Covey Lirio S, Berlin Ivan, Hu Mei-Chen, Hakes Jahn K
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA.
BMJ Open. 2012 Jun 8;2(3). doi: 10.1136/bmjopen-2012-000876. Print 2012.
To investigate whether: (1) smoking predicts suicide-related outcomes (SROs), (2) prior SRO predicts smoking, (3) smoking abstinence affects the risk of SRO and (4) psychiatric comorbidity modifies the relationship between smoking and SRO.
Retrospective analysis of longitudinal data obtained in wave 1 (2001-2002) and wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions.
Face-to-face interviews conducted with persons in the community.
US adults (N=43 093) aged 18 years or older were interviewed in wave 1 and reinterviewed (N=34 653) 3 years later. For the present study, the sample was the subset of persons (N=7352) who at the wave 2 interview reported low mood lasting 2 weeks or more during the past 3 years and were further queried regarding SRO occurring between waves 1 and 2.
SRO composed of any of the following: (1) want to die, (2) suicidal ideation, (3) suicide attempt, reported at wave 2. Current smoking reported at wave 2.
Current and former smoking in wave 1 predicted increased risk for wave 2 SRO independently of prior SRO, psychiatric history and socio-demographic characteristics measured in wave 1 (adjusted OR (AOR)=1.41, 95% CI 1.28 to 1.55 for current smoking; AOR=1.32, 95% CI 1.21 to 1.43 for former smoking). Prior SRO did not predict current smoking in wave 2. Compared with persistent never-smokers, risk for future SRO was highest among relapsers (AOR=3.42, 95% CI 2.85 to 4.11), next highest among smoking beginners at wave 2 (AOR=1.82, 95% CI 1.51 to 2.19) and lowest among long-term (4+ years) former smokers (AOR=1.22, 95% CI 1.12 to 1.34). Compared with persistent current smokers, risk for SRO was lower among long-term abstainers (p<0.0001) but not among shorter-term abstainers (p=0.26).
Smoking increased the risk of future SRO independently of psychiatric comorbidity. Abstinence of several years duration reduced that risk.
探讨以下问题：（1）吸烟是否可预测自杀相关结局（SRO）；（2）既往SRO是否可预测吸烟；（3）戒烟是否会影响SRO风险；（4）精神疾病共病是否会改变吸烟与SRO之间的关系。
对在全国酒精及相关疾病流行病学调查的第1波（2001 - 2002年）和第2波（2004 - 2005年）中获得的纵向数据进行回顾性分析。
在社区中对人员进行面对面访谈。
18岁及以上的美国成年人（N = 43093）在第1波接受访谈，并在3年后再次接受访谈（N = 34653）。对于本研究，样本是在第2波访谈中报告在过去3年中情绪低落持续2周或更长时间，并进一步询问在第1波和第2波之间发生的SRO的人员子集（N = 7352）。
SRO由以下任何一项组成：（1）想死；（2）自杀意念；（3）自杀未遂，在第2波报告。第2波报告的当前吸烟情况。
第1波中的当前吸烟和既往吸烟可独立于既往SRO、精神病史和第1波中测量的社会人口学特征预测第2波SRO风险增加（当前吸烟的调整后OR（AOR）= 1.41，95% CI 1.28至1.55；既往吸烟的AOR = 1.32，95% CI 1.21至1.43）。既往SRO不能预测第2波中的当前吸烟。与持续不吸烟者相比，复吸者未来SRO风险最高（AOR = 3.42，95% CI 2.85至4.11），其次是第2波开始吸烟的人（AOR = 1.82，95% CI 1.51至2.19），长期（4年以上）既往吸烟者风险最低（AOR = 1.22，95% CI 1.12至1.34）。与持续当前吸烟者相比，长期戒烟者的SRO风险较低（p < 0.0001），但短期戒烟者中则不然（p = 0.26）。
吸烟独立于精神疾病共病增加未来SRO风险。数年的戒烟可降低该风险。
