Smoking and the Risk of Suicidal Behavior

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Abstract
A link between cigarette smoking and suicide has been reported in epidemiological investigations since the 1970s.1-6 These associations were observed in studies that controlled for potential confounders, that is, features shared by smokers and by persons who commit suicide, such as income, race, and history of serious physical illness and alcohol abuse. Bolstering the evidence were the findings of a dose-response relationship between the level of smoking and the risk of suicide.1,2,6 The interpretation of these epidemiological observations has been a subject of controversy, however.7

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