Past suicide attempt is the strongest predictor of a future suicide attempt [17,44–47]. If further studies confirm that tobacco use status changes are independent predictors of suicide attempt, pro-active interventions to prevent relapse and tobacco use initiation may reduce suicide attempt risk. A true prospective design that enables a clear indication of the relative timing between tobacco use status change and suicide attempt is needed to clarify the role of cessation of tobacco use as a preventive tactic for reducing the risk of future suicide attempt. Even small increases in the rate of suicide attempt caused by tobacco use may have a major public health importance and as has recently been demonstrated, tobacco control interventions may effectively reduce suicide risk [48].
