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Cigarette smoking and suicidal behaviour: results from a 25-year longitudinal study

Published online by Cambridge University Press:  25 September 2007

J. M. Boden ,
D. M. Fergusson  and
L. J. Horwood
J. M. Boden*
Affiliation:
Christchurch Health and Development Study, University of Otago, Christchurch, Christchurch, New Zealand
D. M. Fergusson
Affiliation:
Christchurch Health and Development Study, University of Otago, Christchurch, Christchurch, New Zealand
L. J. Horwood
Affiliation:
Christchurch Health and Development Study, University of Otago, Christchurch, Christchurch, New Zealand
*
*Address for correspondence: Dr J. M. Boden, Christchurch Health and Development Study, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. (Email: [email protected])
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Abstract

Background

This study examined the associations between cigarette smoking and suicidal ideation and suicide attempts, both before and after control for potentially confounding using fixed effects regression models.

Method

Data were gathered during the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children (635 males, 630 females). The analysis was based on a sample of 1041 participants with available data on cigarette smoking and suicidal behaviour from ages 16 to 25 years. The main outcome measures were suicidal ideation and suicide attempts, ages 16–18, 18–21, and 21–25.

Results

There were significant bivariate associations between the frequency of cigarette smoking and both suicidal ideation and suicide attempts. Cohort members who smoked 20 or more cigarettes per day had odds of suicidal ideation that were 3.39 times (95% CI 2.06–5.59) those of non-smokers, and odds of suicide attempt that were 4.39 (95% CI 2.18–8.85) times those of non-smokers. Control for non-observed fixed confounding factors reduced the association between cigarette smoking and suicidal ideation and suicide attempts to statistical non-significance. After adjustment, those smoking more than 20 cigarettes per day had odds of suicidal ideation that were 1.00 times (95% CI 0.46–2.18) those of non-smokers, and odds of suicide attempt that were 1.84 (95% CI 0.81–4.18) times those of non-smokers.

Conclusions

The findings suggest that the associations between frequency of cigarette smoking and suicidal behaviour may largely be explained by the non-observed background factors and life circumstances that are associated with both cigarette smoking and suicidal behaviour.

Keywords

Cigarette smokinglongitudinal studysuicidal behaviour
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 3 , March 2008 , pp. 433 - 439
Copyright
Copyright © Cambridge University Press 2007

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References

Beautrais, AL, Joyce, PR, Mulder, RT, Fergusson, DM, Deavoll, BJ, Nightingale, SK (1996). Prevalence and comorbidity of mental disorders in persons making serious suicide attempts: A case control study. American Journal of Psychiatry 153, 1009–1014.Google Scholar
Beratis, S, Lekka, NP, Gabriel, J (1997). Smoking among suicide attempters. Comprehensive Psychiatry 38, 74–79.Google Scholar
Breslau, N, Schultz, LR, Johnson, EO, Peterson, EL, Davis, GC (2005). Smoking and the risk of suicidal behavior: a prospective study of a community sample. Archives of General Psychiatry 62, 328–334.CrossRefGoogle ScholarPubMed
Cameron, AC, Trivedi, PK (1998). Regression Analysis of Count Data. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Carlin, JB, Wolfe, R, Coffey, C, Patton, GC (1999). Tutorial in Biostatistics. Analysis of binary outcomes in longitudinal studies using weighted estimating equations and discrete-time survival methods: prevalence and incidence of smoking in an adolescent cohort. Statistics in Medicine 18, 2655–2679.Google Scholar
Fergusson, DM, Boden, JM, Horwood, LJ (2006). Cannabis use and other illicit drug use: Testing the cannabis gateway hypothesis. Addiction 101, 556–569.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ (2001). The Christchurch Health and Development Study: Review of findings on child and adolescent mental health. Australian and New Zealand Journal of Psychiatry 35, 287–296.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Shannon, FT, Lawton, JM (1989). The Christchurch Child Development Study: a review of epidemiological findings. Paediatric & Perinatal Epidemiology 3, 278–301.Google Scholar
Fergusson, DM, Swain-Campbell, NR, Horwood, LJ (2002). Deviant peer affiliations, crime and substance use: A fixed effects regression analysis. Journal of Abnormal Psychology 30, 419–430.Google ScholarPubMed
Gibbons, RD, Hedeker, D, Waternaux, C, Davis, JM (1988). Random effects regression models: a comprehensive approach to the analysis of longitudinal psychiatric data. Psychopharmacological Bulletin 24, 438–443.Google Scholar
Greene, WT (1990). Econometric Analysis. Macmillan: New York.Google Scholar
Heikkinen, ME, Isometsa, ET, Marttunen, MJ, Aro, HM, Lonnqvist, JK (1995). Social factors in suicide. British Journal of Psychiatry 167, 747–753.Google Scholar
Hemmingsson, T, Kriebel, D (2003). Smoking at age 18–20 and suicide during 26 years of follow-up-how can the association be explained? International Journal of Epidemiology 32, 1000–1004.CrossRefGoogle ScholarPubMed
Iancu, I, Dannon, PN, Poreh, A, Lepkifker, E, Grunhaus, L (2001). Alexithymia and suicidality in panic disorder. Comprehensive Psychiatry 42, 477–481.Google Scholar
Iwasaki, M, Akechi, T, Uchitomi, Y, Tsugane, S (2005). Cigarette smoking and completed suicide among middle-aged men: a population-based cohort study in Japan. Annals of Epidemiology 15, 286–292.Google Scholar
Makikyro, TH, Hakko, HH, Timonen, MJ, Lappalainen, JA, Ilomaki, RS, Marttunen, MJ, Laksy, K, Rasanen, PK (2004). Smoking and suicidality among adolescent psychiatric patients. Journal of Adolescent Health 34, 250–253.Google Scholar
Malone, KM, Waternaux, C, Haas, GL, Cooper, TB, Li, S, Mann, JJ (2003). Cigarette smoking, suicidal behavior, and serotonin function in major psychiatric disorders. American Journal of Psychiatry 160, 773–779.Google Scholar
McGee, R, Williams, S, Nada-Raja, S (2005). Is cigarette smoking associated with suicidal ideation among young people? American Journal of Psychiatry 162, 619–620.Google Scholar
Miller, M, Hemenway, D, Bell, NS, Yore, MM, Amoroso, PJ (2000 a). Cigarette smoking and suicide: a prospective study of 300,000 male active-duty Army soldiers. American Journal of Epidemiology 151, 1060–1063.Google Scholar
Miller, M, Hemenway, D, Rimm, E (2000 b). Cigarettes and suicide: a prospective study of 50,000 men. American Journal of Public Health 90, 768–773.Google Scholar
Moriya, F, Hashimoto, Y (2005). Do smokers who commit suicide have high blood levels of nicotine? American Journal of Psychiatry 162, 816–817.Google Scholar
Moriya, F, Hashimoto, Y, Furumiya, J (2007). Nicotine and cotinine levels in body fluids of smokers who committed suicide. Forensic Science International 168, 102–105.CrossRefGoogle ScholarPubMed
Patten, CA, Hurt, RD, Offord, KP, Croghan, IT, Gomez-Dahl, LC, Kottke, TE, Morse, RM, Joseph Melton, L (2003). Relationship of tobacco use to depressive disorders and suicidality among patients treated for alcohol dependence. American Journal on Addictions 12, 71–83.Google Scholar
Schneider, B, Schnabel, A, Weber, B, Frolich, L, Maurer, K, Wetterling, T (2005). Nicotine use in suicides: a case-control study. European Psychiatry 20, 129–136.Google Scholar
Shaffer, D (1993). Smoking, depression, and suicide. American Journal of Public Health 83, 1346.CrossRefGoogle ScholarPubMed
Tanskanen, A, Tuomilehto, J, Viinamaki, H, Vartiainen, E, Lehtonen, J, Puska, P (2000). Smoking and the risk of suicide. Acta Psychiatrica Scandinavica 101, 243–245.Google Scholar
Tanskanen, A, Viinamaki, H, Hintikka, J, Koivumaa-Honkanen, HT, Lehtonen, J (1998). Smoking and suicidality among psychiatric patients. American Journal of Psychiatry 155, 129–130.CrossRefGoogle ScholarPubMed
Vilhjalmsson, R, Krisjansdottir, G, Sveinbjarnardottir, E (1998). Factors associated with suicide ideation in adults. Social Psychiatry & Psychiatric Epidemiology 33, 97–103.Google Scholar
Wu, P, Hoven, CW, Liu, X, Cohen, P, Fuller, CJ, Shaffer, D (2004). Substance use, suicidal ideation and attempts in children and adolescents. Suicide & Life Threatening Behavior 34, 408–420.Google Scholar