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Nicotine use in suicides: a case-control study.

Barbara Schneider1, Axel Schnabel, Bernhard Weber

  • 1Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528 Frankfurt/Main, Germany. b.schneider@em.uni-frankfurt.de

European Psychiatry : the Journal of the Association of European Psychiatrists
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PubMed
Summary
This summary is machine-generated.

Nicotine use is an independent suicide risk factor in men, but not women, even after accounting for psychiatric disorders. This highlights the importance of considering smoking in suicide prevention strategies for males.

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Area of Science:

  • Psychiatry and Behavioral Sciences
  • Epidemiology of Mental Health
  • Addiction Research

Background:

  • Higher rates of substance-related disorders and suicide exist in psychiatric populations compared to the general population.
  • The specific relationship between nicotine use, psychiatric disorders, and suicide risk remains unclear.

Purpose of the Study:

  • To investigate the association between nicotine consumption, psychiatric disorders, and suicide risk.
  • To determine if nicotine use is an independent predictor of suicide, considering psychiatric comorbidities.

Main Methods:

  • A psychological autopsy method was employed, assessing 163 suicides and 396 controls using standardized semi-structured interviews (SCID-I, SCID-II for DSM-IV).
  • Participants were compared based on nicotine consumption and psychiatric diagnoses.
  • Logistic regression analysis was used to examine interactions between tobacco consumption and psychiatric disorders.

Main Results:

  • Suicides exhibited significantly higher rates of current smoking and heavy cigarette use (>20 cigarettes/day).
  • Alcohol dependence, non-substance-related Axis I disorders, and Cluster B personality disorders were independent suicide predictors in both genders.
  • Current nicotine consumption emerged as an independent predictor of suicide risk solely in males (OR = 2.6, 95% CI 1.3-5.2).

Conclusions:

  • Nicotine consumption is an independent risk factor for completed suicide in males, independent of psychiatric disorders.
  • This association was not observed in females, suggesting a gender-specific role of nicotine in suicide risk.
  • Clinical consideration of nicotine use is crucial for suicide risk assessment, particularly in male psychiatric patients.