Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Johann Wolfgang Goethe-University of Frankfurt/Main, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt/Main, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2011 Nov;46(11):1127-32. doi: 10.1007/s00127-010-0287-y. Epub 2010 Sep 21.
Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplified effect on risk prediction has not been investigated so far.
In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 25-74 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption.
After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.14-4.37) and for smoking (SMR = 2.30; 95% CI 1.36-3.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.07-9.46) was observed for smokers with risky alcohol consumption.
The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness.
吸烟和大量饮酒可预测自杀行为。目前尚未研究同时存在这两种情况是否会对风险预测产生放大效应。
在一项基于社区的队列研究中，共有来自三个独立的基于人群的 MONICA 横断面调查（分别于 1984/85 年、1989/90 年和 1994/95 年进行）的 12888 名受试者（6456 名男性，6432 名女性；评估时年龄为 25-74 岁）纳入研究，这些受试者来自代表德国南部人群的社区。使用德国人群的死亡率计算了自杀死亡的标准化死亡率比（SMR），用于吸烟和大量饮酒。
在平均 12.0（SD 4.4）年的随访时间和 154275 人年的风险期后，共有 1449 人死于各种原因，其中 38 人死于自杀。与一般人群相比，自杀死亡率升高与危险饮酒（SMR=2.37；95%CI 1.14-4.37）和吸烟（SMR=2.30；95%CI 1.36-3.63）有关。对于有危险饮酒的吸烟者，自杀死亡率显著升高（SMR=4.80；95%CI 2.07-9.46）。
有吸烟和危险饮酒的受试者发生自杀的相对风险增加约四倍，表明存在协同作用，值得提高警惕。
