Aims. To examine the rates of alcohol‐related harm in relation to levels of alcohol consumption before, during and after a major anti‐alcohol campaign in Moscow. Design. Changes in State alcohol sale and alcohol consumption and certain forms of alcohol‐related harm were observed as a function of time. Findings. Following the 1985 anti‐alcohol campaign, State alcohol sales decreased by 38.0% in 1.5 years in Moscow, and total consumption decreased by 28.6%. At the same time, admissions for alcohol‐related mental and behavioural disorders, deaths from liver cirrhosis, alcohol poisoning and other blood alcohol positive violent deaths decreased by 63.3%, 33.0%, 50.8% and 50.9%, respectively. There was a linear correlation between medical variables and alcohol consumption during its decrease in 1985‐86. An increase in blood alcohol positive violent deaths began in 1987, before the increases in other variables. Growth of total alcohol consumption began in 1987, and continued during all subsequent years, although it was especially high in 1992‐93 at the time of the introduction of market reforms in Russia. Alcohol‐related mental and behavioural disorders and liver cirrhosis mortality increased after a time‐lag following the rise in alcohol consumption. Conclusions. The findings provide stark evidence of the potential impact of policy measures applied to general alcohol consumption on alcohol‐related harm.