A recent meta-analysis provided a more rigorous test of whether cessation might change suicidal behavior (Leistikow & Shipley 1999). This analysis searched for smoking cessation trials in which the rates of smoking cessation were ≥ 10% greater in the active vs. control condition and had a sufficient sample size to detect suicides. The study located three large randomized controlled trials in which the quit rates were 21–24% greater in the active condition. The pooled rate of suicide in the control conditions in these studies was 15/6786 or 0.22%. In the active conditions (in which much more smoking cessation occurred) it was 10/8740 or 0.11%. This trend for fewer, not more, suicides in the group who had more abstinence was not statistically significant but certainly contradicts the hypothesis that cessation would increase suicidal behaviors.
