynMue, TaK H ,goMa. C RpyroHCTOpOHbI, OueHKa He nOKâ3bIBaeT HMKaKOrO B03AeIiCTBH51 Ha ypOBeHb

o6wero noTpe6neHHA anxoronA. Ouexxa nOCTOAHHOT0 3aKpbITMAnHKepO-BOAOTiHbIX Marâ3HHOB no cy66oTaM B 111BeuMM nOKa3bIBaeT

CXOAHOe COKpaLueHHe HeraTMBHbIX nOCneACTBHiï (Olsson andWilkstrom 1984). Nordlund (1985) npoaxanM3Mposan 34)(1;leKT

3KCnepHMeHTanbHOTO 3aKpbITMA B HopBerHH rocyAapcTBexxbiXMarâ3HHOS no cy66oTaM B TeTieHMe rOAa. BbIBOA rnacMn, TITO3aKpbITHe Marâ3MHOB n0 Cy66OTaM OKâ3bIBaeT He6OnbnIOi3 3I1)ItteKT Ha

o6uzee noTpe6neHMe, H nOTpe6MTenM npHCIIOCO6MnMCb K 3aKpbITHK),nOKynaA BHHO H KpenKHe HanHTKM B ApyrHe AHM MnM nOKynaA nMBO.

TeM He McHee, 3T0 noBnHAJI0 Ha ypOBeHb OCTpbIX aJIKOTOnbHbIXnp06neM. 3KCnepMMeHTâJIbHOe 3aKpbITHe no cy66oTaM 10 CneuManH-3MpOSaHHbIX Marâ3HHOB B OHHJIAHAMH, KOTOpOe AnMJIOCb 8 MeCAues,

6bIJl0 M3yTIeHO B pa6OTe Saila (1978). B 3OHe 3KCnepMMeHTa 061ueenOTpe6neHMe aJIKOTOnA ynan0 Ha 3%, a nbAHCTBO B 06üjeCTBCHHbIXMcCTaX H HaCMnMe, CBA3aHHOe C anKOrOneM, KaK BbIACHHJIOCb, Talvice

yMeHbnIHnHCb. He 6bIJI0 o6Hapy-AceHO AOKâ3aTenbCTB nOBbIIIIeHMAnoTpe6neHMA HeneranbHorO anKOTOnA B CJryTiaAX OnbAHeHMA,

npMBeAIIIHX K apeCTy 3a nbAHCTBO (Saila 1978).

6.3.8 MHHHMa11bHbIN BO3paCTHOÎA 17peAell IIOTpe6J7eHNAan KO r01151

ara Mepa o6ecneTlHBaeT TOnbxO TO, TITO Ans onpeAenexxoFiBo3paCTHO14 rpynnbl BbICTpaMBaeTCA 6apbep, npenATCTByfOLuH[1

nOKynKe anKOronA. XOTA B 6on1,iIIMHCTBe cTpaH eCTb HeKOTOpbleMepbl perynMpOBaHMA MHHHMânbHO AOnyCTMMOrO BO3paCTa nOKynKM

ânKOTOnA, OHO TIaCTO rUIOXO C06nK)AaeTCA, a B HeKOTOpbIX CnyTiaAX

rpaHHua yCTaHOBneHa CnMIIIKOM HH3KO. B MMpe CaMbIli BbICOKHFi

BO3paCTHOi%I npeAen A)151 nerf CTpaHbl HeAaBHO 6bin yCTBHOBneH B

CHIA. 3TH M3MeHeHHA nasal BO3MO]KHOCTb npOBeCTM HeCKOnbK0HCCneAOBaHHii n0 nOHuKeHHiO H noBbIIIIeHMIO B03paCTHOTO npeAenanOKynKM anKOronA. 3TM HCCneAOBaHMA B o61ueM o6HapyxcMnM, TITO

nOHDKeHHe BO3paCTHOT0 npeAena ysenMTlMBaeT KOnMTIeCTBO

193

CBA3aHHbIX C anKOFOneM AOpO)xHbIX aBapHg cpeAH Tog rpynnbiHaceneHHA, KOTOpaA nonaAaeT non H3MeHeHHe; B TO spew, Kai(nOBbIHIeHHe Bo3paCTHOro npenena coxpaluaeT nOAo6Hble asapHH.l'1HTepeCHO, 7-ITO B HeCKOnbKHX HCCneAOBaHHAX 6bIJI0 06Hapy)KeHO,

TiTO nOBbInIeHHe BO3paCTHOro npeAena BCerAa npHBOjjHT K

HeMeAneHHOMy COKpanjeHHK) 06LL[er0 noTpe6neHHA anKOFOnA cpenHBO3paCTHOg rpynnbl, nona,galolueg non Z[egcTBHe 3aKOHa. TeM HeMcHee, HenaBHHe HCCneAOsaHHA cpeAH MOJIOAbIX nioneg CesepnogAMepHKH 06Hapy)KHnH AJIHTenbHbIg 34)(lleKT CHH)KeHHA nOTpe6neHHAanKOFOnA y nBaAtjaTHneTHHX TaM, rne neranbHblli BO3paCTHOg npeAen6bin nOBbILIIeH Ha OnHH ron (O'Malley and Wagenaar, 1991).

Biopo o6LLteg CTaTHCTHKH CHIA (GAO, 1987) 413y4I4JIO 32COOTBeTCTBÿIOLLZHX HCCneAOBaHHA, HO MHOrHe H3 HHX 6buIH OLZeHeHbl,

KaK HarIHO He nOCTaTO9HO COCTOATenbHble, 4TO6bI BnHATb HanOJIHTHLIeCKHe peineHHA. 1/I3 14 HCcnenOBaHHg, KOTOpble

ynOBneTBOpAJIH GAO n0 MeTOAOJIOFHi-IeCKHM KpHTepHAM, B 4-xpaCCMaTpHBanHCb aBapHH CO CMepTenbHblM HCXOAOM B HeCKOnbKHX

IIITaTaX, a B nATH - nOA06Hble aBapHH B OTAenbHbIX ulTaTaX (Arnold,1985; DuMouchel, et al., 1985; Emery, 1983; Florida Department ofCommunity Affairs, 1983; Hingson, et al., 1983; Hoskin, et al., 1986;Klein, 1981; Lillis, et al., 1984; Maxwell, 1981; Schroeder andMeyer, 1983; Wagenaar, et al., 1981; Wagenaar, 1987; Williams, etal., 1983). l'IccnenoBaHHA, rAe HCn011b30BanHCb Aaxxble H noOTAenbHblM LIITTM H no HeCKOnbKHM II1TTM Cpa3y 06Hapy)KHnHCOKpaiIjeHHe KOJIHileCTBa CBA3aHHbIX C anKOroneM asapHg,COBepLnëHHbIX MOJIOAbIMH BOAHTenAMH Ha 5% - 28%. GAO npHLnno K3aKnioLieHHIO, LITO Cy1i[eCTByIOT HaAe)KHble HayLIHble AOKa3aTenbCTBa

Toro, LITO nOBb1HIeHHe npenena MHHHManbHOro B03paCTa nOKynKHanKorOJIA COKpalIjaeT KOJIHLIeCTBO CBA3aHHbIX C anKOroneM AOpo)KI-ibIX

aBapHg, COBepIIIëHHbIX MOJIOAbIMH n10AbMH MOJIO)Ke 21 rOAa.

l'1CCneAOBaHHA no 3TOMy Bonpocy npOBOAHnHCb TaiOKe B KaHane,CBA3aHHble c anxoroneM asapHH, cosepiuennbie 16-20-neTHHMH

BOAHTenAMH CaCKaTLIeBaHa 6bInH npoaHanH3HpoBaHbl Shattuck HWhitehead (1976). IIocne CHH)KeHHA MHHHManbHOFO BO3paCTHOFonpenena B 1972 r, Ha6nloAanocb nosbliIIeni3e KOnHLieCTBa CBA3axxbIXC anKOroneM asapHg cpeAH 3TOg Bo3pacTHOg rpynnbl. Bako,MacKenzie H Smith (1976) o6HapyxcHnH 6onee, tIeM 100%nOBbILIIeHHe KOnHTIeCTBa aBTOKaTaCTpO(tl C (PaTâJIbHbIM HCXOAOM B

Anb6epTe CpeAH MOJIOAbIX BOAHTeneg, HMeBLHHX ypOBeHb anKOFOnA B

194

KpOBH 80 Mr% HRH 60nee. OHH cAenanH BbIBOA, 'ITO 3T0 nOBbIIIIeHHe6bIJI0 CB5I3aHO C 60nee HH3KHM BO3paCTHbIM npeAenOM nOTpe6neHHA

anKOronA.

B OHTapHO 6bin CHH)KeH BO3paCTHOH npezjen nOKynKH anKOrOnA

C 21 ,Ijo 18 neT, '-ITO coBnaAano C TeHAeHLIHeil nOnHTHKH

COeAHHëHHbIX I1ITaTOB B 1970-x roAax. Ilocne 3TOTO B OHTapHOnp0H30L11JI0 nOBbILneHHe KOnH'-IeCTBa CB313aHHbIX C anKOrOneMaBTOKaTaCTpO4), COBepLnëHHbIX MOJIOAbIMH nK),ijbMH (Whitehead, etal., 1975; Williams, et al., 1975). Williams 14 ero KonnerH (1975)nOAC4HTa11H, 'ITO B OHTapHo 3a nepBblN rOA nocne CHH)KeHHSIBO3paCTHOrO npeAena B aBTOKaTaCTpO4)aX AOHOJIHHTCnbHO norH6no28 menoseK. Schmidt H Kornaczewski (1975) o6HapyxcHnH3Ha'IHTenbx0e nOBbIUleHHe KonHLIeCTBa AOpO)KHblX aBapHli cpeAHBoAHTeneil 16-19 neT B OHTapHo. Whitehead (1977) npoAonxcaA CBOHpauHHe HCCJIeAOBaHHA (Whitehead, et al., 1975) o6HapyxcHn, 'ITonOBbIIUeHHbIN ypOBeHb CB513aHHbIX C anKOFOnCM KaTaCTpoC1),

COBepLIIëHHbIX MOJ10AbIMH BOAHTenAMH, coxpaHSlncA H'iepe3 4 roAaHOCne H3MeHeHHA BO3paCTHOTO npeAena.

Bo BpeMeHa CHH)ICeHHA BO3paCTHOTO npeAena C 21 Ao 18 neT B1971 r. npOBOAHnHCb Bbl6OpOLIHble OnpoCbl CTyACHTOB BbICLHHX

LLIKOn TOpOHTO B 1968, 1970, 1972 H 1974 roAaX. LIaCTb cTyAeHToB,KOTOpble npo6osanH anKOFOnb XOT51 6b1 pa3, HeMeAneHHO

yBenH9HnaCb AO H nocne BpeMeHH H3MeHeHHA (1970-1972), HO Aaxce6onbluee ysenHVeHHe npoH3oHlno MexcAy 1968 H 1970 roAaMH(Smart and Fejer, 1975). CpasneHHe C KOHTpOnbHON rpynnori HenpoBOAHJIOCb. B H3y'1eHHH CTyAeHTOB KonneA)KeH TOpOHTO 6bIJIOO6Hapy)ICeHO, 4TO C H3MeHeHHeM 3aKOHa CB513aHO nOBbILHeHHe

4aCTOTbI, HO He KOnH'-IeCTBa BbInHTOFO 3a OAHH pa3 (Smart and White,1972).

KpoMe 3THX HCCneAOBaHHIi B BbICLHHX LHKOnax, KanaACKHeHCCneAOBaHHSI npeAnaraEOT BbIBOAb1 O'IeHb CXOAHble C BbIBOAâMHnOny'IeHHbIMil B Cll1A.

6.3.9 OTB@TCTB@HHOCTb CCp@pbl 06CJ1yHCNBBHNA (pa6oTaC I7@pCOHaJ70M I7NT@NHbIX 3aB@A@HNN)

Bo3AeNCTBHe TâKOFO poAa B McCTax npOAaxcH Ha pa3nHB cTanO BnOCneAHHe rOAbI nOnynApHbIM BHAOM anKOrOnbHOH nOJIHTHKH BCeBepHOIi AMepHKe, ABCTpanHH H HHAepnaHAaX. O630pbI AaHHbIXn0 BnHAHHiO B03Ae1iCTBH5I 06Cny)iCHBaHH51 MO)KHO HaIïTH B SaltZ

195

(1987, 1989, 1993), Russ and Geller (1986) and Gliksman and Single(1988). McKnight (1988) coo61uaeT o npoTNBOpetINBbIx Bbisonaxnpo6Horo npoeKTa nposeJiexxoro B Jzsyx urraTax CHIA. OHo6HapyxcNn n031,1TNBHble H3MeHeH145I B B03JjeliCTBHN O6yLIeHHOrOnepcoHana Ha HeTpe3Bblx KJINeHTOB B MiiIiNraxe, HO OTCyTCTBHeTaKOBblx B .lIy143HâHe. bonee HenasHHe HCCneAOBaHHA no o6ylieHNlonepcoHana (Saltz and Hennessy, 1990a, 1990b; Saltz, 1988)nOKa3anN, 4TO OHO ABnAeTCA 6onee 34(beKTHBH6IM, ecru!KOM6NHHpyeTCA C N3MeHeHHeM itiOpMbI O6CnriCiiBaHH5I H npaKTHKHTOprOBnN B KOHTpOnNpyeMOM 3aBeJ1eHHN H C o6y4eHNeMMeHenmCepOB 3aBeAeHNA. HCCne,aOBaHHA nOJjTSep)ICnaIOT 3aKni0'-IeHNe

O TOM, TITO N3MeHeHHe nOBCJ);eHHA nepCOHana MO)KeT npHBeCTH KN3MeHeHHIO ypOBHA COJjep)KaHNA aJIKOrOnA B KpOBH (CAK) KJIHeHTOB,

KOTOpble yXOJJAT N3 JjaHHOro 3aBeJjeHNA H, TaKNM O6pa3OM, CHH3HTbHX nOCneJjyiolLjNi7 PUCK rlOnaCTb B JjOpO)KHyIO KaTaCTpOCby HANCTOJIKHyTbCA C J1,pyrON anKOrOn6HO1-i npo6neMON.

3rN 3I1:4eKTbI o6y4eHN2 nepcOHana 6buIN nponeMOHCTpNpOBaHbIHa MHKpOypOBHe pO3HI-I1-iHbIX nNTCIiHbIX 3aBeJZeH411, H, 06bITiHO,

5IBnAIOTC51 4aCTblO HCCneJ),OBaHH[-1 TaKOrO 06yLIeHNA. B HeJIaBHO3aBepüleHHOM HCCneAOBaHNN npepBaHHbIX BpeMeHHbIX cepNN HolderN Wagenaar (B neTiaTN) o6Hapy>ICnnN, 4TO B OperoHe, B OJ);HOM N3u1TaTOB CHIA, r,qe 6bino npoBeJ>,exo o6A3aTenbxoe o6y4eHNe BceronepCOHana, Topry1011(ero anKOroneM, OHO npHBeno K CTaTHCTH4ecKN3Ha4NMOMy COKpaHIeHHIO KOnN4eCTBa JjOpo)KHbIX aBapNN,B03HNKNINX npH yLIaCTHH anKOrOJ1A, nocne TOrO KaK nO MeHbH1eNMepe 50% nepCOHana3aKOH4NnN 06y4eHHe.

6.3.10 OTB@TCTB@HHOCTb I1@pCOHalla N CâHKIAHN 3a06CJ7yNCHBaH41@ H@Tp@3BbIX KI1N@HTOB

B HeKOTOpbIX CTpaHaX Ha OCHOBe o6n.[ero 3aKOHOJjaTenbCTBa6bIna yCTaHOBneHa rpa)knaHCKaA OTBeTCTBeHHOCTb y4pexcJ>;eHHri

p03HIi4HOi3 TOprOBnH anKOCOneM 3a npoJ.taxcy CHNpTHOrO HeTpe3BbIM

rpa)iCJjaHaM. 3Ta OTBeTCTBeHHOCTb 6b1na B OCHOBHOM OTBeTHOIi, 4TO

03Ha4aJI0 He06X0J)',NMOCTb 3aKOHHOrO BO3Men.[eHNA yluep6a, eCnN06Cny)ICNBaHNe HeTpe3BOr0 4enosexa B pe3ynbTaTe npNBOJ),NJIO KnN4HOiI noTepe HJIH pane (Mosher, 1979, 1987). 3-ro Mo)xeT,HanpNMep, Cny4HTbCA, KOr,I(a HeTpe3Bbli BOANTenb, KOTOpOi'O

06CnyACNnN B nNTei-1HOM 3aBeJ);eHHH, cosepmHn aBapnio H

TpaBMHpOBân HRH y6Hn HeBHHHOrO npoxoxcero. TeM He Mexee,HeJjaBHO 6bIn0 npenJIO)iCeHO HCIIOnb30BaTb OTBeTCTBeHHOCTb

196

nepcoHana, KaK npeBeHTHBHyIO nOJIHTHKy, LITO6bI nOOnlpATb 60nee6e3onacxoe O6Cny)KHBaHHe CHHpTHbIM H npenoTSpaTHTb Bow,IjeHHe BnbxxoM sHJie (Mosher 1983 H 1987; Holder et al., 1993).

Wagenaar H Holder (1991b) HCCne,gosanH Bo3AeHcTBHe Hamac-miry TpasM B aBTOxaTaCTpo(kax, KaK Cne,IZCTBHe pe3KoroH3MeHeHHA 3aKOHa 06 OTBeTCTBeHHOCTH nepCOHana B IITaTe Texac.1iblJla HCHOnb3OBaHa (tiOpMa KBa3H-3KcnepHMeHTanbHorO HCCJIeAOBaHHA

MHO)KeCTBeHHbIX BpeMeHliblx CepHN, BKniOLIaA pa3nHmblecraTxcTHHecxxe MOAenH ,iznA aHanH3a AaHHbIx o TpaBMax C 1978 no1988 rOAbI. ABTOpbI KOHTpOnHpOBanl TaK)Ke 343CtleKTbI, OKa3bIBaeMble

,qpyrHMH H3MeHeHHAMH nonHTHKH, KOTOpble, KaK O)KHjjanOCb, MOryT

HOBnHATb Ha ypOBeHb TpaBM B Texace H 60nee IIHpOKHe B MaCLIITa6eHaIjHH H3MeHCHHA B ypOBHe TpaBM B 1980-x rOnaX. Pe3ynbTaTbInOKa3anH, LITO nocne npHHATHA JiByX rnaBHbIX nOCTaHOBneHHii 06OTBeTCTBeHHOCTH B 1983 H 1984 rOAax nocneAosano cHHxcexxeKOnHLIeCTSa aBapHN, 3aKOHLiHBI1IHXCA TpaBMaMH COOTBeTCTBeHHO Ha

6,5 % H 5,3 %.

Bo Bcex LIITaTax CHIA CynjeCTSyIOT CaxKL[HH nH6o yronoBHOro,nH6O rpa)K,iiaxcxoro xapaKTepa 3a o6Cny)KHBaHHe ABHO HeTpe3BbIXKJIHeHTOB. TeM He McHee, 3(HIeKTHBHOCTb 3THX 3aKOHOB COCTOHT BnpAMON 3aBHCHMOCTH OT yBa)KeHIA K HIM H CHOCO6HOCTH n06HBaTbC31

IX BbInOJIHeHHA. CO6nI0AeHHe noJ106HbIX 3aKOHOB pe,gKO H3yiianOcb.B HeJiaBHeM HccneAOSaHHI McKnight (1992) o6HapyxcHn, IToCO6nK)neHHe 3axoxa, BbIpaACeHHOe B t-IaCTOTe sMellaTenbCTSanepcoxana HnH OTKa3OB o6Cny)ICHTb, nOBbIClnocb Ha 37% nocneBH3HTOB npeRCTaBHTenel%I KOHTpOJIHpyIOLuHX OpraHOB H

npeRynpexCneHIN O BbInOJIHeHHH 3aKOHa. 3T0 6bIJI0 no,ijTBep)KneHOyMeHbLneHHeM B npOLjeHTHOM COOTHOIIeHHH (C 31,2% Ao 24,6%)KOnHLIeCTBa apeCTOS 3a BO)ICJjeHHe B HeTpe3BOM COCTOAHHH nloAeH,BbILICJjLLIHX 143 6apOB HnH pecTopaHoB.

6.3.11 BJINAHNe 113MeHeHHA ,gOCTj/11HOCTH anKOfOJ1A Ha4pe3MepHO I1bFOI1piX

3nHileMHOnorHNecKHe HCCne,IjOBaHHA BnHAHHA H3MeHeHH51

.qOCTynHOCTH anKOrOJIA 4aCT0 COO6LI(aIOT TOnbKO o6 06LgHX

pe3ynbTaTaX. CyLqeCTByIOT, TeM He McHCe, HeKOTOpble uaHHble o6 HXoCo60M BnHAHHH Ha 9pe3MepHO nbK)IWHX. 9TH pe3ynbTaTbI ABnAIOTCAHaCTOJIbKO BaACHbIMH jIJIA nOnHTHLIeCKHX BbIBOJjOB, LiTO MbI

nOI1bITaeMCA B 3TOM pa3,IjeJle CBeCTH BOeJHHO BCe J[aHHble HMeHHO no

197

3TOMy Bonpocy. H3ytlaA pAA Ha6n1oAeHHiï, KâxUjOe 143 KOTOpbIX BOTAenbHOCTH MO)KeT paCCMaTpHBaTbCA KaK Heo6blt-IHOe HRH

3K30T144eCK0e, MbI MO)KCM BbICTpOHTb y6euMTenbHylo CHCTMA0Ka3aTenbCTB, noAAep)xl3Baloluylo yTBep)iCjjeHFie O TOM, zITO B

061ueM KOHTpOnb C1)143HtieCKOrO AOCTyna, KaK npaBl-ino, 3Ha4HTenbHOH 0006biM o6pa30M BnHAeT Ha noTpe6neHHe y-Ipe3MepH0 nbioujHX.MbI 6yAeM CCbinaTbCA Ha HCCneuoBaHHA, KOTOpble LjHTHpOBanFiCbpaHee, HO 6e3 nOBTOpCHHA HeHy)iCHbIX AeTâJIeIï.

BO-nepBblX, COOTBeTCTByK)LUFie nOKa3aTenbcTBa MO)KHO H3B11e4b

143 IiccnenOBaHHIi 3a6acTOBOK no npouaxce anxoronA. Osterberg HSaila B aHanH3e anKOrOnbHbIX 3a6acTOBOK 1972 Ii 1985 ronoB BC1)HHnAHu1414 o6HapyxcHnH coxpaiueHHe nbAHCTBa B O6L11eCTBeHHbIXMecTaX H nonanaHHii B HapKOnOrwIeCKFie KniiHllKii XenbCHHKFi BnepHou pe3KOro CHH)KeHHA AOCTynHOCTii anxoronA. LIpHBeueMApyroH npFlMep, AByXMeCA4HaA 3a6aCTOBKa pa6OTHHKOB p03HH4HOiiToproBnH anxoroneM B LLIBeuHH B 1963 roua npHBena K naueHHlonbAHCTBa B O6LIjeCTBeHHbIX McCTaX Ha 50% B CTOKrOnbMe H Ha 33%B reTe6Opre. r1pOL[eHTHOe KOniiLIeCTBO 3aHATbIX KOOK B yiipexcueHHAX

n0 neLIeHHK) anKOrOn143Ma CHH3HnOCb C 92% RO 3a6aCTOBKH AO 68% BnepnoA 3a6acTOSKH (Medical Research Council, 1965). Pe3KHecABHrH B AOCTynHOCTH anKOrOnA B 17onblIIe B 1980-x, KOTOpble MbIOniiCblBanu paHee He TOnbKO npHBenn K pe3KOMy CHFDKCHHiO o6Luer0nOTpe6neHFIA, HO H KOJIH4eCTBO nepBIii-IHbIX 06paLLjeHFii3 C

anKOrOnbHbIMH nCNXo3aM13 H anKOrOnbHOi3 3aBFiCFIMOCT610

yMexbLHHnocb 1104TH Ha uBe TpeTFI (Wald and Moskalewicz, 1986).O6LuHH pe3ynbTaT 3uecb COCTOHT B TOM, iiTO coxpaujeHHeKOnHLieCTBa HapyLUeHHi3 061ueCTBeHHOrO nopAAKa, HaCHnbCTBeHHbIX.

npeCTynneHFiii, nonauaHFtli B 60nbHHL4y no BHHe anKOronA LIaCTO5IBn51eTCA 60nee 3HaLIFITenbHb1M, geM CHH)ICeHFie O6ujerOnoTpe6neHHA.

TaKHe pe3ynbTaTbI MoryT O6b51CHATbC31 TeM CliaKTOM, 74TO nK)uH,

XpOHHLieCKH 3noynoTpe6nAK)ujHe anKOroneM H HMeiOLCjHe 6oneeH143KHi-i 3KOHOMH4eCKHii CTaTyC, nonBepraK)TCA 6011bLneMy BJIHAHHK),

geM Te nbHJLIjHe, KOTOpble o6nanaK)T 60nbIIIHMH pecypcaMH 14 MOryT06oiiTH 3TO COKpaLLjeHHe nOCTynHOCTH. l'1CKn104eH14eM 143 o6LueronpaBHna ABFinaCb 3a6aCTOBKa B(13HHnAHuHH B 1972 r., KOrua iiaCTOTaapeCTOB 3a nbAHCTBO 6e3A0MHbIX XpOHIiLieCKFiX ânKOrOnFiKOB

COKpaTHJIOCb B MeHblHeii CTeneHH, geM McHee COljnanbHO

H3OnHpOBaHHbIX nbiOlijHX (Osterberg and Saila 1991). B TO BpeMA

198

HeneranbHblN anKOrOnb IIIHpOKO HCIIOn630BanCA cpeAH 6e3,4oMHbIX

nbAHHij B CDHHnAHAHH, H, CneJ.tOBâTenbHO, OHH nojjBeprnHcbMeHb1IlcMy BnHAHHiO H3MeHeHHi%I ,I(OCTynHOCTH neranbHorO aJIKOronA.

Bo BpeMA 3a6acTOBKH 1985 r., xOrAa HeneranbHblr%I anKOTOnb HenoTpe6nxncA, pe3ynbTaTbI B (DHHJIAH,I;HH BHOBb COBnanH c o6lueFiKapTHHOf4: KOJIHTIeCTBO apeCTOB 6e3,I10MHbIX nbAHHLt COKpaTHJ1OCb

HaMHOrO pe3LIe, gem KOJIHLIeCTBO apecTOB niOZ[eM, HMeioLL[HX )KHnbe

(Osterberg and Saila 1991).

Apyron pA,ii ,a0Ka3aTenbCTB nonyLieH IIpH 3xCnepHMeHTanbHOM3aKpbITHH BHHHO-BO,I;OLIHbIX Marâ3HH0B no Cy66oTaM B LIIBeLjHH B

1981r., KOTOpoe noKa3ano, KaK Aaxce MHHHMaJIbHble H3MCHeHH51,I[OCTynHOCTH anKOrOnA MOryT OKâ3bIBaTb Bb160p0LIHbIFi 34xpeKT Ha

nbAHHIX C OrpaHHLIeHHbIMIi pecypcaMH. 3aKpbITHe BHHHO-BOjjOLIHbIXMara3HHOB no Cy66oTaM npHBeno K CHH)KeHH1O nbSIHCTBa B

o61I(eCTBeHHbIX McCTaX, LIHCna ,ItOMau1HHX CKaH,ganOB H

HaCHnbCTBeHHbIx npecTynneHHïl (Olsson and Wikstrom 1982; Lenke,1990). Bo3MomKHOe 06bACHeHHe COCTOHT B TOM, LITO COLjHanbHO-H30JIHpOBaHHble nbAHHLjbI HCnbITbIBaIOT CJIO)KHOCTH B nnaHHpOBaHHH

CBOerO nOTpe6neHHA H B HaKOnJIeHHH cpe,gCTB, LiTO6bI CnpaBHTbCA cnepepblBaMH B npe,gJIO)KCHHH anKOTOnA. bOnee TOTo, Nordlund (1985)06Hapy)ICHn, TITO 3aKpbITHe CneljHanH3HpoBaHH6IX Marâ3HHOB

p03HHLIHOM TOprOBnH B HopaerHH no Cy66oTaM B TeLieHHe roAaOKâ3an0 3HaTiHTenbHOe Bo3,IjelicTBHe Ha npo6neMHO nb10CgHX.

KonHLIecTBO OTTIeTOB fIOnHLjHH O nbAHCTBe H,I;OMaLIIHHX cKaHljanaX

no Cy66oTaM H B nepBOH nOJIOBHHe AHS1 BOCKpcCCHbA yMeHbuIHJIOcb.

HCCne,qOBâHHA, KOTOpble OueHHBa1OT nOCne,IjCTBHA CHCTeMbIpanHOHHpOBaHHA Hull eë OTMeHbI, npeAcTasnAiOT HaM cneAyfoluHHpA,q AOKa3aTenbCTB. OTMeHa paLjHOHHpOBaHHA CnHpTHOrO B 1955 r. B

LIIBeL[HH COnpOBO)xZ[anaC6 LIeTbIpeXKpaTHbIM nOBbIIUeHHeM

CMepTHOCTH B pe3ynbTaTe L(Hppo3a (Norstrom, 1987), B TO BpeMA KaKOTKa3 OT panHOHHpOBaHHA B I'peHnaHAHH npHBen K nOBbILIIeHH10ypoBHA 3ape1-HCTpHpOBaHHbIX HaCHJIbCTBeHHbIX npeCTylLfIeHHIi,

,i[oMaulHHx ccop H cnyLlaeB OTCyTCTBHSI 3a6oTbI o ,i(eTAx (Schechter,1986). CneAyloluHri H OLlexb Bâ)KHbIiï pA,ij ROKâ3aTenbCTB

npOHCXOjjHT 143 06CyKrteHHbIX BblLUe HCCne,loBaHHFi noMHHHMan6HOMy Bo3paCTHOMy npeAeny (6.3.8), r,ge pe3ynbTaTbI

y6ej[HTen6H0 nOKa3bIBaiOT, LITO 3KOJIOCHLIeCKHe Mepb1 MOryT

npej.jOTBpaTHTb cHTyanHOHHO-OnacHOe nOBe,1;eHHe MOJIOJibIX nK)Jje1i,

KOTOpble CKJIOHHbI K 3nOynOTpe6neHHIO anKOroneM. H HaKOHeIj,

199

HccnenosaHHSI o6yliexxx nepcoHana (6.3.9) H OTSeTCTBexxocTHnepcoxana (6.3.10) npenocTasnaloT Aoxa3aTenbCTBa no ApyroMyspiny cTpaTerHH, KOTOpbIIi MO)KeT BO3AeIiCTBOBaTb Ha nb5IHH11.

B HTOre, TaKHM o6pa30M, MO)KHO CAenaTb O6OCHOBaHHbINBbIBOA, LITO Ha6op 3KOJIOFHLIeCKHX Mep nOBnHSieT Ha noBeneHHeLIpe3MepHO HnH npo6neMH0 nbtOnjHX. B TOIi Him HHOIi (l)OpMe, 3TOT

BbIBOA nOCTOSIHHO noATBep)KAaeTCSI. r1pOTHBOnOJIO)ICHble FHHOTe3bI o

TOM, LITO KOHTpOnb AOCTyna B OCHOBHOM COCTaBHT HeyAO6CTBO AJISI

TOit iiaCTH HaCeneHHSt, KOTOpaSI nbeT yMepeHHO, B TO BpeMSI KaKHaH60nee BpeAHOe nOTpe6neHHe LIpe3MepHO nbIOIIjHX OCTaHCTCSIHe3aTpOHyTbIM, OCTanHCb HenOATBep)tCAëHHbIMH.

6.4 TOPFOBbIE COF03b1 V1 ,gOCTYIIHOCTb AJ1KO1-OJ1S1

KaK y)Ke roBOpHnocb, HcTOpHLIecKHe orpaHHLIeHHSI AOCTynHOCTH

anKOFOna H HanHLIHSI ero B p03HHLIHOIi ToproBne SIBnSIiOTCSI

BHyTpeHHHMH, a He MewnyHapOAHbIMH. B 60nbIIIHHCTBe CTpaHanKOronb, KOTOpbIÎ-t 11p0113BOAHTCSt B 3TON cTpaHe, TM we HnoTpe6nsleTcsl, HO eCTb CTpaHbl BCCbMa 3aHHTepeCOBaHHbte B

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204

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222

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(Homel, 1988).

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BoA11Teneli (Committee on Benefits and Costs of Alternative FederalBlood Alcohol Concentration Standards for Commercial VehicleOperators, 1987).

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223

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npHOCTaHOBKa AeiiCTBHSi BOAHTenbCKHX npas 6bina CaMOii

3ci(tleKTHBHOii. Tashima H Peck (1986), Sadler H Perrine (1984),McKnight H Voas (1991) o6HapyxcHRH, HTO cpeAH BTOpHiIHoHapyLHHBLHHX 3aKOH O BO)KAeHHH B HeTpe3BOM COCTOMHHH, TeBOAHTenH, AeriCTBHe npas KOTOpbIX 6bIM0 npHOCTaHOBneHO, HMenHBHOCneACTBHH 6onee HH3KHÎ1 ypOBeHb HeC'IaCTHbIX Cny'-IaeB B HbMHOM

BHAe, 'ieM Te, KOrO OTnpaBnMnH Ha Re'ieHHe OT aRKOrOMH3Ma. CMOTpH

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224

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HeTpe3BOM cOCTOAHHx.

Zador et al. (1988) 143MepAJIx 3I141eKTIiBHOCTb TpeX THIIOBHaKâ3aHxA H npxlilnx K 3aKnI01IeHxIO, 'ITO npxOCTaHOBKa stieNCTBxAnpaB 06naJ[aeT Hax6OnbLIIxM 34)(1)eKTOM. 3T0 xCCneJjOBaHxe, KOTOpOeOXBaTxnO HecKOnbKIiX IIITaTOB CHIA, npeJtCTaBxnO AâHHble 06344eKTI4BHOCTx C,itepNCHBaHHA c nOMOLI[bIO npxcyNCJ(eHNA KpaTKHX

CpOKOB TiOpeMHOrO 3aKnIOLIeHxA 3a nepBblN cnyLlax BONCJjeHxA BHeTpe3BOM COCTOAHxH.

Snortum et al. (1986) coo6LualoT, LITO npo6neMHO nbloluxx BHopBerxx yJlepNCxeanx OT BONCZ(eHxA B HeTpe3BOM COCTOAHxx

yrpo3or4 TIOpeMHOrO 3aKnI011eHx51. CXO,IHble pe3ynbTaTbl 6binxnonyLleHbl B CllIA, nOCne BBe,iZeHxA 60nee cypOBbIX caxxLjlili(Nichols, 1988; Insurance Institute for Highway Safety, 1987a,1987b).

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225

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HeTpe3BOM COCTOAHHH 6onee TIeM OAHH pa3, oC06eHH0 3a KOpoTKNNnepllOA BpeMeHH, CKOpee BcerO, MHOrO nbK)T. B pe3ynbTaTe neTleHHeMO)KeT 6bITb Ha3Ha4eHO CyAOM KaK TIaCTb ilni! anbTepHaTHBaTiOpeMHOMy 3aKnIOTieHHIo. KpaTKHe 3aMeTlaHHA 06 3(14eKTHBHOCTHHa3HaTMeHHOrO CyAOM neTIeHHA npHBOAATCA nO3)Ke B rnase 9 BKOHTeKCTe 6051ee HIHpOKOIi AHCKyCCHH 06 34)(beKTHBHOCTH neTleHliA.

.11eTleHHe nK)Aeii, MHOëOKpaTHO HapyIIIFiBIIIi-iX 3aKOH O BO)K,TjeHHH

B HeTpe3BOM COCTOAHilH ABnAeTCA npHMepOM napaAOKCanp0(pHnaKTHKH. TaKHe BOAHTenH, ilMeA BbICOKyK) CTeneHb nHTIHOrOpHCKa, He CO3AaK)T 60nbHIHHCTBa CB513aHHbIX C ânKOrOneM npo6neM(Perrine, Peck and Fell 1989). CAepxcHBaHHe 6yAymero so)iCAexHA BHeTpe3BOM COCTOAHHi! CpeAH BcerO HaCeneHilA, TaKilM O6pa3OM,ABnAeTCA HaH60nee 3(I(beKTHBHOii CTpaTerHeiï.

7.2 HA3HA4EHVIE BO,gNTEJ1EM

OAHOii H3 cTpaTerHii COKpameHHA CB513aHHbIX C anKOrOneMaBTOKaTaCTpo(l), ABnAeTCA Ha3HaTieHHe OnpeAenëHHOrO TlneHa AaHHOH

rpynnbi nioAeH, KOTOpble co6HpaioTCA BMeCTe sbinHTb, BoAHTeneM,KOTOpbIÎ! He 6yAeT nHTb Hni! BbinbeT nHIIlb HeMHOrO. l'1CHOnb3OBaHHe

"Ha3HaTleHHOrO BOAIiTenA" ABn51eTC5I nonynApHOi%I CTpaTerHeii BOMHOrHX cTpaHaX. AnbTepHaTHBOi%I ABnAeTCA CTpaTerHA 6e30naCHOiïe3AbI, KOrAa nblOn.[He HaHHMaIOT KOrO-51H60 N51H HM 06ecneTlHBaK)T

HanHTIHe BO3MO)KHOCTH 6e3onaCHO AOeXaTb OT MecTa BbIHHBKH AOAoMa (Apsler, 1988). geMOHCTpauHOHHble npOrpaMMbl, HalueneHHble

226

Ha yxpenneHHe noAxona "Ha3HaLtexne BonHTenA", noxa3anHnOBbILUeHHe LLHcna coo6LueHHil o6 yLiaCTHH B TaKHX nOnbITKaX>KHTeneli CHIA, HO 3T0 nOBbILUeHHe He MO>KeT 6bITb 6e30r0B0pOLIHOnpunHcano oco6oH peKnaMe 3TOro nonxona (DeJong and Winsten,1989). KpHTHKH pelueHHA "Ha3HaLIeHI35I BoAi3TeneM" npeAnonaraloT,LITO 3T0 MO>KeT CnOCO6CTBOBaTb LIpe3MepHOMy H He6e30nacHOMynoTpe6neHnlo cpeAH npyrHx yLIaCTHiiKOB rpynnbl H MoxceT

nOApbIBaTb aHTI-IâJIKOrOnbHble peKOMeHnaL[HH AnSI MOJIOne>iCH

(DeJong and Wallack, 1992). KOHTpOnbHble OL(eHKÜ 34)(tieKTa

cTpaTerHH "Ha3HaLIexxe BOAHTeneM" Ha coxpaH.teHHe CB5I3aHHbIX c

anKOrOneM aBTOKaTaCTpO(I), OTCyrCTByIOT.

7.3 AJIKOrO11b V1 BO)MEHV1E 11O,11KV1

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roAbl 6bino npli3HaHO npo6neMol3 o6LLrecTBexxoÎI 6e3onacxoCTii BcTpaHax, rAe KaTaHHe Ha nOAKe SIBJIAeTCSI OCHOBHbIM BHAOM OTAbIXa.

B(13HHnAHAHH B 60nee nOJIOBHHbI, a B HeKOTOpbIX pai70HaX no 75%ncex CMepTenbHblX CnyLlaeB npH BO>KneH1-iFi nOAKH npOH3OIilnO npH5103HTHBHOM yposxe CAK y yLIaCTHHKOB (Pikkarainen and Penttila,1990). Ee30naCHOCTb BO>KneHHA MOTOpHbIX nOAOK SIBnSIeTCSI, TaKHM

06pa30M, 065IaCTblo 06LLjeCTBeHHON O6eCIIOKOeHHOCTH B 0:13HHnSIHnHH.

libIJIO 06Hapy>KeHO, LITO Cpenii ynpasnRloujl-Ix nOAKOIi nloneN,CTaBHIHX yLiaCTHHKaMH HeCLIaCTHbIX cnyLlaeB B CIllA, 50% nHnHcnllpTHble HanHTKH (National Transportation Safety Board, 1993), a BTeLIeHHe AByxneTHerO H3yLieHHA B LIITaTe KanH(tiOpHHSI 6bIJI0O6Hapy>KeHO, LITO ânKOrOnb ABnAeTCA (f)aKTOpOM aBapHI3HOCTH B 59 %

HeCLIaCTHbIX CnylaeB npH KaTaHHH Ha MOTOpHOil nOAKe (CaliforniaDepartment of Boating and Waterways). I'nasxOï-i npHLIHHoH cMepTHnloneH, yTOHyBLIIHX B pe3ynbTaTe HecLiacTHOro CnyL-IaA npH KaTaHHHHa nOAKe, LI3CT0 ABnAETCA BbICOKHH ypOBEHb CAK. B-HHnAHAHH B70% BCeX HeCLIaCTHbIX cnyLlaes ripa BO>KneHHH nOAKH, yTOHyBII1HeHMenH yposexb 6onee 10 Mr% (Pikkarainen and Penttila, 1991).Howland H Hingson (1988) npoBenH o6LLtHl3 o63opHCCneAOBaTenbcKHX naHHbIX no anKOrOnIO H yTOnneHHHKaM,

BK1I011a5I nOAOLIHbIC KaTacTpO(Ibl.

B HeKOTOpbIX HHAyCTpHanbHbIX cTpaHâX 3aKOHOM yCTaHaBnHBanCA

npenenbHbll4 ypOBeHb CAK nJIA BOAHTeneH nOAKH, XOTA OH 06bILIHOBbILLIe, LIeM yCTaHOBneHHblli ypOBeHb nnA BO>KAeHHSI aBTOMO6Hn51 B

227

Toil ?foe cTpaHe. HanpHMep, 3ax0H B cDHHnsIHAHH onpejjenAeT ypOBeHbCAK B 150 Mr% (no CpasHexHlo c 25 Mr% jjnA jjopor), a nposepxa.iZblxaxHSI Ha BOjjaX npoBOAHTCSI Ha o3ëpax B nepHOjj neTHHX MecSIueB.CxoAHasl nporpaMMa oCTaxOBKH H nposepKH npoBOjjnnacb B CiiiAnpH6pexcxoli CJryxC6oii. OckleKT TaKHX 3aKOHOB o6 ypOBHe CAK HaKOnHLIeCTBO nOj(OLIHbIX KaTaCTpOCl) HIM CMepTenbHblX HeCLIaCTHbIX

CnyLlaeB CHCTeMHO He H3yLIanCA.

7.4 AJIKOROJ1b M rPA)K,gAHCKASI ABV1AlAU1A

Bo3jjeliCTBHe anxoronsl Ha HaBbIKH nHnoTHposaxxsl H BOxcjjeHHAcaMoneTa ABnsIeTCSI 3HaLIHTenbxblM (Billings et al., 1991). BbinonojjCLIHTaHO, LITO 30% CMepTenbHO TpaBMHpOBaHHbIX nHJIOTOB

LIaCTHbIX CaMOneTOB 6b1nH B COCTOAHHH OnbAHeHHA (Holdener, 1993;Gunby, 1984). PHCK BO3HHKHOBeHHA CBA3aHHbIX C anKOrOneMKpynHblX KaTaCTpocli COCTaBJISIeT npejjMeT onaceHHA AnaKOMMepT-ieCKOli aBHauHH H, npejjnonaraeTCA, LITO nHJIOTbI jjonx<HbI6bITb Tpe3BbIMH. B CHIA 3T0 onpejZeJIAeTCA, KâK HeynOTpe6neHHeânKOrOJIA B TeLIeHHe 8 LIaCOB no noneTa, a yposexb CAK 4 Mr% HJIHBbIllle ABnAeTCA HenpHeMneMbIM (ICADTS Reporter,1991). BIIIBelivapHH npasnno "8 LIaCOB 6e3 anKOronA" npHBOjjHTCA B

pyKOBOjjCTBe n0 BOxUjeHHIO, HO He yCTaHOBneH OnpejjeneHHbINypoBeHb CAK (Holdener, 1993). HauHOxanbHble aBHanHHHH BEspone npoBOjjAT nporpaMMy, c(f)oxyCHposaHHylo Ha npo(liHnaKTHKe,paxxeM BbIABnexHH H neLIeHHH nHJIOTOB, 31I0ynOTpe6n5110IijHX

aJlxoroneM (Holdener, 1993). CxojjxaA nporpaMMa 6b1na BsejjeHa BCI_IIA COBMeCTHO C ACCOLjHaLjHeN nHJIOTOB aBHanHHHN. C 1990 rojja

HCnOnb3yeTCA HauHOHanbHbll'i perHcTp BojjHTeneli CHIA, LiTO6blOnpejjenHTb H nHIiIHTb npasa noneTOB nHJIOTOB, KOTOpble

yLIaCTBOBâJIH B npaBOHapylneHHAX, CB513aHHbIX C anKOrOneM HJIHHHbIMH HapKOTHKaMH (Sweedler, 1993). BHHMaHHe K pones anKOronAB CMepTenbHbIX aBHaKaTacTpocbaX B CHIA npHBeno B pe3ynbTaTe KCOKpaII[eHHIO KOJIH'-IeCTBa CnyLlaeB CMepTenbHOTO TpaBMHpOBaHHA

nHJIOTOB, HaXOjjAIIjHXCA non jjeliCTBHeM anxoronA (Yesavage andLeirer, 1986), HO He06XojjHMo nposeCTH 6onee TIIjaTenbHbleHCCnejjOBaHHA n0 OueHKe 344eKTHBHOCTH.

228

7.5 OfPAHV14EHV1A no MECTY f10TPE6J1EHVIAAJ1K0r011A

11onNTNKa 3anpelljeHNSi noTpe6nSIT6 CniipTHOe B onpeAenexxblxMecTâX npMMeHAeTC51 B pa3nMt1HbIX liaCTAX MMpa. B CeBepHOHAMepHKe 3T0 O6bI1IHO 11pOBOANJ1OCb B paMKaX 3aKOHOB npOTHBny6nNiiHOrO nbAHCTBa (NHOPAa, LITO6bI npeAOTBpaTNTb OnbAHeHMe Ha

n1oAAx). He TaK j[aBHO, KaK LIaCTb nOnMTMKM 061ueCTBeHHOM

6e3onacHocTN, 6bIJIO BBeAeHO 3anpeL[jeHNe 11oTpe6n51Tb anxoronb Bnapxax, MecTax OTu61Xa, TaxiiX KaK nnSDK, Ha pa6o9Nx MecTax HJIH B

aBTOM06NnSIX.

O6CyxcAeHMe OrpaHNLIeHHIi noTpe6neHHA CnHpTHOCO B

06HtecTBeHHbIX McCTaX B KaHaAe 6bIna nposeuexo Giesbrecht MDouglas (1990), Murray H Douglas (1988), rue 3TH MepblpaCCMaTpHBaIOTcSI, KaK CpeRCTBO COKpaTNTb KOHIIInMKT6I H HaCNnNe B

061I1eCTBeHHbIX napKaX H CHH3HTb yXyAHIeHNe HaBbIKOB ynpaBneHNA

y BoJZNTeneN, Bble3)KaK)Ii1NX 143 napKa, rAe BO3MMiCHbI BbIHNBKM.OUeHKa TaKON MyHHI.jNnanbHON 11OJ114TNKN B 3anaAHOM OHTapMO

6bina nposeuena Gliksman et al. (1990). B noABeprHyroM3KCnepNMeHTy paHoHe cywecTBOBana noBblHlexnoe o6n.tecTBeHHOenoHNMaHNe 3THX orpaHNileHNH H noablLneHHOe )KenaHMe

nOA11NHATbCA HM 6e3 KaKMX-11H60 N3MeHeHHH KOHTpOJ151. 3TH AâHHble

rlpeJjCTaBNnN nepBOHaiIanbHble AOKa3aTenbCTSa, 7iTO 1110AM He

06513aTenbH0 npOTNBOCTOAT MeCTHOH nOJINTHKe OrpaHNLIeHMA

nOTpe6neHMA anKOrOnSI B MCCTaX 061I.AeCTBeHHOrO OTAbIXa. RO CMX

nop He CyIIteCTByeT KOHTpOnbHOH OIjeHKM 343(tieKTOB 3T01'O pO.IjaOrpaHMHeHNH Ha CB513aHHble C anKOrOneM CO6bITN5I B 061HeCTBeHHbIX

McCTaX NnM BJINAHNA Ha nocneuylolltNe CnyLIaM BO)KAeHNA B

HeTpe3BOM COCTOAHMN.

CTauNOHbI BcerO MNpa ABJIA1OTCA McCTOM HINpOKOMâcHITa6HOH

CNOpTNBHOH AeATenbHOCTN n1oAeH. K TOMy )Ice, OHM ABnAIOTCA BCë

6011ee Bâ)ICHbIM NCTOiiHHKOM AOXOAa, BKnK)LIaA npM66lnb OT npOAa)ICM

anKOrOJIA. rOpAOCTb 3a KOMaHuy, KOrAa oHa COBMeH(aeTCA C

nOTpe6neHMeM anKOrOJIA, MONCeT BpeMeHaMN BbInNTbCA B 6yHHOe,Bpaxcue6Hoe I11114 HaCNnbCTBeHHOe noBeueHMe. B CTpaHaX, rixe

06H(enpNHATbIM CpeACTBOM e3A6I AO cTauNOHa SIBJISIeTCA nM4HbIHaBTOM061,111b, BO)Ic.ZjeHMe B HeTpe3BOM moue MO)KeT 6bITb u06aBneHO K

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OTubIXa. B pe3ynbTaTe BO MHOI'NX CNOpTMBHbIX COOpy)KCHMAX3anpelueHO nOTpe6neHMe H npouaxca anxoronA, HAN npouaxca

229

anxoronA 3asepUIaeTCA no xpaiiHeii Mepe 3a =lac go KoHlja

CopeBHOBaHHii, LITO6bI COKpaTHTb ypOBeHb CAK nbiOnjil?C 3pliTenei1

(Coleman, 1991; Fisher and Single,1987). 344eKTHBHOCTbn0Jj06HbIX OrpaHHLieHMii Ha CTaJjHOHaX He H3YLIanaCb.

7.6 OT,gEJ1EHNE f1OTPE611EHV1A A11KOrOJIA OTOIIACHbIX C101TYALIVIN: YPOKIVI, KOTOPbIEHEO6XO,0,14MO YCBOATb 11 f1YT101 f1PO,gBU1)KEHVIABIlEPE,q

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3aKOHbI npOTHB BO>K,LjeHMA B HeTpe3BOM COCTOAHHH, KOrJga OHH3HeprHLiHO npeTBOpAIOTCA B>KH3Hb, ABnAIOTCA BbICOK03I1CpeKTHBHON

rOCyJjapCTBeHHOM nOJIMTHKON B nnaHe npeJjOTSpaLLjeHHA TpaBM HcnaCeHHA >10H3HeN. OJgHaKO 3TH ycneXM rOCyJgapCTBeHHOii nonHTHKHH 06LuecTBeHHOe nOHHMaHFie He06XOJjHMOCTH eë BbIHOJIHeHMA HenpHLLInH B OJgMH JjeHb, OHH nposOJjFUIHCb nOCTeneHHO, npHnOCTOAHHOM CTHMYnHpOBaHHH H nOJiJgep>KKe HCCneJjOBaTenbCKMX

}CHJIHIi.

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TepneHMe MOryT npMBeCTH K 6naronpHATHbIM pe3ynbTaTaM.

BBeJgeHHe 3aKOHOB n0 BO>iC,IjeHHiO B HeTpe3BOM COCTOAHHM MO>KeT

6bITb Ha3BaHO "yMHOii nonHTHKOii": MbI 3HaeM, LITO OHa JgeiiCTByeT HnOHHMaeM, KaK yCHJIHTb eë JjeiiCTBHe. ApyrOii ypOK COCTOHT B TOM,LITO MbI MO>KeM yBMJgeTb 3JjeCb MHTepeCHbIFi npHMep npOBeJjeHHA Mep,

JjeiiCTBYIOLLjMX B LjenAX HHTepeCOS o6LLjeCTBeHHOFO 3J[OpOBb5I, HO Ha

OCHOBe 3aKOHa, KOTOpblli BbIHOJIHHM TOnbKO npn noJjgepxcxeo6LgecTBa H npH OCO3HaHHH pHCxa 6bITb 06Hapy>KeHHbIM H

BO3MO>KHO apeCTOBaHHbIM. B 3aKJIK)LIeHHe MO>KHO yrBepxcJgaTb, LITO

OnbIT n0 nonHTHKe npOTHBOCTOAHMA BO>KJgeHHIO B HeTpe3sOM

COCTOAHHM YKa3bIBaeT HaM Ha TO, LiTO OnpeJjeneHHble B03JgeiicTBMA,HaLjeneHHble Ha OnpeJgeneHHble THnbI CBA3aHHbIX C nOTpe6neHHeM

230

anKOCOnA npo6neM MoryT npxxecTH nOnb3y TaK )Ke, KaK H o6uH4eCTpaTeCHH THna TeX, KOTOpble MbI 06CyfflanH B JxpyrHx rnaBax.

11To KaCaeTCA JjanbHeFiüIerO npOJjBH)KeHHA BnepeJ( no np06neMe

BO)K,aeHHA B HeTpe3BOM BHJJe, TO 04eBHJLHa He06X0JjHMOCTb

npOnOn)KeHHA HCCne,a0BaHHi7, JjaJIbHeNHIero pâ3BHTH51 nOnHTHKH H

peulHTenbHOCO H IIIHpOKOMaCnITa6HOCO BbIHOJIHeHHA CynjeCTByIOmHX

peuleHHli. CyaxeCTByIOT TaKACe HHTepeCHble BOnpOCbl Ha TeMy, KaK

ypOKH, yCBOeHHble B CB5I3H C nOnHTHKOR npOTHBOJjeFICTBHA

BO)KJjeHHIO B HeTpe3BOM COCTOAHHH, MOryT 6bITb pacnpoCTpaHeHbl Ha

J(pyrHe THnbI npo6neM. MbI ynOMAHynH B 3TOII rnase HeCKOnbKoCXO)1HbIX 06nacTei7, r,IJe CymeCTByeT nepBblli OnbIT HOnHTHKH, XOTA

3,4eCb JJO CHX nop HMeeTCA o4eHb MânO HCCneJjOBaTenbCKHX OL[eHOK:

BO)KneHHe nOAKH, ynpaBneHHe CaMOneTOM H 3aKOHbI, HanpaBneHHbleHa perynNpoBaHHe nOTpe6neHHA anKOCOnA B o61ijecTBeHHbIX MecTaX -

BOT HeCKOnbKO npHMepoB. Heo6XOJ(HMO ewe TBOp4CCKH nOJjyMaTb O

upyrHx THnax npo6neM rJie, nOnb3y5lCb noJUiep)KKOÿ O61ueCTBa,MO)KHO pa3pa6oTaTb nonHTHKy H OTAenHTb nOTpe6neHHe anKOronA OT

nOTeH1[HanbHON onaCHOCTH.

231

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239

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3I1-4eKTa. Pe3ynbTaTbi nOCTOAHHO AeMOHCTpnpOBanH 60nee HH3KneypOBHH nOTpe6neHNA a11Kor011A H CBA3aHHbIX C 3THM npO65IeM, TaKHX

KaK ypOBeHb CMepTHOCTH B aBTOKaTaCTpOItiaX B TeX cTpaHaX, rAe 6bin

BBe,gëH 3anpeT (Saffer, 1991). B cTpaHax, r,ae ,Ijei%ICTByeT 3anpeTpeKnaMbI KpenKHX CnHpTHbIX HanHTKOB, ypOBeHb noTpe6neHHAanKOr011A nOi1TN Ha 16% HH)Ke, item B cTpaHax, rae TaKOrO 3anpeTaHeT; B TO BpeMA, KaK B CTpaHaX, r,ge ,aeNCTByeT 3anpeT Ha peKnaMynHBa H BHHa, ypOBeHb nOTpe6neHHA aJIKOrOJTM 11011TH Ha 11% HHxCe,

gem B cTpaHax, rJ(e cyn(eCTByeT 3anpeT TOnbKO Ha peKnaMy KpenKI4XCI1IipTHbIX HanHTKOB. ypOBeHb CMepTHOCTH B aBTOKaTaCTpO43aX 6bin

Ha 10% HHxCe, KOrJ1a 6bina 3anpeliteHa peKnaMa KpenKHX CnHpTHbIXHanHTKOB, H Ha 23% HHxCe B CTpaHaX, me BMeCTe C 3anpeTOM HapeKnaMy KpenKHX CnHpTHbIX HanHTKOB AeiiCTBOBan TaK)Ke 3anpeT Ha

pexnaMy nHBa H BHHa. KOHeiiHO, BIIOJIHe BepOATHO, LiTO TaKHepa3nWIHA TaiUKe oTpa)KaiOT Jtpyrne H3MexeHHA B o6n(ecTBe,

npHBO,i1,AItuHe K TOMy, LiTO COIIHanbHblN KJIHMaT ,aOCTHraeT TONCTa,11HH, KOrAa 3anpeT peKJIaMbI CTaHOBHTCA npHeMneMON nOnHTHKOH

(Young,1993; Saffer, 1993).

B HeKOTOpbIX HCCJIeAOBaHHAX HCnOnb30BâJIHCb JjaHHble OnpOCOB

H ,genanaCb nOnbITKa 06Hapy)KHTb B3aHMOCB513b Ha HHAHBHJjyanbHOM

ypoBHe Mexc,gy CaMOOTLIëTOM O npoCMOTpe peKnaM6I H ApyrHMHCOOTBeTCTByIOnIHMH nepeMeHHbIMH, BKniOilaA nOBeAeHHe H

nO3HaHHA, O KOTOpbIX COO6HMeT CaM LIe110BeK. 3TOT

245

HCCneAOBaTenbCKHIï nOAXOA He n03BOnSIeT H3MepHTb ,gonrocpOLIHbII%I

HaKOIIHBIIIHIiCSI 3C1(1)eKT peKnaMbl aJIKOrOnSI, COrnaCHO

TeopeTHLIeCKHM oCHOBaM rHnOTe3bI KynbTHBauHH (Gerbner eta1,1986) H TeopHH couHanbxorO o6ytIeHHSI (Bandura, 1977, 1986).

TeM He McHee, CJIO)KHO, HCHOnb3y51 jjaHHble OnpOCOB pa3nHLIHbIX

CeKTOpOB 061ijeCTBa, BbISiBHTb npHLIHHHOe HanpaBneHHeB3aHMOCBSI3H. 1libIJIO npOBeAeHO -rpm HCCne,ijOBaHHSI cpeAHnOApOCTKOB H MOJIOAbIX nIOAeï'r, H BO BCeX 6bina 06HapyxceHaHe60nbulaSl, HO 3HaLIHMaSI B3aHMOCB5I3b Me)KAy npOCMOTpOM peKJIaMbI

anKOrOJISI H 6onee BbICOKHM ypOBHeM noTpe6neHHSI, O KOT'OpOMC006ujaIOT yLIaCTHHKH, a TaK)ICe COOTBeTCTByiOIuHM OTHOUIeHHeM Kanxoronlo (Strickland, 1982, 1983; Atkin, Hocking and Block, 1984;Atkin and Block, 1984). FibIJIO o6Hapyxcexo, LITO pexnaMa nHBanoBbluiaeT noTpe6neHHe rima cpe,ijH nOApoCTKOB H MonojjbIX niOljeli.Cornacno Strickland nSITHMHHyTHOe ysenHLieHHe npocMoTpapeKnaMbl anKOrOnSI COOTBeTCTByeT nOBbIUICHHIO noTpe6neHHSI HanSITb rpaMM 3TaHOna B AeHb. HanpHMep, B npOBeneHHOM cpe,tuHMOnOAbIX nloAerI HccneAosaHHH Atkin H Block (1984); Te, KTOcoo6njan o LIacTOM npocMoTpe peKnaMbl nHBa H BHHa, BbInHBanH BcpeAHeM TpHAUaTb ßO3 nHBa 3a npeAbl,CjyIIjHFi MeCSIu no cpaBHeHHIO crpynnoFi He CMOTpSIUjHX peKnaMy H noTpe6HBLUxx B cpeAHeMnSITHaAUaTb n03 nHBa. r10Tpe6neHHe KpenKHX CHHpTHbIX HanHTKOBTaK)iCe BapbHpOBanOCb B 3aBHCHMOCTH OT npocMoTpa neLIaTHOIipeKnaMbl KpenKHX CHHpTHbIX HanHTKOB B CpeACTBaX MaCCOBOIiHH(l)opMauHH. II03HTHBHOe COOTHOUleHHe, 06HapyNCeHHOe B 3T14Xo63opax Me)KAy npOCMOTpOM peKnaMbl, nOTpe6neHHeM anKOI'OnSI HOTHOIIIeHHeM K anKOrOnIO npHCyTCTByeT Torna, KorAa ApyrHe,BHOCSIIijHe CBOI%I BKnaA nepeMeHHble, TaKHe KaK AeMOrpaCpHLIeCKHiâCpaKTop, BnHSIHHe O6HjeCTBa H npOCMOTp MaTepHâTIOB cpeACTBMaCCOBON HH(flOpMaLjHH C HH6IM COnep)ICaHHeM HaXOASITCSI nOA

KOHTpOneM.

gaHHble OnpocOB Tax)ICe Co6HpanHCb AnSI H3yLleHH5I BnHSIHHSIpeKnaMbl anKOrOnSI Ha TeX, KTO enje He nbeT. B HeAaBHeMHCCneAOBaHHH CpeAH AeTeri CHIA B03pacTa OT AecSITH AoLIeTbIpHaAUaTH neT HCHOnb3OBanOCb HeBO3BpaTHOe MOAenHpOBaHHe

CO CKpbITbIMH nepeMCHHbIMH AnSI OLjeHKH B3aHMOCB513H Me)ICAyAeTCKHM nOHHMaHHeM peKnaMbl anKOrOnSI H y6enCjjeHHSIMH onoTpe6neHHH H HaMepeHHH nHTb (Grube and Wallack B neLIaTH).gent, KOTOpble npaBHnbHO MOrnH nOHSITb 6011bLIIHHCTBO peKnaMHbIX

246

MaTepi3anoB o nHSe, o6naj[anH 6onee n03HTHBHbIMH y6emKgeHHMMH onOTpe6neHHH aRKOrOnA H rosopHnH, LITO OHH co6HpaioTcSi nHTb=tame, KaK B3pocnbie. 3TOT 3(1)(tleKT coxpaHSIncSI jjamKe Korga060IOJjHblii 34)(1)eKT 3HaHH5I H y6emKJ[eHHA HO OCO3HaHHK) peKnaMbl

KOHTpOnHpOBânC5I.

B OAHOM HeJjaBHeM JjRHTenbHOM HCCRe,i[OBaHHH H3yLIanaCbB3aHMOCB5i3b MemKJty KOnHIieCTBOM BCHOMHeHHOIi peKnaMbl anKOrOnSI

H noTpe6neHHeM anKOrOnSi B 60nee n03J(HeM Bo3pacTe. 3Aecb 6bina06HapymKeHa 3Ha9HTenbHaA B3aHMOCB513b MemKgy KOnHLIeCTBOM

peKnaMbI anKOrOnSi, KOTOpyIO BCIIOMHHnH TpHHagL[aTHneTHHe

ManbLIHKH HOBOIi 3enaHA1114 H HX nOTpe6neHHeM nHBa, O KOTOpOMOHH C006njHnH CaMH B BOCCMHaJjI);aTb neT. L1aCTOTa noTpe6neHHSIânKOronA B BOCCMHaJtIZaTb ReT He 6bina B3aHMOCBSI3aHa C

KORHIIeCTBOM peKnaMbl, HO Te, KTO BCIIOMHHn 6Onbnle peKTIaMbI (B60nbuleii IiaCTH TeReBH3HOHHOii peKnaMbi nHBa) COO61IZHRH onoTpe6neHHH 6onbulero KOJIHIieCTBa nHBa BO speMA cnyHaeBBbInHBKH (Connolly et al, B neLiaTH).

B HTOre, HCCneTIOBaHHA n0 peKnaMe anKOronA, KoTOpble LiacToXapaKTepH3yK)T KaK npej[CTaBnAioütHe He,qOCTaTOIIHO ,ItaHHbIX HnpOTHBOpeIiHBble pe3ynbTaTbl O BnHAHHH peKnaMbl Ha nOTpe6neHHeânKOrOnA (Smart, 1988), 6binH yCHneHbl B nOCneAHHe rOgbITüjaTenbHOi4 KOHIjenTyanbHOH H McTOJjOJIOrHIIecKOH KpHTHKOH

(HanpHMep, Atkin, B nevaTH; Saffer, B neLIaTH). MemKHagHOHanbHbleaHâRH3bI 3anpeTOB Ha peKJlaMy, HeCKOnbKO KOppenAHHOHHbIX

aHanH3OB n0 BnHAHHIO AeNCTBHA peKnaMbl, HCKOTOpble MCTOgHIICCKH

6onee 3HaIIHTenbHb[e 3KCnepHMCHTanbHble HCCRe,IZOBaHHA H OAHOgJIHTenbHOe HCCnegoBaHHe, KoTOpble HMeIOTCA CeliLIaC B HanHLIHH, -BCe OHH npegnonaralOT cyureCTSOBaHHe onpegenëxnoro BnHSIHHA.goxa3aTenbcTBa Toro, tITO BnHAHHe peKnaMbl HesenHKO, HO OHaBHOCHT CBOH BKRaJt B (bOpMHpOBaHHe nHTeiiHoro nOBeJjeHHM, TaKHM

o6pa3OM, CTanH HeMHOrO cHnbHee, LieM paHbule.

8.1.2 3cpcpeicT o6pa3oBarenbHbix KaMnaHHk cpe,gcTBMaCCOBON NHct3OpMaqNN

CTpaTerHA, KoTOpaA LlacTo npHMeHSlnacb ceKTOpaMH 3Apaso-oxpaxeHHA H conHanbxoro o6ecnelleHHM - 3TO nepegaliH HRHny6nHKauHH pexoMeiigal.iHH o6pa3osaTenbxoro nnaxa B Cpe,gcTBaxMaccosoii HHItlopMaI.jHH. Ponti TenesHJZeHHA KaK cpeJjcTSa MaccoBOÎ-iHHcl)opMauHH H pa3BneLIeHHA, CTaxoBHnacb BCë 6onee

247

BcenpoHlixa101ue{i, HCn0nb3OSaHne TenesHjjeHHSI cTaxoBHnocb BC6onee nonynSIpHbIM. r1epBOHaLIanbHble nOnbITKH npHMeHHTb

TeneBH3HOHHble KaMnaHHH, iIT06bI nOBnHATb Ha nOBeJjeHne

OTHOCHTenbHO BbIni3BKH H 143yiieHHe 3THX nOnbITOK, noxoxceI-iCXOAI-IJIN H3 TeOpeTHiieCKOii nepCneKTHSbI "npSIMOrO 3(liCpeKTa". rlpl-i

3TOM O)iCH,11ânOCb, LITO MaCCOBaSI ay,gHTopMSI, KOTOpaH npocnyLUana

y6eJjxTenbHble peKOMeHJlawin win HH(l)OpMaLjIiIO o6 anKorone, 6ygeTnpAMO npocTxMynHpoBaxa K ,geHCTBHIO (Dorn and South, 1983).1ZOCneJjyIOLL[He KaMnaHHH cMOAenxpoBanH onpeAenenxble THnbInoBegeHHSI, Hcn0nb3ySI nogXOg TeopxH COnHanbHOrO 06yiieHHA(Bandura, 1977; 1986), H nOnblTanHCb C0o61LjHTb HHCIIopMauxlo BCOOTBeTCTBHH C CHCTeMaMH L[eHHOCTeii pâ3nHiiHbIX CeKTOpOs

ayAnTOpHH (Rubin, 1986; Ajzen and Fishbein 1975; Petty andCacioppo, 1981).

MHOrne KaMnaHHH CpeJjCTS MaCCOBOn nHt)OpMaLjnn BbICTynaRH3a "yMepeHHOe" nOTpe6neHHe anKOronSl. CiOJZa BXO,I1,HnH CTpaTeTHHno COKpaLL[eHHK1 KOnHileCTBa nOTpe6neHHSi, TaKHe KaK BBeJjeHHe BynoTpe6neHHe 6e3a51K0ronbHblX HanHTKOB (Baber et al, 1989);OnnCaHHe HeraTHBHbIX 344eKTOB OnbSIHeHHSI HRH XpOHHifeCKOFOnOTpe6neHnA, TaKHX KaK yXy,IjLneHne CeKCyanbHblX - ilTo6bIR0 06-beKTOM KaMnaHHH BO CDpaHLjHH (COmltl, 1990), H onncaxne11O3HTHBHbIX nocneJtCTBHIi 6onee yMepeHHOFO nOTpe6neHHSi, TaKHXKaK BO3MO>iCHOCTH CHOpTHBHOFO nnaHa HIM ynyilLIIeHHe CeKCyanbHOii

npHBneKaTenbHOCTn. HnnIOCTpaL[neii nOCneZ[HerO noAxoAa 6bina'caw-lam-1A B KanH4IOpHHH, B KOTOpOIi nnaTHaSI TeneBH3HOHHa5I

peKnaMa, cnoc06cTByK)LLlaSI MeHbLIIeMy nOTpe6neHHK1 anKOFORAHcnonb3osana TeMy " IIo6egHTenn" (Wallack and Barrows, 1983).ABTOpbI 3T0rO HccneAOBaHHA C0o6LL[HnH, iITO B yCROBHAX

Coe,E(HHëxxbIx 111TaTOB, r,lIe MCTMiiacTaA TeneBH3HOHHaA peKJlaMannsa, cno)cxo 6bIR0 CO3JLaTb pexnaNMy yMepexnoMy noTpe6neHnio,KOTOpaA 6bl ACHO BOCnpHHHMânaCb 3pHTen51MH

B BenHKO6pHTaHHH H HeJjaBHO B ABCTpanHH CpeJjCTSa MaCCOBOii

HHgiOpMaLjHH nCHORb3OBanHCb JVIA peKnaMbI OnpegenëHHOrO ypOBHA

nOTpe6neHHA anKOronA, KOTOpble Hâ3bIBânHCb pa3yMHbIMH,

nOJIXOJjALIjnMH HRH Aaxce 6e30nacHblMH. Ha CeBepO-BOCTOKe AHFRHH,HanpHMep, B paMKax KaMRaHHH 1981 roJta cpeJtcTSa MaccosOHmutlOpMaIiHH HCn0nb30BanFiCb, iITO6bI AaTb peKOMeHaaLjHIO n0noTpe6neHHIo aJlKOronA. Tam CnpalunBanOCb: "IlATb nHHT mumKaKEiblii geHb - 3T0 CnHLIIKOM MHOFO JIM BaIIIerO 6nara. r1paBHnbHO

248

HnH HeT?" H peKOMeHAOBanOCb nHTb Ase HnH TpH nHHTbI, ABa HnHTpH pa3a B HeAenIO. 3TOT peKOMeHAaTenbHbni nOAXOA npeAHa3HaLIeHHe TOnbKO Ana cTpaH, rj(e nOTpe6nSIIOT KpenKHe CHHpTHble HanHTKH H

nHBO H rAe 6o11biuylo TpeBory BbI3bIBaIOT oCTpble nOCneACTBH5lnepenoeB BO BpeMA KyTe)Keii, HO TaK)Ke npHMeHHM B O61ileCTBaX, rAeB TpaAHLIHH BbI3biBalOII.lee 03a60TIeHHOCTb BHHOnHTHe, 3(I4eKTKOTOpOrO OTpaaCaeTCSI Ha yposne XpoHHT-IeCKHX 3a6onesaHHii.HanpHMep, nepBasi TeneBH3HOHHa51 KaMnaHH51 BO OpaHI4HH, KOTOpa51

npoxoAHna s 1984-1986 roAax, Aasana coo6nleHHe : "Un verre, ça va,trois verres, bonjour les degats" (OAHH cTaxaH - xopomo, TpH cTaxaxa- yTpenHHe npo6neMbl) H "pensez au deuxieme verre.... pour l'eau"(HaLIHHaIiTe jlyMaTb, BbIHHBa51 BTOpOIi cTaxaH - H AyMaiiTe O BoAe)(Ministere des Affaires Sociales et de l'Integration 1991).

Apyroii pacnpocTpanenxoii TeMOii 6bina He06X0AHMOCTb

H36eraTb BO)iCAeHHSI B HeTpe3BOM COCTOSIHHH (Hewitt and Blane,1984). K cepeAHHe BocbMHAecSITbIx rOAOB peKOMeHAaLIHH npoTHBBO)KIleHH5I B HeTpe3BOM COCTOSIHHH CTaJIH npeBanHpyK)IIIHM BHAOM

pexnaMbl o6ulecTBeHHoii cny)K6b1 npasHTenbc-rsa CHIA (Atkin,1989), H 6bInH TaK)Ke pacnpocTpaxeHHoii TeMoii A5151 peKnaMbl

yMepeHHoro noTpe6neHHU, KoTOpylo Cy6cHAHpoBana npoMblLUneLIHOCTb.

TeM He Mexee, HecMOTpSI Ha nonynslpnocTb KaMnaHHii cpeAcTBMaccoBOli HH(popMaLIHH KaK npeseHTHBHOIi cTpaTerHH, 3aTpaTbl HaHHX 6bInH HeCpaBHHMbI C 3aTpaTaMH Ha KOMMep9eCKylO peKnaMyanKOrOJISi. B HaH60nee qacTO ny6nHKyeMbIX HCcneAOBaHHSIX HeH3ylIanHCb npSlMble 344eKTbI o6pa30BaTenbHblX KaMnaHHN cpeACTsMaCCOBON HHCtOpMaLIHH Ha nOBeAeHHe nbiOHIHX C HCHOnb30BaHHeM

3KOHOMeTpHi-IeCKOr0 aHanH3a no AaHHbIM o6iuero noTpe6neHHSI, He6bIJI0 nOnbITOK O6Hapy)KHTb no AaHHbIM CaMOOTLIeTOB KoppenSlmHloMe)KAy npoCMOTpoM H nOTpe6neHHeM anKOrOJTSI H OTHOIIteHHeM KHeMy, XOT5I B OAHOM HeAaBHeM AJIHTeJ1bHOM HCCneAOBaHHH He 6bIJI0

o6Hapy)KeHo HHKaKOii B3aHMOCB513H MexcAy KOnHi-IeCTBOM

BCIIOMHeHHOH yLIaCTHHKaMH onpoca peKnaMbl Ha TM "yMepeHHorOnOTpe6neHH51" H KOnH4eCTBOM BbInHTOCO HMH anKoronSl (Connelly etal, B neLIaTH).

B 60nbLHHHCTBe oLIeHO,IHb1X HCCneAOBaHHIi BnHSIHHS1 KaMnaHHN

CpeACTS MaCCOBOIi HH(icopMaInHH BMeCTO 3TOr0 O6bIiIHO HCIIOnb3yeTC51

KBa3H-3KCnepHMeHTanbHa4I (PopMa, LIT06bI H3yLIHTb OTHOCHTCnbHOKpaTKOCpOT-IHblli 34)ctleKT KaMnaHHÎ-i Ha 3pHTen5I. FibIJIO npoBeAeHOHeCKOnbKO 0630pOS no OLIeHKe KaMnaHHii CpeACTS MaCCOBOii

249

HHCtlopMauRR, xoTOpbfe nposoAHnHCb B 1970-x ro,gax H B 1980-xroAax. Bce OHR COBnanR BO MHeHHH, 'ITO 6onbHIHHCTBO KaMnaHHIinpOAeMOHCTpHpOBanH OrpaHHLIeHHblii 34)CbeKT Ha y6excAeHHA Rn03RuHIO 3pHTeneli H HHKaKOTO BnHAHHA Ha c006LZaeMOeyHacTHHxaMH onpocoB nOTpe6neHHe aJlKOronA (Wallack, 1980; Blaneand Hewitt, 1980; Dorn and South, 1983 ; Moskowitz, 1989).

3TOT BbIBOA 614n CAenaH BHe 3aBRCHMOCTH OT HCLOnb30BaHHOTOnoAxoAa. HanpHMep, xaMnaHHA CHIA "IIo6eAHTenH" HenpoAeMOHCTpHpOBana HHKaKOTO BnHAHHA Ha o6eCHOKOeHHOCTb nonOBOAy anKOTOnA, HH KaKHX-111460 143MeHeHHIi B noTpe6neHHR, noc0o6LjeHHSIM CaMHX y'iaCTHHKOB. C nOMOLL[bI0 KaMnaHRIi CpeACTBMaCCOBOLi HH(i)OpMaLtHH CTeneHb nOHHMaHHA yposxefi BbIHHBOKnOBbICHnaCb, HO 6e3 KaKoro-nH6o BHAHMOTO B03AeiïCTBHA HanoTpe6nexne (Budd, Gray and McCron, 1983; Lefler and Clark,1990).

CynIecTByeT Hecxonbx0 HCKniOLIeHHIi 143 3T01-0 O6LLjerO BbIBOAao6 OTCyTCTBHH Bo3AeIiCTBH51 Ha noBeAeHHe. HaH6oneepacnpocTpaHexnble R3 HHx Ha6n1oAanFicb, KorAa HaL(enexxble HanpociRnaKTHKy BOKAeHRA B HeTpe3BOM COCTOAHHH TeneB143140HHbleKaMnaHRH, CO'IeTanHCb C ApyrHMH MepaMH, TaKHMH KaK

HHARBHAyaJlbHble HHCTpyKL(HH n0 HCHOnb30BaHHIO npH6opa armH3MepeHHA ypOBHA aJIKOronA B KpoBH (Worden et al, 1989), HBb160pOLIHa51 npOBepKa AbIXaHHA (Homel, 1988). KaMnaHHH npOTHBBoKAeHHA B HeTpe3BOM COCTOAHHH '-IaCTO AafOT ACHbIO peKOMeHAaL(RR

B OTnH'iRe OT KaMnaHHFi no yMepCHHOMy RAR pa3yMHOMynOTpe6neHHio, R 3T0, B03MO>KHO, BHeCJIO CBOIi BKnaA B HX

OTHOCHTenbxblli ycnex (Moskowitz, 1989).

CoHeTaHRe KaMnaHHIi CpeAcTS Maccosoii HHctoopMaLtHH cApyrHMH 6onee HHAHBHAyanbHO HanpaBneHHbIMH B03AeNCTB4IAM14Taxxce AanO HeKOTOpble npH3HaKH BO3MO)KHOCTH BbI3BATbOnpeAeneHHble H3MeHeHHA. HanpHMep, Ha H3MeHeHHe nOTpe6neHHA,O KOTOpOM C006LganH CaMH y'IaCTHHKH, TeneBH314OHHaA KaMnaHHA,KOTOpaA peKnaMHposana TeXHHKy noBeAeHHA CHHxcafoLi[yIonOTpe6neHHe, nOBnHAna TOnbKO TOrAa, Koma 3Ta KaMnaHHACOnpOBOxKAanaCb nHCbMOM, HOCnaHHbIM AO Ha.'iana KaMnaHHH(Barber et al, 1989). Taxxce CTOHT 3aMeTHTb, 'ITO 3Ta KaMnaHHA6onbLne Mo,iZenHpoBana oco6blli THn noBeAeHHA, 'IeM nblTânacbH3MCHHTb oTHOL1eHHe. TaKxce HMeIOTCA HeKOTOpble AaHHble OHe6011bLHOM 34L1 leKTe Ha nOTpe6neHHe anKOTOAA CpeAH noApOCTKOB

250

IllKOnbHHKOB, KOr,i[a peKOMeHAaL(HH CpcACTB MaCCOBOii HHpOpMaLuHH

KOM6HHHp0BanHCb CO CneLjHanbHOli IIIKOnbHOIi nporpaMMOIi,KOTOpaA BKniOLIana B ce6A AOMaIIIHioIO pa6oTy, L[enbi0 KOTOpOii 6bIJI0npHBneveHHe poAHTeneH (Pentz et al, 1989). TaxHM we o6pa3oM,KaMnaHHH CpeACTS MaCCOBOH HHCPOpMaI(HH, KOTOpble ABnAnHCbLIaCTbIO BCeCTOpOHHeIi npOrpaMMbl AeriCTBHIi Ha McCTHOM ypoBHe,

npHBOAHJIH K COKpaLIteHH10 TpaBMaTH3Ma Ha AOpOraX (Hingson, et al

1993).

KaMnaHHH cpenCTB Maccosol4 HH(popMaIjHH MOT Tax)KeBHOCHTb CBOI4 BKna,T; B Co3,I[aHHe COLjHanbHOrO KJIHMaTa BOKpyrnOTpe6neHliA anKOrOnSI, Rance KOr,Tja KaMnaHHA nepBOHaLIanbHO 6bina

COpHeHTHpOBaHa Ha HH,I1HBH,ayyanbHOe nOBeAeHHe OTHOCHTCnbHoBbInHBKH r1pH OueHKe npOBeAeHHOH B HOSOH 3enaHAHH KaMnaHHH,KOTOpa3I 6bIJIa HaL(eneHa Ha "yMepeHHoe nOTpe6neHHe" cpeAHMOJIOA6IX n6I0II.1HX My)KLIHH, 6bIJIO 06Hapy)iCeHO, LITO niOAH,

nouseprulHecx B03AeFiCTBHI0 xaMnaHHH cHnbnee noJlnep)KHBanHaHTHanKOTOnbHyK) nOnHTHKy B cd)epe AOCTynHOCTH, LjeH H peKnaM6I

no CpaBHeHHIO C )KHTenAMH ropouos, He nOABepraBlIIHxCA

BO3AeIiCTBHIO KaMnaHHH (Casswell et al, 1989). KaMnaHHA cpeACTBMaCCOBOii HHCpopMauHH ycneLQHO nOBbICHna OCO3HaHHe H CTeneHbnOAAep)KKH nonHTHKH no AOCTynHOCTH anKOronA B McCTaX OTAbIXa B

OHTapHo (Douglas, 1990; Glicksman, 1986). KaMnaHHH cpeAcTsMaCCOBOH HH(pOpMaIjHH MOryT CO3JjaBaTb npaBosoe OCHOBaHHe ,I[JIAAeiïCTBHH Ha McCTHOM ypoBHe, HaLjeneHHbIX Ha npO(pHnaKTHKyanKOronbxblx npo6neM (Grant and Room, 1983).

IIoABOAA HTOrH, MO)KHO CKa3aTb, LITO Te nOnbITKH OgeHHTb344exT KaMnaHml cpeAcTB MaccosOï-i HH(1)opMaLjHH Ha noBeAeHHen610ujHX, rAe HCIIOnb30BânaCb KBa3H-3KCnepHMeHTanbHaA (pOpMa, B061I(eM, He CMOrnH yCTaHOBHTb 3HaLIHTen1,HOTO B03AeNCTBHA 3THX

KaMnaHHN Ha noTpe6nenxe. KorAa KaMnaHHH COnpOBONCAanHCbHH6IMH Me)KnHLIHOCTH6IMH H C(pOKyCHpOBaHHbIMH Ha nOJIHTHKyB03AeIiCTBH5IMH, HM yAaBanOCb BHeCTH CBOI%I BKnaA B H3M0H0HHe

nOBeneHHA.

8.1.3 OpraHH3a4NSi iQ@NCTBNN Ha M@CTHOM ypOBH@

ACxCTBHA Ha McCTHOM ypoBHe ABnAiOTCA L[eneHanpaBneHHbIMH

yCHnHAMH, KOTOpble rlpeAnpHHHMaiOTCA B McCTHbIX yCJIOBHAX AnA

TOTO, LIT06bI nOBnHSITb Ha TO, KaK nK)AH nbiOT HJIH LITO AyMaIOT OnoTpe6neHHM anKOTOnA. OHM LuMpe, LIeM AeiïCTBMA, HCXOAAII.jHe H3

251

oAHOrO HCTOLIHHKa, -mime KaK npeAnpliHiiMaeM6Ie B ytlpexC,IjeHFISIx

o6pa3oBaxi35i HRH upasooxpaxeHHSI. BMeCTO 3TOro co3,IIaIOTCSI

aJIbSIHCbI Ha McCTHOM ypOBHe MexCAy HeCKOJIbKiiMli CeKTOpaMi3, TITO

TIacTo npHBOAHT B pe3yJlbTaTe K MHOrOCTOpOHHeMy nOAXOAy.

r1oAo6Hble nporpaMMbl LracTO COLIeTafOTCA C KaMnaHHAMH CpeACTBMaCCOBOii HH(bOpMaL[HH, LITO6bI BOCHOJ1b3OBaTbC51 AOHOJIHHTeJIbHbIMH

npeHMyLueCTBaMH, KOTOpble MOryT 6bITb nOJIyLIeHbI 6JiarojiapA(tlyHKuHH TeJIeBIineHIiSI CTâBHTb BOnpOC Ha nOBeCTKy AHA (McCombs

and Shaw, 1972) H B3aHMOAeHCTBHIO MexcAy peKOMeHAauHSIMHcpencTB MacCOBOii HHPopMaluii H MexCJIHLIHOCTHbIMH BJIHAHHeM(Rogers and Shoemaker, 1971). OHH TaioKe HcnoJIb3yIOT cTpaTerHHnOzuiepxcKH Llepe3 cpeAcTBa Maccosoii HHIl)opMagHH, LITO6bI

npOABHHyTb HHHLiHaTHBb1 O611ieCTBeHHOii nOJIHTHKH (Wallack, 1990).

CyluecrsyKrr HeCKOJIbKO 0ny6JIHKOBaHHbIX OLieHOLIHbIX HCCJIeAOBaHHii

TaKHX McCTHbIX yCHJIHN. OjiHOFi H3 HIiX 6bIJIa OLieHKa npOBe,lieHHOFi B

1980-x roAax B HOBON 3eJIaHAHH KaMnaHHH, rjie npNMeHSIJIaC6

cPopMa KBa3H-3Kcnepi-iMeHTa. Emma nocTaBJIeHa 3aAaLIa nOJIyTiHTbnoAAep)KKy AIN KJIIOTIeBbIx Mep rocyjiapCTBeHHON noJIHTHKH,

BKJIIOLIaIOH(HX orpaHi3TieH1IA AOCTynHOCTH H pCKJIaMbI aJlKoroJlSi, aTaK)Ke nOJIHTHKy ueH. gelicTBHA Ha MecTHOM ypoBHe BKJIIOTIaJIH Bce6A nponaraHAy B cpeAcTBax MaccoBori HH(loopMauHH,

061ueCTBeHHble MeponpHATHSt H co3AaHHe MexCCeKTOpaJIbHbIX

aJI65IHCOB, TITO6bI 06eCneLiHTb pa3BHTHe MeCTHOH nOJIHTHKH B

HHTepecaX O6LueCTBeHHOrO 3.ApaBOOXpaHeHH2 (Stewart and Casswell,1993). TaioKe npOBOAHJIHCb KaMnaHHH noA,Iepx<KH B cpeAcTBaxMaCCOBOii HH(1)opMaLjHH. KaK noKa3aJIH onpocbl Bcero HaceneHHA,npOeKTbI AeiiCTBHii Ha McCTHOM yposxe OKa3aJIH BJIHAHHe Ha

nOAliepxCKy nOJIHTHKH, H TaK)Ke Ha TO, KaK CB513aHHble C aJIKOr'oJIeM

BOnpOCbI BOCnpHHHMâJIHCb JIHAepaMH O6LLieCTBeHHOro MHeHHA

(Casswell and Gilmore 1989; Casswell et al 1989).

B ApyrHx oueHHBaeMblx npoeKTax 3aAaLIH 6bIJIH HanpaBJIeH6I Ha6onee npAMoe BO34IeiiCTBHe Ha JIHTIHOCTb, C nOMO11ib10 o6yTIeHHA BMâJI6IX rpynnax B McCTHbIX yLipexcAeHHAx (Wallack and Barrows,1983; Giesbrecht et al 1990). B KanHCpopHHHCxoii KaMnaHHH"1-1o6ejiHTeJIH" HCIIOJIb3OBâJIHCb pexoMeHAa1iHH cpeAcTB MaccosoiiHH(kOpMaL[HH H AHCKyCCHH B MâJIbIX rpynnax, HO He 6bIJIo

06HapyxCEHo HHKaKHX H3MeHeHHii B OTHOLneHHH HRH nOBeAeHHH(Wallack and Barrows, 1983). Giesbrecht et al. (1990) coo6luaeT onporpaMMe, nposeAeHHOIi B ManenbxOM ropOAe B K)xcxOM OHTapHO.OCHOBHaA 3ajiaTia HCCJIeAOBaHHA AaHHOii nporpaMMbl 3aKJIIoLiaJIacb B

252

TOM, HTO6bI Onpe,ÿenHTb, MO)KHO Bit nOBnHATb Ha o6uleepaCnpeneneHHe nOTpe6neHHA anKOrOnA B ropojje nyTëM H3MeH8HHA

npHBbILieK B nOTpe6neHHH anKOronA y 3Ha'-IHTenbHOTO 'iliCna3nOynOTpe6nAioIIIHX anKOrOneM nHIj C nOMOIIIbio npOBOZIHMbIX OJaH

Ha OjIHH 06y'IeHHA H KOHCynbTHpOBaHHSI. ApyTHe aCneKTbl COCTOAJIH

B CTI-IMynAIIHH ZIOIIOJIHHTenbHOH nporpaMMbl H nOnHTHLIeCKHX

HHHLIHaTHB nyTëM M0614JIH3aLIaH H OpraHH3aIIHH McCTHOTO

HaCeneHHA. Pe3ynbTâTbl noKa3anH, tiro nOTpe6neHHe aJIKOronA, OKOTOpOM C006njanH CaMH y'iaCTHHKH ,IIaHHOii KOHCynbTaljHOHHOii

nporpaMMbl, 3Ha9HTenbHO COKpaTHJIOCb. TeM He McHee, He

Ha6niOjlanOCb 3HaLiHTenbHOTO CHIDiCeHHA B O61lIeM KOnHLIeCTBe

anKOTOnA, npojlaHHOrO B npejjenaX pIaHHOTO ropolla. Kax noxa3anonpoc HaCeneHHA, He Ha6nI0Aan0Cb H CyIIIeCTBOHHOTO cjlsHra BpacnpeJ.IeneHHH nOTpe6neHHA anKOronA.

OAHHM H3 npOCKTOB ,IIeIiCTBHii Ha MCCTHOM yposxe, KOTOpbIHnpO,qcMOHCTpHpOBan 34CI)eKTHBHOCTb B COKpaIIIeHHH HaHOCHMOTO

anKOTOneM Bpe,ila, 6bin npOeKT, HaueneHHblli Ha: BOAC,rIeHHe B

HeTpe3BOM COCTOAHHH, BeCbMa pHCKOBaHHOe nOBejleHHe ripaBO)K,aeHHH, CMepTb H TpaBMaTH3M B aBTOKaTaCTpOCliaX (Hingson et al,

1993). 3ToT npOeKT BKn10'Iân B ce62 IIIKOnbHOe o6pasoBaHHe;KaMnaHHH no HHC1)opMHposaHHlo HaceneHaA; oco6o Tpe6osaTenbaoeBbIIIOJIHeHHe 3aKOHa O BOACneHHH B HeTpe3BOM COCTOSIHaH H

Co6nI0,aeHHA HHbIX npaaHn IIOpOxCHOTO ,aBa)KeHHA; npOrpaMMbIo6yLIeHHA OTnyCKaioüler0 anKOTOnb nepCOHana. B LIenOM, B IJ1CTMropo.qaX paiiOHa, rAe ocyI.gecTBnAncA npoeKT, CHHJKeHHe KonHLIecTSaasapHli CO CMepTenbHblM HCXO,IIOM 66IJIO Ha nBa,gIjaTb npOgeHTOB6onbnle, 'ieM Ha OCTânbHOii TcppHTOpHH IIITaTa.

OIjeHKa noJjXOjIOB jIeHCTBHiI Ha McCTHOM ypOBHe ABnSIeTCAOTHOCHTenbHO HOBbIM, HO paCTynjHM noneM npHJlo)ICeHIiSI yCHnHiiânKOTOnbHbIX HCCnejIOBaHHN. Ha jlaHHblil MOMeHT gOKâ3aTenbCTBa HX

BnHAHHA Ha anKOTOnbHble rip06neMbl OrpaHaHeHbl, HO 3Ta CTpaTerHAjIOCTOIiHa ZlânbHeliLIIaX HCCne,IIOBaHHii.

8.1.4 ÎlpOrpaMMbl 06pa30BaTeJlbHblX r4pe)KgeHNM

O6pa3oBaTenbHble npOrpaMMbl B IIIKOnaX 6bIn4 IIIHpOKO

paCnpOCTpaHeHHbIM H nOnynApHbIM nojlXOjIOM. PaHHHe nOnbITKH6bIJIH nepBOHa4anbHO OCHOBaHbI Ha MOjIenH "3HaHHe - OTHOIUeHHe -nOBejleHHe", HCCMOTpA Ha oTCyTCTBHe 3MnHpaHeCKOi4 nO,a)TepxcKH3TON KOHIjenLIHH (Moskowitz, 1989). Ilocne,rzyiolgae nOnXoAbI

253

B1(nI04âJIH B ce6A 06y4eHHe pa311H4HbIM COUHanbHblM HaBbIKaM, CnpeAOCTâsneHHeM TeXHHLieCKOH HHCliOpMauHH no aJIKOronIO H

nOCne,gCTBIiAM ero nOTpe6neHHA. IIOAXOA COuHaJIbHOrO BJIHSIHHSIBKJIiOLiaeT B Ce6A B03AeFiCTBHA, HaueneHHble Ha npez(nonaraeMbleCpaKTOpbI BnHAHHA Ha nOTpe6ReHHe âJlKoronA: noBeAeHHe

cBepCTHHKOS; nOSeAeHHe poAHTeneli; cpeAcTSa MaCCOBON

HH(lOpMauHH; o6y4eHHe HaBbIKaM npOTHBOCTOAHHA, noMoraioiuHMCOnpOTHBJIATbCA AaBneHH10 npHHHMâTb HapKOTHKH; CHRbHble KOHTp-

apryMeHT6I HnH 1303M0)KHOCTb nonpaKTNKOBaTbCA B ânbTepHaTHBHOM

nOBeAeHHH; 06y4eHHe )K143HeHHbIM HaBbIKaM, KOTOpble MOryT

nOMOT-Ib CTyAeHTaM B npOTHBOCTOAHHH nOTpe6neHHIO HapKOTHKOB

(Botvin, 1987; Hansen et al, 1988; Gerstein and Green,1993). ApyroiinOAXOA MeHee copi3eHTHposaH Ha BnHAHHe couxaJI6HOro oxppiCeHHA,a 6onee Ha BnHAHHe Ha R144HOCTb 4epe3 yny4HieHHe caMooueHKH,pa3BHTHe yMeHHA cnpaBHTbcA co cTpeccoM, 4epe3 npoACxeHHeCHCTeMbI ueHHOCTeii H pa3BHTHe yMeHHA npHHHMaTb peLUeHHA(Hansen et al, 1988: Gerstein and Green, 1993).

HecMOTpA Ha 6on61tloe KO11144eCTSO Ouex04HbIX HCCneAOBaHHIinporpaMM nepsH4HOii npO41HnaKTHKH B y4peKAeHHAx o6pa3osaHNA,AO CerOAHAIIIHerO AHA pe3yJlbTaTbl He Aa1OT nOBOAa ARA oIITHMH3Ma.

B csoxx o63opax Staulcup et al. (1979), Goodstadt (1978, 1980,1989) H 3aTeM Moskowitz (1989) npHLIIRH K CXOAHOMy 3aKJII04eHIiIO.Ho MaTepHanaM nHTepaTypbl, KOTOpaA oueHHSaeT Ha4âR6Hyi0 HCpeAHIOIO CTyneHb o6pa3oBaTenbHblX nporpaMM CepeAHHb1 1980-xro,gOB, Moskowitz cAenan cneAyloLuiie BbIBOA61. BO-nepBblX,06pa30BaTenbHble npOrpaMMbl B OCHOBHOM 6bI11H He344eKTHBHbI BnpOCpHnaKTHKe noTpe6neHHA anKorORA; XOTA MHOrHe npOrpaMMbl6bInH yCneiHHbIMH B nnaHe nOBbILIIeHHA 3HaHHii, TOR6K0 HeKOTOpblenOBnHAnH Ha OTHoLHeHHe, H eH(C MeHbHlee HX 4HC110 nOBnHARO HanOTpe6neHHe. BO-BTOp6IX, 60116LHHHCTBO HCCneAOBaHHii CTpaAaIOTCepbe3HbIMH MeTOA0110rH4eCKHMH HeAOCTaTKaMH, 4TO nOApblBaeT1303MO)iCHOCTb AenaTb BbIBOAbI 06 344eKTHBHOCTH npOrpaMMbi. B-TpeT6HX, B 60nbHIHHCTBe OueHOK He OnpeAenAIOTCA uenH H 3aAa414nporpaMMbl, He OnHCblsaeTCA HaCeneHHe, H36paHHOe o6'beKTOMAeiiCTBHA. l'iOnee TOrO, A0KJIaAbI coo6LuâJIH TOnbKO O BHeIIIHeMOniicaHHH nporpaMM H HccneAoBaHHA He oueHlisaJlH 11011HOTy

BbIHORHeHH51 nporpaMMbl (Moskowitz, 1989).

CaMble nOCneAHHe HCCneAOBaHHA BKJII04a1oT HeKOTOpble

pa60TbI, KOTOpble o6pautaloTCA KO MHOrHM yKâ3aHH6IM

254

MeTOAonorwiecKHM npo6neMaM. OHH cTapaioTCA OueHHBaTb

nporpaMMbl, xoTOpbie sxniotIaioT onHcaHHbie paHee noAxo,qCOL[HanbHbIX HaBbIKOB H noAXOA BJIHAHHA Ha nHLIHOCTb. EbIJI0

npOBeAeHO HeCKOnbKO meTa-aHanH30B aHTHHapKOTHLIeCKOTO

o6pa3osaHHA (Tobler, 1986; 1989; Bangert - Drowns, 1988; Bruvoldand Rundall 1988). 3TH, a TaKxce HeCKOnbKO OpHrHHanbHblXHCCneAOBaHHFi 6bInH npoaxânH3HpoBaHbl Gerstein H Green (1993).3-ro nocneAHee HccneAosaHHe noAAepxcHBaeT c,i>;enaxxbie MoskowitzBbIBOAbI O TOM, 9TO He CyLLjeCTByeT nOCTOAHHOrO H3MepHMOTOBJIHAHHA 06pa3oBâTenbHblX nporpaMM Ha nOTpe6neHHe anKOronA,Aaxce 'coma TLItaTenbHO4i OLLeHKe nOAsepranHCb nporpaMMbILuHpOKOMaciuTa6HOT0 COL(HanbHOTO BO3AeiiCTBH51 (Gerstein andGreen, 1993).

CTyAeHTbI KonneANCei7 H yHHBepCHTeTOS Cny>iCHnH 06-beKTOM BCë

60nbIHerO LIHCna KaMnaHHN. 9TH BO3AeNCTBHA BbIpOCnH OT 3aH5ITHii B

ManblX rpynnax, rAe Aasanacb HH(l)OpMaL[HA H npoBOAHnocb

o6yLieHHe HnH KOHCynbTHpoBaHHe, ;Jo 6onee BCeCTOpOHHHX,

Me)KAHCIjHnnHHapxbIX nporpaMM (Bloch and Ungerlieder, 1988;Caleekal-John and Pletscht, 1984), BlcnioLlaioLgHx ynpasneHHeyCJIOBHAMH H npOIJ;eAypOii nOAa9H anxoronbHbIX HanHTKOB (Mills etal., 1983). Goodstadt H Caleekal-John (1984) cAenanH o63opHeCKOnbKHX HCCneAOBaHHN BO3AeÎ-ICTBHN, npOBeAëHHbIX Ha 6a3eKonneANCa, H COO6LL[HnH O nO3HTHBHbIX 34I(1)eKTaX B nATH H3 HHX. TeM

He McHee, Moskowitz (1989) noAllepKHBaeT, LITO BO MHOTHX

npoeKTaX OTBeTCTBeHHOCTb 3a ynpaBneHHe nporpaMMOFi B03naranaCbHa CTyAeHTOB-Ao6pOBOnbI(eB, KOTOpble MOrnH OKa3aTbCA aTHHH7IHbIMH,

H npHpoAa KypCa MOrna He COOTBeTCTBOBaTb ero ycneXy.

8.1.5 3TNK@TKN Ha 6yT61J1KaX C a11KOrO17bHbIMNHa11NTK8MN

C nOMOIi[bIO AaHHbIX onpoca OLrCHHBanOCb BnHAHHe

npeAnpHHATOii B CHIA HHHHHaTHBbI nOMeli[aTb Ha 6yTbIJIKaX3THKeTKH C npeAynpe>KAeHHeM O B03AeiïCTBHH anKorOnA Ha

3AOpoBbe. 1-lepe3 IueCTb MecAL(eB nocne BBeAeHHA 3THKeTOK

npH6nH3HTenbHO 25% OnpauIHBaeMbIX COO6LL[HnH, LITO BHAenH

3THKeTKy, H 3Ta Iw(Ppa 6bina BbILUe cpeAH MHOrOnbiOLLIHX (KOTOpbiegame noAsepranHCb B03AeiiCTBHK) npeAynpexcAeHHA Ha 3THKeTKe).Te H3 MHOronbIOLLHIX, xoTOpble BOAAT mammy nocne BbInHBKH, ewevaLge BCHOMHHanH O npeAynpexcueHHH o6 onacxocTH BoxcAeHHSI BHeTpe3BOM COCTOAHHH H COO61IZanH O npeAnpHHATbIX HMH ivarax,

255

tITO66l I-136eXKaTb BO)K,IIeHHA B HeTpe3BOM coCTOAxxH (Greenfield et al,

1992). IloBblluexHe KonHVecTSa coo6tueHHH o noAo6xblx LHarax6bIJI0 npOTHBOHOJIO)KHO CHI-I)iCCHHK) TaKOBbIX B OHTapHO, KaHaAa, rAe

3TI-IKeTKH BBeAeHbl He 6bIn4.

BepeMeHHble )KeHLuHHbI 0006njIUIH O HeKOTOpOM CHH)KeHHHnoTpe6nellxA ceMb MecAues cnycrA nocne BBe,geHHA npe,nynpexcAaloLuHx3THKeTOK, H 3T0 OTHOCHJIOCb K ManOnbIOLL[HM, rUIOA KOTOpbIX HeCTOnb noABeprancA pHCKy (Hankin et al., 1993). ApyrxeHCCneAOBaHHA TaKxce H3yilanM: 00O3HaHHe CyLqeCTBOBaHMA 3THKeTOK,

BOCnpHATHe pHCKa 06LueCTBOM H H3MeHeHHA B nOBeAeHMH (Mazis etal, 1991; Mayer et al, 1991; Mayer and Smith; 1991, Graves, 1992). BcsoeM o63ope 3THX HccneAosaHHH Hilton (1992) npeAnonaraeT, iiTOAOCTHrHyTb TOTO, LIT06bI 3THKeTKH 6bInH 3aMeileHbl, 6bIn0 He nerKO,XOTA ypOBeHb 3TOr0 paCTeT CO BpeMeHeM, H noxoxce, LITO 3THKeTKH60nbIHe 3aMexaIOT B rpynnax pncxa, HaMeileHHbIX B KaveCTBe0fteKTa B03AeFICTBIi51. bOnbIIIHHCTBO AaHHbIX rOBOpHT o6OTCyTCTBHH H3MeHeHH11 B 00O3HaHHM pHCKa, H TOnbKO HeKOTOpblepe3ynbTaTbl rOBOpAT o6 H3MeHeHHH nOBeAeHHA, KOTOpOe MO)KHOOTHeCTH K AeNCTBH10 npeAynpexcAaK)IueH 3THKeTKH.

8.2 BJIVIAHVIE HA COLIV1AJ1bHbIVI KJ1VIMAT

COL[HanbHbIM KnHMaTOM OTHOCHTen6HO anKOrOJISI MbI Ha3bIBaeM

Ha6op pa3nHLiH6IX MHeHMH 0 nOTpe6neH4H anKOPOJIA, OTHOIIIeHHe KanKOrOnbH6IM np06neMaM H OnpeAenexMe nOAXOAALuHX ARA HXpeLneHHA Mep, KOTOpble CyIL[eCTByIOT B 061ueCTBe Ha AaHHbIÎ-1 MOMeHT

BpeMeHli H KOTOpbIeI MO)KeT McHATbCA CO BpeMeHeM (Partanen andMontonen, 1988). HeneHanpaBneHHble BO3AeliCTBH51, KOTOpb1e

noABepraloTCA oueHKe B 3TOii rna6e, H Apyriie acneKTbl o6cy)iCAexHAo61I4ecTBOM TeMbI anxorOnA, BepoATHO, nOMOI'yT onpeAenHTb 3TOTCOuHanbHbIi%I KnHMaT, HO HOAO6Hble Bo3AeiiCTBHA C TpyAOM

nOAAaiOTCA 3KCnepHMeHTânbHOMy axai-1143y.

1lOAXOAbI, KOTOpble OHHCbIBaIOTCA B 3TOÎ-i rna6e, nepBOHailanbHo6bInM HanpaBneHbI Ha H3MCHeHHe HHAHBHAyânbHOrO nOBeAeHHAOTHOCHTenbHO BbInHBKH H OueHHBanHCb C 3THX n03HuHI4. TeM HeMcHee, He 3aBHCHMO OT TOrO, BnHAIOT JIM OHH Ha nIOAeH, iibenOTpe6neHHe ABnAeTCA uenbi0 H3MeHeHHIi, OHM MOryT, TM He McHee,BJIHATb Ha 06LueCTBeHHOe o6Cy)KAeHHe H, TaKHM 06pa3oM, Ha

256

COL[HanbHbIli KJIHMaT OTHOCHTenbHO anKOrOnSI. Hanpi3Mep,06pa30BaTenbHble KaMnaHHH CpeACTB MaCCOBOii HHCpopMaLjHH HnHLIIKOnbHble KaMnaHHH, ecnH OHH aAeKBaTHO cy6cHAHpyloTcx Hnpo(pecCHOHanbHO npOBOASITCS1, MOryT 6bITb CHI'HâJIOM TOFO, 1-1TO

anKOrOnbHble npo6neMbl SIBJIAIOTCSI npeAMeTOM TpeBOrH o6mecTBa.TaKHM xce O6pa3OM, BO3M0)KHO, 6onee 3HaLIHMbIM 3C1(11eKTOM

peKJIaMbI ânK0001151 SIBnSIeTCSI ee BnHSIHHe Ha COLjHâJIbHbIiI KJIHMaT

(XOTSI npeAnonaraeTcsi onpe,genexxblil npSIMOiI 34)IpeKT). IibIJIO

BbICKâ3aHO npeAnOJIO)ICeHHe, LITO peKnaMa aJIKOrOnSI CO3AaeT

npeACTaBneHHe o pOnH aJIKOrOnSI B 06LI[eCTBe (Postman et al, 1988) HB CBOiO ovepeAb, coxpaivaeT BO3MO)KHOCTb BOnnoLL[eHHSI

aHTHanKOrOnbHOM nOnHTHKH 06L11eCTBeHHOI'O 3ApaBOOXpaHeHHSI (van

Iwaarden, 1983; Farrell, 1985). JIH6epanH3agHx HopM xoHTponx 3apexnaMoii anKOrOJISi no TeneBHAeHHIO, xoTOpaSI 11O3BO115IeT

H306pa)KaTb HCHO51b30BaHHe aJIKOCOnSI B CBSI3aHHbIM C

CHnbHOAeiiCTBy10L14HMH MHCpaMH AaHHOii KynbTypbl, Cny)KHT

CHrHânOM 60nbLUeli npHeMneMOCTH noTpe6neHHSI anKOrOn51;

o6paTHoe yTBep)ICAeHHe COCTOHT B TOM, 9TO AeIiCTBHSI,

HanpaBneHHble Ha ycHneHHe KOHTpOnSI HaA peKnaMOM, rOBOpSIT onOBbILneHHH 03a609eHHOCTH 3THM BOnpOCOM. BnHSIHHe 3anpeTOB Ha

pexnaMy, cornacxo AaHHbIM Saffer (1991) H Km yxce OTMevanOCb,MO)KeT T-iacTH7-IHO oTpaNCaTb Ae6aTbl 06H(ecTBa Boxpyr BBeJteHHSinOAO6HbIX OrpaHHi-IeHHii H TOT CpaKT, LiTO COL[HanbHbIli KnHMaTAOCTHr cTaAHH, KOrAa BO3M0)KH6I nOA06Hble AeiiCTBHSI.

BnHSIHHe 1-1OA06HbIX B03AeliCTBHii H ApyrHx aCneKTOB

o61uecTBeHHOTO o6cyxcAeHHx Ha COL(HanbHbIN KnHMaT 14

nocneAyiolnHe nonHTHLIecxHe AeiiCTBHSI He TaK npOCTO OL(eI-IHTb.Henb3SI Tax)ICe AenaTb npeAnonoxceHHSi o xapaxTepe BnHSIHHSI HaCOljHanbHblii KnHMaT HCXOASI 143 3aAaLI BO3AeIiCTBH51. HanpHMep,KaMnaHHH CpeACTB MaCCOBOii HHCpOpManHH H nIKOn, KOTOpb1e 6bInH

CCpOKyCHpOBaHbI Ha AOnyCTHMbIX ypOBHSIX noTpe6neHHSI,noABeprnHCb KpHTHKe KaK ycHnHBaIoLLjHe O)KHAaHIie TOFO, i-ITO

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279

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306

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307

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BHAHM, KaK peKOMeH,ItamIO B LIHCTOM ange, KOTOpyIO, MbI HaAeeMCSE,

npe,I);nOJIaraeMaSl ayAHTOpHSI BbIHeCeT 113 3TOE%I KHHTH.

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308

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309

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312

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316

ABTOpaMVI 3TOV1 KHlnrvi nBnnlorcn: Griffith Edwards, Peter Anderson,Thomas F. Babor, Sally Casswell, Roberta Ferrence, Norman Giesbrecht,Christine Godfrey, Harold D. Holder, Paul Lemmens, Klaus Mäkelä ,Lorraine T. Midanik, Thor Norström , Esa Österberg, Anders Romelsjö,Robin Room, Jussi Simpura H Ole- Jrrgen Skog.

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ISBN 92 890 4335 0 WBelnl.i.cpp.43.-