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Suicide and Other-Cause Mortality after Early Exposure to Smoking and Second Hand Smoking: A 12-Year Population-Based Follow-Up Study.

Chen VC, Kuo CJ, Wang TN, Lee WC, Chen WJ, Ferri CP, Tsai D, Lai TJ, Huang MC, Stewart R, Ko YC - PLoS ONE (2015)

Bottom Line: Participants who were currently smoking at baseline had a greater than six-fold higher suicide mortality than those who did not smoke (29.5 vs. 4.8 per 100,000 person-years, p<0.001) as well as higher natural mortality (33.7 vs. 10.3 per 100,000 person-years, p<0.001).The estimated depression-adjusted odds ratio did not change substantially.This study showed evidence of excess suicide mortality among young adults exposed to active or passive early life cigarette smoking.

View Article: PubMed Central - PubMed

Affiliation: Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital and Chang Gung University, Chiayi, Taiwan; Department of Psychiatry, Chung San Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

ABSTRACT

Background: The association between smoking and suicide is still controversial, particular for early life cigarette smoking exposure. Few studies have investigated this association in adolescents using population-based cohorts, and the relationship with second hand smoking (SHS) exposure has not been addressed.

Methods and findings: In this study, we followed a large population-based sample of younger people to investigate the association between smoking, SHS exposure and suicide mortality. Between October 1995 and June 1996, 162,682 junior high school students ages 11 to 16 years old living in a geographic catchment area in Taiwan were enrolled and then followed till December 2007 (1,948,432 person-years) through linkage to the National Death Certification System. Participants who were currently smoking at baseline had a greater than six-fold higher suicide mortality than those who did not smoke (29.5 vs. 4.8 per 100,000 person-years, p<0.001) as well as higher natural mortality (33.7 vs. 10.3 per 100,000 person-years, p<0.001). After controlling for gender, age, parental education, asthma, allergic rhinitis, and alcohol consumption, the adjusted hazard ratios for suicide were 3.69 (95% CI 1.85-7.39) in current smokers, and 1.47 (95% CI 0.94-2.30) and 2.83 (95% CI 1.54-5.20) respectively in adolescents exposed to SHS of 1-20 cigarettes and >20 cigarettes/per day. The estimated depression-adjusted odds ratio did not change substantially. The population attributable fractions for suicide associated with smoking and heavy SHS exposure (>20 cigarettes/per day) were 9.6% and 10.6%, respectively.

Conclusions: This study showed evidence of excess suicide mortality among young adults exposed to active or passive early life cigarette smoking.

No MeSH data available.


Related in: MedlinePlus

STROBE style flow chart of the cohort in southern Taiwan included in analysis.
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pone.0130044.g001: STROBE style flow chart of the cohort in southern Taiwan included in analysis.

Mentions: The cohort was followed by record linkage to the Taiwan National Death Certification System from January 1, 1995, to December 31, 2007, as previously described [17]. Using unique and compulsory national identity numbers, linkage was made between the cohort and Death Certification System data which records causes of death. By December 31, 2007, 902 participants had died, with suicide listed as the cause of death for 106. The average and total duration of follow-up in this study was 11.98 years and 1,948,432.63 person-years (the flow chart as Fig 1).


Suicide and Other-Cause Mortality after Early Exposure to Smoking and Second Hand Smoking: A 12-Year Population-Based Follow-Up Study.

Chen VC, Kuo CJ, Wang TN, Lee WC, Chen WJ, Ferri CP, Tsai D, Lai TJ, Huang MC, Stewart R, Ko YC - PLoS ONE (2015)

STROBE style flow chart of the cohort in southern Taiwan included in analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4519334&req=5

pone.0130044.g001: STROBE style flow chart of the cohort in southern Taiwan included in analysis.
Mentions: The cohort was followed by record linkage to the Taiwan National Death Certification System from January 1, 1995, to December 31, 2007, as previously described [17]. Using unique and compulsory national identity numbers, linkage was made between the cohort and Death Certification System data which records causes of death. By December 31, 2007, 902 participants had died, with suicide listed as the cause of death for 106. The average and total duration of follow-up in this study was 11.98 years and 1,948,432.63 person-years (the flow chart as Fig 1).

Bottom Line: Participants who were currently smoking at baseline had a greater than six-fold higher suicide mortality than those who did not smoke (29.5 vs. 4.8 per 100,000 person-years, p<0.001) as well as higher natural mortality (33.7 vs. 10.3 per 100,000 person-years, p<0.001).The estimated depression-adjusted odds ratio did not change substantially.This study showed evidence of excess suicide mortality among young adults exposed to active or passive early life cigarette smoking.

View Article: PubMed Central - PubMed

Affiliation: Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital and Chang Gung University, Chiayi, Taiwan; Department of Psychiatry, Chung San Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

ABSTRACT

Background: The association between smoking and suicide is still controversial, particular for early life cigarette smoking exposure. Few studies have investigated this association in adolescents using population-based cohorts, and the relationship with second hand smoking (SHS) exposure has not been addressed.

Methods and findings: In this study, we followed a large population-based sample of younger people to investigate the association between smoking, SHS exposure and suicide mortality. Between October 1995 and June 1996, 162,682 junior high school students ages 11 to 16 years old living in a geographic catchment area in Taiwan were enrolled and then followed till December 2007 (1,948,432 person-years) through linkage to the National Death Certification System. Participants who were currently smoking at baseline had a greater than six-fold higher suicide mortality than those who did not smoke (29.5 vs. 4.8 per 100,000 person-years, p<0.001) as well as higher natural mortality (33.7 vs. 10.3 per 100,000 person-years, p<0.001). After controlling for gender, age, parental education, asthma, allergic rhinitis, and alcohol consumption, the adjusted hazard ratios for suicide were 3.69 (95% CI 1.85-7.39) in current smokers, and 1.47 (95% CI 0.94-2.30) and 2.83 (95% CI 1.54-5.20) respectively in adolescents exposed to SHS of 1-20 cigarettes and >20 cigarettes/per day. The estimated depression-adjusted odds ratio did not change substantially. The population attributable fractions for suicide associated with smoking and heavy SHS exposure (>20 cigarettes/per day) were 9.6% and 10.6%, respectively.

Conclusions: This study showed evidence of excess suicide mortality among young adults exposed to active or passive early life cigarette smoking.

No MeSH data available.


Related in: MedlinePlus