Cigarettes and suicide: a prospective study of 50,000 men.
OBJECTIVE
This study examined the relation between smoking and suicide, controlling for various confounders.


METHODS
More than 50,000 predominantly White, middle-aged and elderly male health professionals were followed up prospectively with biennial questionnaires from 1986 through 1994. The primary end point was suicide. Characteristics controlled for included age, marital status, body mass index, physical activity, alcohol intake, coffee consumption, and history of cancer.


RESULTS
Eighty-two members of the cohort committed suicide during the 8-year follow-up period. In age-adjusted analyses with never smokers as the comparison group, the relative risk of suicide was 1.4 (95% confidence interval [CI] = 0.8, 2.3) among former smokers, 2.6 (95% CI = 0.9, 7.5) for light smokers (< 15 cigarettes/day), and 4.5 (95% CI = 2.3, 8.8) among heavier smokers. After adjustment for potential confounders, the relative risks were 1.4 (95% CI = 0.9, 2.4), 2.5 (95% CI = 0.9, 7.3), and 4.3 (95% CI = 2.2, 8.5), respectively.


CONCLUSIONS
We found a positive, dose-related association between smoking and suicide among White men. Although inference about causality is not justified, our findings indicate that the smoking-suicide connection is not entirely due to the greater tendency among smokers to be unmarried, to be sedentary, to drink heavily, or to develop cancers.
Miller
M
M
Department of Health Policy & Management, Harvard School of Public Health, Boston, Mass. 02115, USA. mmiller@hsph.harvard.edu
Hemenway
D
D
Rimm
E
E
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D003069:Coffee; D015986:Confounding Factors, Epidemiologic; D004327:Drinking Behavior; D006281:Health Occupations / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D003069:Coffee