Is there a relationship between elderly suicide rates and smoking? A cross-national study.

BACKGROUND

An independent relationship between smoking cigarettes and completed suicides has been reported in several cohort and case-control studies of younger subjects, but this relationship has rarely been examined in the elderly.

METHODS

The relationship between the prevalence of smoking in males and females and suicide rates in males and females in the age-bands 65-74 years and 75 + years was examined using national-level aggregate data from the World Health Organisation and the United Nations Development Programme websites. In addition to univariate analysis, multivariate analysis were conducted to ascertain an independent relationship between the prevalence of smoking and elderly suicide rates.

RESULTS

The main findings were: (i) on univariate analysis, the prevalence of smoking in males was positively correlated with suicide rates in males aged 65-74 years and males aged 75 + years, but this relationship was absent in females and (ii) on multivariate analysis there was no independent relationship between the prevalence of smoking in males and suicide rates in males in both the elderly age-bands.

CONCLUSIONS

There is a case for examination of the relationship between smoking and elderly suicides in individual-level cohort or case-control studies because of the potential methodological difficulties in cross-national studies using national- level aggregate data, paucity of cohort or case-control studies at an individual-level in the elderly, and the observation of an independent relationship between smoking and completed suicides in individual-level cohort and case-control studies in younger age groups.