Suicide risk increased by smoking.

smoking1A study, published in the journal Nicotine & Tobacco Research, has raised another public health risk associated with smoking particularly concerning for young people who make up the largest group of smokers. The Center for Disease Control and Prevention lists suicide as the 10th leading cause of death in the United States.

Smoking has been found to increase suicide risk and polices that limit smoking reduce suicide rates. The research analyzed data compiled from different states. States that adopted aggressive tobacco-control policies saw their suicide rates decrease, compared with the national average. States that promoted smoking with lower cigarette taxes and more lax policies toward smoking in public had an increase in suicide rates by 6 percent.

“Our analysis showed that each dollar increase in cigarette taxes was associated with a 10 percent decrease in suicide risk,” said Richard A. Grucza, PhD, , associate professor of psychiatry at the University of Washington, school of medicine. “Indoor smoking bans also were associated with risk reductions.”

“States started raising their cigarette taxes, first as a way to raise revenue but then also as a way to improve public health,” Grucza explained. “Higher taxes and more restrictive smoking policies are well-known ways of getting people to smoke less. So it set a natural experiment, which shows that the states with more aggressive policies also had lower rates of smoking. The next thing we wanted to learn was whether those states experienced any changes in suicide rates, relative to the states that didn’t implement these policies as aggressively.”

“If you’re not a smoker, or not likely ever to become a smoker, then your suicide risk shouldn’t be influenced by tobacco policies,” Grucza said. “So the fact that we saw this influence among people who likely were smokers provides additional support for our idea that smoking itself is linked to suicide, rather than some other factor related to policy.”

“Nicotine is a plausible candidate for explaining the link between smoking and suicide risk,” Grucza said. “Like any other addicting drug, people start using nicotine to feel good, but eventually they need it to feel normal. And as with other drugs, that chronic use can contribute to depression or anxiety, and that could help to explain the link to suicide.”


Grucza RA, Plunk AD, Krauss MJ, Carazos-Rehg PA, Deak J, Gebhardt K, Chaloupka FJ, Bierut LJ. Proving the smoking-suicide association: Do smoking policy interventions affect suicide risk? Nicotine & Tobacco Research, July 2014; DOI: 10.1093/ntr/ntu106

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