Iwasaki Motoki, Akechi Tatsuo, Uchitomi Yosuke, Tsugane Shoichiro
Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
Ann Epidemiol. 2005 Apr;15(4):286-92. doi: 10.1016/j.annepidem.2004.08.011.
To clarify whether cigarette smoking was associated with completed suicide in a cohort of middle-aged Japanese men.
A total of 45,209 out of 57,714 men, aged 40 to 69 years, in nine public health centers across Japan responded to a self-administered questionnaire that included questions regarding their smoking history. The questionnaire was distributed in 1990 (Cohort I) and in 1993 and 1994 (Cohort II). By the end of 2000, 173 suicides were identified by death certificates.
After adjusting for potential confounders, current smokers had a marginally higher risk of suicide than never smokers. Current smokers with more than 60 pack-years of cigarette smoking had a more than two-fold higher risk of suicide than never smokers (pooled multivariate relative risk=2.1; 95% confidence interval, 1.1, 4.0), but a significant dose-response relationship between pack-years of smoking and suicide was not found. The risk of suicide increased significantly with increasing numbers of cigarettes smoked per day (p for trend=0.036). Smoking status, duration of quitting, duration of smoking, and age at the start of smoking were not significantly associated with suicide risk.
Our results suggest that heavy smoking, particularly a large number of cigarettes per day at baseline was associated with an increased risk of suicide independent of several potential confounders.
明确在一组中年日本男性队列中，吸烟是否与自杀死亡有关。
日本九个公共卫生中心的57714名年龄在40至69岁的男性中，共有45209人回应了一份包含吸烟史问题的自填问卷。该问卷于1990年（队列I）以及1993年和1994年（队列II）发放。到2000年底，通过死亡证明确定了173例自杀案例。
在对潜在混杂因素进行调整后，当前吸烟者自杀风险略高于从不吸烟者。吸烟量超过60包年的当前吸烟者自杀风险比从不吸烟者高出两倍多（合并多变量相对风险=2.1；95%置信区间，1.1，4.0），但未发现吸烟包年数与自杀之间存在显著的剂量反应关系。自杀风险随着每日吸烟量的增加而显著增加（趋势p值=0.036）。吸烟状况、戒烟持续时间、吸烟持续时间和开始吸烟年龄与自杀风险无显著关联。
我们的结果表明，重度吸烟，尤其是基线时每日吸烟量较大，与自杀风险增加有关，且独立于几个潜在混杂因素。
