From the mid 1980s mortality levels have fluctuated greatly in the former Soviet Union. After dropping substantially during the late 1980s, mortality rose to unprecedented levels during the early 1990s. The sharp fluctuations in mortality are commonly linked to variations in alcohol consumption in connection with the anti-alcohol campaign launched in 1985. This large-scale natural alcohol policy experiment has produced very mixed appraisal and this article provides a systematic review of the wide variety of judgments, focusing on goals, implementation, and effects on life expectancy, alcohol consumption, mortality, crime, etc. Deviant evaluations are in part ascribable to a general schism between narrowly focused epidemiological perspectives on public health interventions and broader social science approaches to political reform.