Increased Risk of Suicidal Ideation in Smokers and Former Smokers Compared to Never Smokers: Evidence from the Baltimore ECA Follow-Up Study

Abstract

Objective The incidence rate of suicidal ideation amongst current and former smokers versus never smokers is not known. Main Findings The age-adjusted incidence of suicidal ideation was highest among current smokers, followed by former, and never smokers. The adjusted hazard for suicide ideation was 2.22 (95%CI=1.48, 3.33) and 1.19 (95%CI=0.78, 1.82) for current and former smokers respectively, compared to never smokers. Conclusion Current smokers have increased risks of suicidal ideation above and beyond the risk for never and former smokers regardless of age, gender, history of depressive disorder and/or anxiety symptoms, and alcohol abuse/dependence. Smoking cessation might be beneficial for some suicide prevention efforts.

Suicidal Behavior, Smoking, and Familial Vulnerability

“…Our results extend the growing literature that establishes the association between smoking and suicidal behaviors (Breslau et al, 2005;Clarke et al, 2010;Kessler et al, 2009). Our results are consistent with previous research, which found that more severe smoking phenotypes, such as nicotine dependence, have a stronger association with suicidal behavior than less severe phenotypes such as ever smoking (Beratis et al, 1997;Hemenway et al, 1993;Hemmingsson & Kriebel, 2003;Iwasaki et al, 2005;Kessler et al, 2009).…”

“…The severity of smoking is associated with suicidal behavior. Regular smoking is associated with a greater risk of suicide attempt than smoking experimentation (Riala et al, 2007), and the association is still stronger in current smokers than in ever-smokers (Breslau, Schultz, Johnson, Peterson, & Davis, 2005;Clarke et al, 2010). Kessler et al (2009) suggest that only nicotine dependence and not less severe smoking phenotypes remains significantly associated with suicide plans after adjusting for potential confounders.…”

“…Compared with never-smokers, both former and current smokers are more likely to report suicidal ideation (Clarke et al, 2010). The severity of smoking is associated with suicidal behavior.…”

Genetics of smoking and depression

“…In addition to major depression and depressive symptoms, nicotine dependence is also associated with elevated rates of suicidal ideation and previous suicide attempts (Bronisch et al 2008;Clarke et al 2010). An emerging body of literature focused on the relationship between smoking and anxiety disorders showed elevated levels of smoking in individuals with post-traumatic stress disorder (PTSD; 45 % compared to 23 % in general population) and panic disorder (36 % compared to 23 %) (Lasser et al 2000).…”

Understanding Psychiatric Comorbidities and Addictions

“…In this approach, the participant is not asked to explain the sources of variation in his or her psychiatric experiences. Instead, the multiple regression model incorporates covariate terms for onset of drug use, as well as other potentially influential covariates, and seeks estimates of the comorbidity associations under these constraints, without reliance upon self-reports of what causes this or that (e.g., see Clarke et al, 2010).…”