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Nicotine use in suicides: a case–control study

Published online by Cambridge University Press:  16 April 2020

Barbara Schneider ,
Axel Schnabel ,
Bernhard Weber ,
Lutz Frölich ,
Konrad Maurer  and
Tilman Wetterling
Axel Schnabel
Affiliation:
Centre of Forensic Medicine, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
Bernhard Weber
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Lutz Frölich
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Konrad Maurer
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
Tilman Wetterling
Affiliation:
Centre of Psychiatry, Department of Psychiatry and Psychotherapy I, Johann Wolfgang Goethe-University, Frankfurt/Main, Heinrich-Hoffmann Street 10, 60528Frankfurt/Main, Germany
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Abstract

Purpose

Despite of higher rates of substance-related disorders in psychiatric patients and suicides than in the general population, there is no clear specificity to the relationship between nicotine use and other psychiatric disorders for suicide risk.

Methods

One hundred and sixty-three suicides (mean age 49.8 ± 19.3 years; 64.4% males; using psychological autopsy method) and 396 control persons (mean age 51.6 ± 17.0 years; 55.8% males) were assessed with a standardised semi-structured interview including SCID-I and SCID-II (for DSM-IV). Suicides and controls were compared in terms of nicotine consumption and psychiatric disorders. Logistic regression was used to evaluate the interactions of tobacco consumption with psychiatric disorders.

Results

Suicides were significantly more often current smokers and heavy users of cigarettes (>20 cigarettes per day; P < 0.001, each). Alcohol dependence, other axis I disorders than substance-related disorders, and cluster B personality disorder(s) remained independent predictors for suicide in both genders, current nicotine consumption only in men (OR = 2.6, 95% CI 1.3–5.2).

Conclusions

In males, but not in females, nicotine consumption contributed to risk of completed suicide after control for psychiatric disorders and has to be considered as independent risk factor for suicide.

Keywords

Nicotine consumptionSuicideRisk factorsPsychiatric disordersPsychological autopsy
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 2 , March 2005 , pp. 129 - 136

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