Joint heavy use of alcohol, cigarettes and coffee and the risk of suicide.
OBJECTIVE
To estimate the relationship between joint heavy use of alcohol, cigarettes and coffee, and the risk of suicide in a general population with high rate of suicide.


METHODS
Prospective cohort analyses.


METHODS
Finland.


METHODS
Data from 36,689 adult (age range 25-64 years) men and women who participated in the population surveys between 1972 and 1992.


METHODS
The mortality of the cohort was monitored for a mean of 14.4 years, which yielded 169 suicides. Criteria for heavy use of each psychoactive substance were defined as follows: alcohol (> 120 g/week), cigarettes (> or = 21/day) and coffee (> or = seven cups/day).


RESULTS
About half the men and 80% of the women did not use any of the psychoactive substances heavily. Every third man and every fifth woman used one substance heavily, and the prevalence for those who exceeded criteria for joint heavy use of two substances was 9% for men and 1% for women. Joint heavy use of all three substances was rare. The adjusted relative risk of suicide increased linearly with increasing level of joint heavy use of alcohol, cigarettes and coffee. Among subjects with heavy use of one substance the risk was 1.55 (95% CI = 1.10, 2.18), with joint heavy use of two substances 2.22 (95% CI = 1.37, 3.61), and with joint heavy use of all three substances 3.99 (95% CI = 1.80, 8.84) compared with no heavy use.


CONCLUSIONS
Clustering of the heavy use of alcohol, cigarettes and coffee could serve as a new marker for increased risk of suicide.
Tanskanen
A
A
Department of Psychiatry, University of Kuopio, PO Box 1777, 70211 Kuopio, Finland. antti.tanskanen@kuh.fi
Tuomilehto
J
J
Viinamäki
H
H
Vartiainen
E
E
Lehtonen
J
J
Puska
P
P
D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D003069:Coffee / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000523:psychology*; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention
D003069:Coffee