title: Do alcohol restrictions reduce suicide mortality?
abstract: OBJECTIVE
  Blood alcohol concentration (BAC) at the time of suicide was examined in relation to the marked falls in suicide rates and per capita alcohol consumption in Estonia during the major Soviet anti-alcohol campaign from 1 June 1985.
  
  
  METHODS
  In all, 5054 suicide cases (76% males, 24% females) were examined with respect to the official autopsy reports of the Estonian Bureau of Forensic Medicine (autopsy rates: 95% of males, 88% of females) before (1981-84), during (1986-88) and after (1989-92) the campaign. Cases were divided by gender and BAC level (0.5-1.49, 1.5-2.49 and > 2.5 per thousand).
  
  
  RESULTS
  During the campaign, annual per capita alcohol consumption in Estonia fell from 10.9 to 6.6 l. Alcohol in blood was found in 47.9% before, 35.1% during and 40.9% after the campaign. During the intervention, BAC-positive, i.e. alcohol-positive, suicides decreased by 39.2% for males and 41.4% for females, with the largest fall occurring at the BAC 2.5 per thousand + level for both sexes. Changes in BAC-negative suicides were modest. When the campaign ended suicide rates started to rise.
  
  
  CONCLUSIONS
  Investigation on an individual level showed that alcohol consumption was a common precursor to suicide and that rigorous alcohol restrictions were accompanied particularly by a decrease in BAC-positive suicide mortality among both sexes. However, the 'natural experiment' does not, in terms of study design, demonstrate convincingly that the fall in the suicide rate was due specifically to the decrease in alcohol use as such.
authors.affiliation: Estonian-Swedish Mental Health and Suicidology Institute, Centre for Behavioural and Health Sciences, Tallinn, Estonia. airiv@online.ee
authors.forename: Airi
authors.initials: A
authors.lastname: Värnik
authors.forename: Kairi
authors.initials: K
authors.lastname: Kõlves
authors.forename: Marika
authors.initials: M
authors.lastname: Väli
authors.forename: Liina-Mai
authors.initials: LM
authors.lastname: Tooding
authors.forename: Danuta
authors.initials: D
authors.lastname: Wasserman
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood / Q000331:legislation & jurisprudence* / Q000401:mortality*; D000435:Alcoholic Intoxication / Q000097:blood / Q000401:mortality; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention