Prospective association between tobacco smoking and death by suicide : a competing risks hazard analysis in a large twin cohort with 35-year follow-up

Show full item record



Permalink

http://hdl.handle.net/10138/224216

Citation

Evins , A E , Korhonen , T , Kinnunen , T H & Kaprio , J 2017 , ' Prospective association between tobacco smoking and death by suicide : a competing risks hazard analysis in a large twin cohort with 35-year follow-up ' , Psychological Medicine , vol. 47 , no. 12 , pp. 2143-2154 . https://doi.org/10.1017/S0033291717000587

Title: Prospective association between tobacco smoking and death by suicide : a competing risks hazard analysis in a large twin cohort with 35-year follow-up
Author: Evins, A. E.; Korhonen, T.; Kinnunen, T. H.; Kaprio, J.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2017-09
Language: eng
Number of pages: 12
Belongs to series: Psychological Medicine
ISSN: 0033-2917
URI: http://hdl.handle.net/10138/224216
Abstract: Background. The relationship between smoking and suicide remains controversial. Method. A total of 16 282 twin pairs born before 1958 in Finland and alive in 1974 were queried with detailed health and smoking questionnaires in 1975 and 1981, with response rates of 89% and 84%. Smoking status and dose, marital, employment, and socio-economic status, and indicators of psychiatric and somatic illness were assessed at both time points. Emergent psychiatric and medical illness and vital status, including suicide determined by forensic autopsy, were evaluated over 35-year follow-up through government registries. The association between smoking and suicide was determined in competing risks hazard models. In twin pairs discordant for smoking and suicide, the prospective association between smoking and suicide was determined using a matched case-control design. Results. Smokers had a higher cumulative suicide incidence than former or never smokers. Heavy smokers had significantly higher suicide risk [hazard ratio (HR) 3.47, 95% confidence interval (CI) 2.31-5.22] than light smokers (HR 2.30, 95% CI 1.61-3.23) (p = 0.017). Compared with never smokers, smokers, but not former smokers, had increased suicide risk (HR 2.56, 95% CI 1.43-4.59), adjusting for depressive symptoms, alcohol and sedative-hypnotic use, and excluding those who developed serious somatic or psychiatric illness. In twin pairs discordant for smoking and suicide, suicide was more likely in smokers [odds ratio (OR) 6.0, 95% CI 2.06-23.8]. Conclusions. Adults who smoked tobacco were more likely to die by suicide, with a large, dose-dependent effect. This effect remained after consideration of many known predictors of suicide and shared familial effects, consistent with the hypothesis that exposure to tobacco smoke increases the risk of suicide.
Subject: Nicotine dependence
prospective cohort studies
smoking
suicide
tobacco
NATIONAL EPIDEMIOLOGIC SURVEY
CIGARETTE-SMOKING
LIFE SATISFACTION
COMPLETED SUICIDE
PSYCHIATRIC-DISORDERS
NICOTINE WITHDRAWAL
REGRESSION-MODELS
METAANALYSIS
POPULATION
BEHAVIOR
515 Psychology
3124 Neurology and psychiatry
3142 Public health care science, environmental and occupational health
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
prospective_ass ... t_with_35year_followup.pdf 221.1Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record