Suicide by charcoal burning in Taiwan, 1995-2006

We sought to identify risk factors and trends that might underlie the greatly increased incidence of charcoal-burning suicide in Taiwan and to learn whether the increasing accessibility of a single suicide method can increase overall suicide rates.

Data from a national mortality register for subjects who committed suicide during 2001 to 2006 and who were 15 years old or older when they died was analyzed. A review of available evidence and comparisons with historical cases were also performed.

From 1995 to 2006, 68% of suicides in Taiwan involved males, and suicide rates for men increased from 9.5 to 26.7 per 100,000 population; suicide rates for women rose from 5.6 to 11.7 per 100,000 population. The sex ratio (M:F) increased from 1.69:1 to 2.28:1. The greatest increase in suicide rates occurred among those 25-44 years of age. The incidence of charcoal-burning suicide was 0.22 per 100,000 in 1999 but reached 6.48 per 100,000 in 2006. Age, gender, marital status, and year of committing suicide were significant predictors for suicide by charcoal burning. This single suicide method accounted for 33.5% of suicide deaths in Taiwan in 2006.

The number of suicides by charcoal burning may be under- or overestimated, and life events of the suicide subjects were not analyzed.

Romanticizing suicide by charcoal burning by the media and cultural influences may have contributed to the increased suicides. Prohibiting sale of charcoal in convenience stores, enforcing media guidelines, and setting up carbon monoxide detectors may help prevent suicide by charcoal burning.