title: [Nicotine and cotinine levels in body fluids of habitual smokers who committed suicide].
abstract: Suicide is a serious social problem because over 30,000 people commit suicide every year since 1998 in Japan. Cigarette smoking is associated with a higher risk for suicide and attempted suicide. We determined nicotine and cotinine levels in blood and urine of 104 deceased individuals (21 suicides and 83 non-suicides). Of the 21 suicides, 16 (76.2%) were smokers; the smoking rate in non-suicides was 41.0% (34 persons). Average levels of nicotine and cotinine in blood were significantly higher in the suicide smokers than in the non-suicide smokers (nicotine: 95.6 +/- 43.9 ng/ml vs. 28.0 +/- 15.2 ng/ml, p < 0.0001; and cotinine: 385 +/- 220 ng/ml vs. 229 +/- 181 ng/ml, p < 0.02). Average levels of nicotine and cotinine in urine also significantly higher in the suicide smokers than in the non-suicide smokers. There were eight patients with psychiatric diseases such as schizophrenia, depression and alcohol dependence. Of the eight patients, four were suicide smokers; only a person used antipsychotics. Thirty-one alcohol-intoxicated decedents consisted of 8 suicides (8 smokers) and 23 non-suicides (17 smokers). Our data demonstrate that there is a marked increase in cigarette smoking in habitual smokers with psychiatric disorders before committing suicide. Quantitatively monitoring the severity of stress using blood nicotine level may enable physicians more objectively to find out nicotine dependents who are in the state of an imminent suicide attempt and timely to administer medical treatment for preventing suicide.
authors.affiliation: Department of Legal Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Moriya
authors.forename: Junichi
authors.initials: J
authors.lastname: Furumiya
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003367:Cotinine / Q000097:blood* / Q000652:urine; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009538:Nicotine / Q000097:blood* / Q000652:urine; D012306:Risk; D012907:Smoking / Q000097:blood* / Q000453:epidemiology* / Q000652:urine; D013315:Stress, Psychological / Q000175:diagnosis; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
chemical_list: D015415:Biomarkers; D009538:Nicotine; D003367:Cotinine