Smoking and suicide: a brief overview.
paper
Cited
Public
- Authors
- Hughes, John R
- Year
- 2008
- Journal
- Drug and alcohol dependence
- PMID
- 18676099
- DOI
- 10.1016/j.drugalcdep.2008.06.003
- PMCID
- PMC2585177
This article provides a brief overview of the rationales, possible mechanisms and epidemiological data on the association of smoking, smoking cessation and cessation medications with suicide. Current smoking is reliably associated with suicide both in case-control and cohort studies. The three most plausible (but relatively untested) explanations for the association are that smokers have pre-existing conditions that increase their risk for suicide, smoking causes painful and debilitating conditions that might lead to suicide, and smoking decreases serotonin and monoamine oxidase levels. Stopping smoking appears to lead to major depression in some smokers; thus, it could induce suicide; however, smoking cessation has not been associated with suicide in the few studies available. Regulatory agencies have stated bupropion, rimonabant and varenicline appear to be associated with suicide; however, the data for these statements have not been presented in sufficient detail to assess their validity. Most prior data have come from post hoc analyses. Studies that a priori focus on understanding smoking and suicide are now needed.
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| # | Section | Preview |
|---|---|---|
| 0 | 1. Introduction | Many prior studies have found an association of current smoking and suicide (Leistikow & Shipley⦠|
| 1 | 1. Introduction | The aim of the current review is to provide, in one place, an overview about the association of⦠|
| 2 | 1. Introduction | The term βsuicideβ can refer to several outcomes; i.e., thoughts, behaviors, attempts orβ¦ |
| 3 | 2. Methods | To obtain information the author initially searched PubMed for the occurrence of the following⦠|
| 4 | 3. Results β 3.1. An Overview of Theories and Mechanisms for Associations of Suicide vs. Smoking, Smoking Cessation or Use of Smoking Cessation Medications | Before reviewing the data on the association of smoking, cessation, and cessation medications withβ¦ |
| 5 | 3. Results β 3.1. An Overview of Theories and Mechanisms for Associations of Suicide vs. Smoking, Smoking Cessation or Use of Smoking Cessation Medications | These theories/mechanisms can be conceptualized as a 3 Γ 3 matrix with one factor representingβ¦ |
| 6 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.1. Smoking as a Non-Causal Marker | Many studies have consistently found an association of current smoking and risk of suicidal thoughtsβ¦ |
| 7 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.1. Smoking as a Non-Causal Marker | One method to test this βsmoking as a markerβ explanation is to determine if the association ofβ¦ |
| 8 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.1. Smoking as a Non-Causal Marker | disappears when depression is added as a βconfounderβ (Breslau et al. 2005), this may not ruleβ¦ |
| 9 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | Smoking could cause suicides via several mechanisms. The first posits that smoking worsens mood,β¦ |
| 10 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | There are plausible mechanisms to account for such behavioral toxicity. Reductions in serotonin haveβ¦ |
| 11 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | could have influenced prolactin levels by nonserotonergic mechanisms (Anthenelli & Maxwell 2000).β¦ |
| 12 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | Another possible mechanism is that low levels of monoamine oxidases (MAOs) A and B--enzymes thatβ¦ |
| 13 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | A third mechanism posits that smoking causes physical illnesses and physical illness is a leadingβ¦ |
| 14 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | The fourth mechanism is that (a) the nicotine in smoking acts as an antidepressant, and (b) someβ¦ |
| 15 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | relevant is that antidepressants might cause chronic insomnia that would worsen mood. Smoking doesβ¦ |
| 16 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.2. Smoking as a Psychological or Physical Toxin | a stimulant; however, its stimulant actions differ from those of prototypic stimulants such as theβ¦ |
| 17 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.1. Possible Mechanisms β 3.2.1.3. Smoking as Self-Medication | Smoking has been associated with many psychological symptoms and psychiatric disorders (Hughes 1999;β¦ |
| 18 | 3. Results β 3.2 Association of Suicide with Current Smoking β 3.2.2. Epidemiological/Clinical Data | Many studies have found cross-sectional and prospective associations of suicide with currentβ¦ |
| 19 | 3. Results β 3.3. Association of Suicide and Smoking Cessation β 3.3.1. Possible Theories and Mechanisms | The above section dealt only with the association of suicide and current smoking. Whether longerβ¦ |
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