Tobacco use and suicide attempt: longitudinal analysis with retrospective reports

• Published in: PloS one Vol. 10; no. 4; p. e0122607
• Main Authors: Berlin, Ivan, Hakes, Jahn K, Hu, Mei-Chen, Covey, Lirio S
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07-04-2015; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Adults; Aged; Alcohol; Alcohols; Analysis; Census of Population; Chronic obstructive pulmonary disease; Demographics; Dependence; Drug dependence; Drug use; Epidemiology; Female; Health risk assessment; Human health and pathology; Humans; Hypoxia; Impulsivity; Initiators; Interviews; Life Sciences; Longitudinal Studies; Male; Mental disorders; Middle Aged; Nicotine; Prevalence; Prognosis; Psychiatry; Retrospective Studies; Risk; Risk Factors; Smoking; Smoking - epidemiology; Smoking - psychology; Studies; Suicidal behavior; Suicide; Suicide, Attempted - statistics & numerical data; Suicides & suicide attempts; Surveys; Tobacco; Tobacco Use Disorder - epidemiology; Tobacco Use Disorder - psychology; Young Adult; New York; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0122607

Suicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established.
We investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2.
Among the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2.
In a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA.