Kathy Lally / The Washington Post

MOSCOW — Hours after his inauguration last May, President Vladimir Putin signed a decree ordering his government to increase Russian life expectancy to 74 years by 2018, reflecting urgency in the effort to keep the world’s largest country filled with enough people to sustain it.

Last year, life expectancy here was 66.5 years, according to estimates by the CIA World Factbook — 60.1 for men and 73.2 for women — compared with 78.5 years in the United States and 79.8 in the European Union. More people are dying than are being born.

Russians bear a staggering load of risk factors for disease, with 60 percent of men smoking and each citizen consuming, on average, more than four gallons of pure alcohol a year. Half the population is overweight.

Two big steps are in the works to change some of the dynamics. Russia’s lower house of parliament overwhelmingly passed a bill forbidding smoking in public places, which the upper house approved Wednesday and is expected to be signed quickly by Putin. And a law that went into effect Jan. 1 has designated beer as an alcoholic beverage instead of a food, prohibiting its sale in ubiquitous street-corner kiosks.

But advocates for better health, leading to longer lives, say Russia needs to do far more.

“Cigarettes are incredibly cheap,” said Dmitri Yanin, chairman of the Conference of Consumer Protection Societies. “I think we can change consumer behavior eventually, but it won’t be quick because the law doesn’t include economic measures.”

Poor demographic trends have troubled Russia since the collapse of the Soviet Union, with a population of 148 million 20 years ago reduced to about 143 million now. In 2006, Putin ordered subsidies for women who give birth, calling the demographic situation “Russia’s most acute problem today.” Last year he said the population could decline to 107 million by 2050 if trends are not reversed.