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Cigarette smoking and risk of completed suicide: a meta-analysis of prospective cohort studies.
J Psychiatr Res 2012; 46(10):1257-66JP

Abstract

BACKGROUND

Epidemiologic studies have reported conflicting results relating smoking to suicide risk. We conducted a meta-analysis of prospective cohort studies to evaluate the association of cigarette smoking with completed suicide.

METHODS

Eligible prospective cohort studies were identified from PubMed and EMbase databases (from 1966 to May 2011) and the reference lists of retrieved articles. Two authors independently extracted data and assessed study quality using the Newcastle-Ottawa Scale. Study-specific risk estimates were pooled using random-effects model and generalized least squares trend estimation was used to assess dose-response relationship.

RESULTS

Fifteen prospective cohort studies involving 2395 cases among 1,369,807 participants were included in the meta-analysis. Our data suggested that cigarette smoking significantly increased the risk of completed suicide. Compared with never smokers, the pooled RR was 1.28 (95% CI: 1.001-1.641) for former smokers, and 1.81 (95% CI: 1.50-2.19) for current smokers, respectively. Subgroup analyses showed that the increased suicide risk among current smokers appeared to be consistent, although there was heterogeneity among studies of current smoking (p < 0.001). Significant dose-response relationship was found between smoking and suicide, and the risk of suicide was increased by 24% for each increment of 10 cigarettes smoked per day (RR, 1.24; 95% CI: 1.20-1.28).

CONCLUSIONS

Our meta-analysis robustly demonstrates that cigarette smoking is associated with an increased risk of completed suicide, consistent with a dose-response relationship. This conclusion has an important public health message for countries with high smoking prevalence and high suicide rate such as China.

Authors+Show Affiliations

State Key Laboratory of Cardiovascular Diseases, Department of Evidence Based Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22889465

Citation

Li, Dianjiang, et al. "Cigarette Smoking and Risk of Completed Suicide: a Meta-analysis of Prospective Cohort Studies." Journal of Psychiatric Research, vol. 46, no. 10, 2012, pp. 1257-66.
Li D, Yang X, Ge Z, et al. Cigarette smoking and risk of completed suicide: a meta-analysis of prospective cohort studies. J Psychiatr Res. 2012;46(10):1257-66.
Li, D., Yang, X., Ge, Z., Hao, Y., Wang, Q., Liu, F., ... Huang, J. (2012). Cigarette smoking and risk of completed suicide: a meta-analysis of prospective cohort studies. Journal of Psychiatric Research, 46(10), pp. 1257-66. doi:10.1016/j.jpsychires.2012.03.013.
Li D, et al. Cigarette Smoking and Risk of Completed Suicide: a Meta-analysis of Prospective Cohort Studies. J Psychiatr Res. 2012;46(10):1257-66. PubMed PMID: 22889465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking and risk of completed suicide: a meta-analysis of prospective cohort studies. AU - Li,Dianjiang, AU - Yang,Xueli, AU - Ge,Zeng, AU - Hao,Yongchen, AU - Wang,Qianqian, AU - Liu,Fangchao, AU - Gu,Dongfeng, AU - Huang,Jianfeng, Y1 - 2012/08/11/ PY - 2011/12/11/received PY - 2012/02/18/revised PY - 2012/03/08/accepted PY - 2012/8/15/entrez PY - 2012/8/15/pubmed PY - 2013/2/5/medline SP - 1257 EP - 66 JF - Journal of psychiatric research JO - J Psychiatr Res VL - 46 IS - 10 N2 - BACKGROUND: Epidemiologic studies have reported conflicting results relating smoking to suicide risk. We conducted a meta-analysis of prospective cohort studies to evaluate the association of cigarette smoking with completed suicide. METHODS: Eligible prospective cohort studies were identified from PubMed and EMbase databases (from 1966 to May 2011) and the reference lists of retrieved articles. Two authors independently extracted data and assessed study quality using the Newcastle-Ottawa Scale. Study-specific risk estimates were pooled using random-effects model and generalized least squares trend estimation was used to assess dose-response relationship. RESULTS: Fifteen prospective cohort studies involving 2395 cases among 1,369,807 participants were included in the meta-analysis. Our data suggested that cigarette smoking significantly increased the risk of completed suicide. Compared with never smokers, the pooled RR was 1.28 (95% CI: 1.001-1.641) for former smokers, and 1.81 (95% CI: 1.50-2.19) for current smokers, respectively. Subgroup analyses showed that the increased suicide risk among current smokers appeared to be consistent, although there was heterogeneity among studies of current smoking (p < 0.001). Significant dose-response relationship was found between smoking and suicide, and the risk of suicide was increased by 24% for each increment of 10 cigarettes smoked per day (RR, 1.24; 95% CI: 1.20-1.28). CONCLUSIONS: Our meta-analysis robustly demonstrates that cigarette smoking is associated with an increased risk of completed suicide, consistent with a dose-response relationship. This conclusion has an important public health message for countries with high smoking prevalence and high suicide rate such as China. SN - 1879-1379 UR - https://www.unboundmedicine.com/medline/citation/22889465/Cigarette_smoking_and_risk_of_completed_suicide:_a_meta_analysis_of_prospective_cohort_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3956(12)00095-7 DB - PRIME DP - Unbound Medicine ER -