Scots are drinking themselves to death at twice the rate of people elsewhere in the UK, according to a report exposing the country's increasingly grim relationship with alcohol.

The Office for National Statistics (ONS) said yesterday that, despite having only 8.5% of the UK population, Scotland has three-quarters of the worst 20 areas for drink-related fatalities.

Deaths from cirrhosis and other alcohol-related disease are higher in Scotland than any other region of the UK for men and women, and all age groups.

Scottish dominance of the drink-death tables has also increased: between 1991-97, 12 regions of the top 20 were in Scotland for men, and nine for women. Between 1998-2004, those figures jumped to 15 and 14 respectively. Glasgow had the highest number of fatalities, for both men and women.

The figures emerged on the same day as the Scottish Executive issued an update on its 2002 Action Plan on Alcohol with a promise to crack down on shops selling drink to children.

It is hoped the plan will change the country's drinking culture through greater self-regulation by pubs and off-sales, early intervention for problem drinkers, and more education for children.

However, it was criticised for offering no new ideas on one of the biggest factors affecting alcohol consumption - its price.

In its latest health report, the ONS said annual alcohol-related deaths had doubled in the UK from 1991 to 2004, from 4144 to 8221. The study also found the death rate for men was twice that for women.

In 1991, alcohol fatalities were 9 and 4.8 per 100,000 population for men and women respectively. By 2004, the rates had risen to 17.4 for men and 8.1 for women.

The sharpest rises were among the 35 to 54 age group.

Cirrhosis of the liver, the result of years of excess consumption, accounted for 85% of fatalities, with other liver disease, heart complaints, alcohol psychosis, and alcohol poisoning making up the rest. The figures excluded alcohol-related accidents.

The ONS study offered the first comparison of deaths in Scotland with other UK regions.

It showed that between 2002-04, death rates for Scots men were 39.1 per 100,000 but 17.4 across the UK. Among women, rates in Scotland were 15.7 per 100,000, against 8.1 in the UK.

Andrew McNeill, director of the Institute of Alcohol Studies, said the figures stemmed from low prices and said more needed to be done to protect the young.

"Alcohol consumption is going up in Britain, and going down in countries such as France and Italy, because alcohol is cheaper and available at more outlets in this country than ever before."

Jack Law, chief executive of Alcohol Focus Scotland, said: "We need to ask what is so different about Scotland's drinking culture, compared with the rest of the UK. Forty-five Scots are now dying because of drink every single week. Much more work needs to be done to reach people in the most deprived social groups because they are most likely to die from alcohol abuse."

The SNP and Tories said the figures were "disturbing" and questioned what ministers were doing to address them.

Shona Robison, SNP health spokeswoman, said: "It's a national tragedy that Scotland's record of alcohol-related deaths is twice as bad as anywhere else in the UK. It's time to tackle Scotland's binge drinking culture."

For the Tories, Dr Nanette Milne added: "Society has clearly changed over the past two decades, and we now see women drinking nearly as much as men. Sadly, this would suggest the Lib-Lab pact's strategy to tackle alcohol abuse isn't making any real impact on the problem."

A Scottish Executive spokesman said: "As the chief medical officer said in his most recent annual report, alcohol-related harm is one of the top public health concerns in Scotland.

"Everyone has a role to play changing our drinking cul- ture. Our updated Action Plan contains a range of new and improved initiatives to help us towards the shift needed."