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Evaluation of the risk relationship between average alcohol volume consumed and suicide: An analysis of mortality
Shannon Lange1,2,3,4, Yachen Zhu5, Charlotte Probst1,2,3,6
1Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.
Objective:
To evaluate the relationship between average alcohol volume consumed per day and suicide.
Methods:
Data from the annual, cross-sectional US National Health Interview Survey, 1997-2018, was obtained, and linked to the 2019 National Death Index. The association between average alcohol volume consumed in grams per day (g/day) and suicide was quantified using Cox proportional hazards model (multiplicative) and Aalen's additive hazard model. All analyses were stratified by sex, and adjusted for education, marital status, race/ethnicity, and survey year.
Results:
On the multiplicative scale, for males, former drinkers and those who consumed on average (40, 60] g/day had about 53% (HR=1.53, 95% CI: 1.10, 2.13) and 77% (HR=1.77, 95% CI: 1.17, 2.66) greater risk of dying by suicide, compared to lifetime abstainers, respectively. There was no significant association found for former or current drinkers among females, on the multiplicative scale. On the additive scale, for males and females, being a former drinker was associated with 11.4 (95% CI: 2.3, 20.4) and 5.6 (95% CI: 0.8, 10.4) additional deaths per 100,000 person years, compared to lifetime abstainers. For males only, drinking (40, 60] g/day on average was associated with 23.2 (95% CI: 6.7, 39.7) additional deaths per 100,000 person years. Level of education was not found to modify the focal relationship for males or females.
Conclusions:
The findings suggest that the relationship between average alcohol volume consumed per day and suicide is nuanced. Additional research on the respective relationship is needed, including repeated measures of average alcohol consumption over time.
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