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Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis

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  • Iván Echeverria

    (TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain
    Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain)

  • Miriam Cotaina

    (TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain
    Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain)

  • Antonio Jovani

    (TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain
    Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain)

  • Rafael Mora

    (Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain)

  • Gonzalo Haro

    (TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain
    Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain)

  • Ana Benito

    (TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, 12006 Castellón, Spain
    Torrente Mental Health Unit, Hospital General de Valencia, 46900 Torrente, Spain)

Abstract

There is an association between smoking and suicide, even though the direction and nature of this relationship remains controversial. This meta-analysis aimed to evaluate the association between smoking and suicidal behaviours (ideation, planning, suicide attempts, and death by suicide). On 24 August 2020, we searched the PubMed, Cochrane library, Scopus, Web of Science, TRIP, and SCIENCE DIRECT databases for relevant articles on this topic. Twenty prospective cohort studies involving 2,457,864 participants were included in this meta-analysis. Compared with never smokers, former and current smokers had an increased risk of death by suicide (relative risk [RR] = 1.31; 95% CI [1.13, 1.52] and RR = 2.41; 95% CI [2.08, 2.80], respectively), ideation (RR = 1.35; 95% CI [1.31, 1.39] and RR = 1.84; 95% CI [1.21, 2.78]), and attempted suicide (RR = 1.27; 95% CI [0.56, 2.87] and RR = 1.71; 95% CI [0.73, 3.97]). Moreover, compared to never smokers, current smoker women (RR = 2.51; 95% CI [2.06–3.04] had an increased risk of taking their own life ( Q = 13,591.53; p < 0.001) than current smoker men (RR = 2.06; 95% CI [1.62–2.62]. Furthermore, smoking exposure (former and current smokers) was associated with a 1.74-fold increased risk (95% CI [1.54, 1.96]) of suicidal behaviour (death by suicide, ideation, planning, or attempts). Thus, because of the prospective relationship between smoking and suicidal behaviours, smoking should be included in suicide risk scales as a useful and easy item to evaluate suicide risk.

Suggested Citation

  • Iván Echeverria & Miriam Cotaina & Antonio Jovani & Rafael Mora & Gonzalo Haro & Ana Benito, 2021. "Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis," IJERPH, MDPI, vol. 18(11), pages 1-15, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:6103-:d:569520
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    References listed on IDEAS

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    1. Hemenway, D. & Solnick, S.J. & Colditz, G.A., 1993. "Smoking and suicide among nurses," American Journal of Public Health, American Public Health Association, vol. 83(2), pages 249-251.
    2. Jalal Poorolajal & Nahid Darvishi, 2016. "Smoking and Suicide: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-18, July.
    3. Miller, M. & Hemenway, D. & Rimm, E., 2000. "Cigarettes and suicide: A prospective study of 50 000 men," American Journal of Public Health, American Public Health Association, vol. 90(5), pages 768-773.
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    Cited by:

    1. María Barroso-Hurtado & Daniel Suárez-Castro & Carmela Martínez-Vispo & Elisardo Becoña & Ana López-Durán, 2023. "Perceived Stress and Smoking Cessation: The Role of Smoking Urges," IJERPH, MDPI, vol. 20(2), pages 1-11, January.

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