Independent and Combined Tobacco and Alcohol Use Associated With Suicide Risk

alcohol, smoking
alcohol, smoking
Regardless of sex, current smokers with AUDIT scores ≥20 were at the highest risk for suicide in analyses, although men more frequently exhibited suicidal behaviors.

The findings of a cross-sectional study in the Journal of Affective Disorders positively correlated smoking status and alcohol use with suicidal incidents, especially when tobacco and alcohol use were combined.

The study was conducted in the Department of Preventive Medicine at Yonsei University in the Republic of Korea. Among highly industrialized nations, Korea has been noted for its high suicide rate, as well as for the relative frequency of smoking and social drinking.

The study used data compiled between 2013 and 2015 on 21,654 respondents from the all-ages Korea National Health and Nutrition Examination Survey. The survey included questions on suicidal thoughts, plans, and attempts in the previous year and smoking status. Further screening was done using the Alcohol Use Disorder Identification Test (AUDIT) developed by the World Health Organization.

Suicidal thoughts or behavior were present in 1718 of the respondents. The risk for suicide increased in accordance with alcohol consumption. Men and women with AUDIT scores ≥20 exhibited a significant risk for suicidal behaviors (P <.001). Both current and past smokers had a significant risk (P <.05), although current smokers were at higher risk.

Analyses showed that, regardless of sex, current smokers with AUDIT scores ≥20 were at the highest risk for suicide, although men exhibited suicidal behaviors more frequently. Women who had never smoked, as well as men who had previously smoked, exhibited suicidal behavior least frequently.

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The study did not account for completed suicides, nor was it able to assess for depression. Additionally, only smoking status, not frequency, was considered in analysis.

“Considering that individuals with mood disorders have a greater rate of tobacco [use], smoking may be an additional informative variable when evaluating suicide risk,” the author stated.


Jung M. The relationship between alcohol abuse and suicide risk according to smoking status: A cross-sectional study [published online September 22, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.09.077