use and psychiatric co-morbidity (Hemmingsson & Kriebel, 2003). Consensus on the nature of the association is needed and could influence suicide risk assessment and broaden our understanding of the harms of tobacco smoking. To reduce the public health burden of suicide mortality, prospective and longitudinal research is needed to improve prediction and identify modifiable risk factors for suicide (Franklin et al. 2017). To investigate whether tobacco smoking is independently and possibly etiologically associated with suicide, we evaluated the prospective association between tobacco smoking and change in smoking behavior with subsequent suicide over 35 years in a large, population-based twin cohort, controlling for multiple confounders.
