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Direct Estimation of Alcohol-Attributable Fractions for Suicide in the United States, 2021
Julien Robitaille1, Jürgen Rehm1, Mark S Kaplan1
1Julien Robitaille, Jürgen Rehm, Carolin Kilian, Laura Llamosas-Falcón, and Shannon Lange are with the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Mark S. Kaplan is with the Luskin School of Public Affairs, University of California, Los Angeles.
Abstract:
Objectives. To estimate the alcohol-attributable fraction (AAF) for suicide in the United States. Methods. Using restricted-access data from the National Violent Death Reporting System for 2021, we estimated the sex-specific AAF for suicide, among those 15 years of age and older, by sociodemographic characteristics and suicide means. An alcohol-attributable suicide was defined as that for which the decedent had a blood alcohol concentration of 0.10 grams per deciliter or higher. Results. In 2021, the AAF for suicide for males (20.2%) was significantly higher than that for females (17.8%; P < .001). The AAF for suicide was higher for both males and females who used a firearm as the means of suicide (23.4% and 22.8%, respectively) compared with their counterparts who used other means (16.5% and 15.9%, respectively). Conclusions. Despite some variation, AAFs for suicide were consistently high, with about 1 in 5 suicides being attributable to alcohol use. Therefore, suicide prevention initiatives in the United States should also target excessive alcohol use. (Am J Public Health. 2025;115(3):364-368. https://doi.org/10.2105/AJPH.2024.307910).
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