The sample does not include individuals younger than 18 years old, a population particularly at risk of both tobacco use initiation and suicidal behavior. Because other SROs such as suicide ideation or wish to die were not questioned from all Wave 2 participants, comparisons among suicide attempt and other SRO could not be performed. The lack of the exact date of the suicide attempts and tobacco use status changes does not allow a prospective analysis, precluding inferences regarding a causal relationship. This study did not assess the reverse predictive relationships of a prior suicide attempt with the tobacco use variables. The possibility cannot be discounted that a suicide attempt or a concurrently occurring psychiatric disorder provoked a return to tobacco use or resorting to tobacco use by a never tobacco user. Because of the low cell counts for smoking change variables, interactions could not be tested but may exist. This study used only Wave 1 demographic and psychiatric covariate predictors; changes in those characteristics may be linked to changes in tobacco use status and suicide attempt. Because life stressors can
