title: Suicide by gassing in Hong Kong 2005-2013: Emerging trends and characteristics of suicide by helium inhalation.
abstract: BACKGROUND
  Increased use of lethal suicide methods can have a profound impact on overall suicide incidence; the epidemic of suicide by barbecue charcoal gas poisoning in some East Asian countries is a recent example. There have been concerns about recent rises in suicide using gases in some Western countries.
  
  
  METHODS
  We investigated suicide by gassing in Hong Kong (2005-2013) using Coroner's files data. The characteristics were compared between suicide by helium inhalation, charcoal gas poisoning, and other methods.
  
  
  RESULTS
  About one sixth (1407/8445, 16.7%) of all suicides used gases. Charcoal-burning suicides constituted the majority (97.5%) of them but showed a reduction over the 9-year period (-33%). Helium suicide was not recorded in 2005-2010 but increased from one in 2011 to three in 2012 and 11 in 2013, accounting for 1.2% of all suicides in 2013. Similar to the profile of charcoal-burning suicides, helium suicides were younger and more likely to have debt problem and less likely to receive psychiatric treatment than other suicides. Internet involvement related to the method was found in one third of cases of helium suicide.
  
  
  CONCLUSIONS
  The small number of helium suicides (n=15) limits the power to examine their characteristics.
  
  
  CONCLUSIONS
  Suicide by charcoal burning showed a downward trend whilst there was an alarming increase in helium suicide in Hong Kong. Public health measures to prevent an epidemic of helium suicide similar to that of charcoal-burning suicide may include close monitoring of trend, responsible media reporting, and restricting online information about and access to this method.
authors.affiliation: Institute of Health Behaviors and Community Sciences, and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Chang
authors.affiliation: Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
authors.forename: Qijin
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
authors.forename: Esther S T
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong. Electronic address: sfpyip@hku.hk.
authors.forename: Paul S F
authors.initials: PS
authors.lastname: Yip
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002606:Charcoal / Q000506:poisoning*; D002648:Child; D005260:Female; D005739:Gas Poisoning / Q000453:epidemiology* / Q000523:psychology; D006371:Helium / Q000506:poisoning*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013405:Suicide / Q000523:psychology / Q000639:trends*; D055815:Young Adult
chemical_list: D002606:Charcoal; D006371:Helium
keywords: Charcoal burning; Epidemiology; Helium; Suicide; Suicide methods; Time trend