The rigorous methodology employed in the NESARC gives eminent credence to the central findings of this analysis—an independent effect of smoking on SRO and the absence of a positive influence of prior SRO on future smoking. These results are consistent with the hypothesis that smoking exerts a contributing, and not simply a correlational, effect on risk of SRO. By contrast, these results are inconsistent with the hypothesis that SRO causes smoking or that a third factor causes both smoking and SRO. The neurobiological, genetic, psychiatric and psychological underpinnings of these associations warrant further investigation. The knowledge gained could advance prevention and treatment options for reducing the prevalence of tobacco use and suicide.
