The current study did not find a significant association between DSM-IV nicotine dependence and suicide attempt. This finding corresponds with data from 5,001 respondents in the National Comorbidity Survey (1990–1992) [13] and its follow up survey (2001–2003) [19] but differs from two cross-sectional studies, both using the NESARC, which found that nicotine dependence was associated with suicide attempt in the Wave 1 [20] and in the Wave 2 sample [18]. Differences in the longitudinal design of the present study based on NESARC data and the National Comorbidity Survey [13,19] versus the cross-sectional analyses [18,20] may account for the contradictory results. Moreover, nicotine dependence as defined by DSM-IV and tobacco use are two alternative approaches to the issue of the association of tobacco use with suicide attempt. The first one is based on behavioral patterns, the second one on the pharmacological effects of substance use. The two obviously may have an overlap, but our data, that uniquely allow such a comparison, show that tobacco use/consumption is more predictive of suicide attempt than DSM-IV nicotine dependence.
