The impact of hazardous drinking on suicide among working-age Russian males: an individual-level analysis.

AIMS

To estimate the association between hazardous drinking and suicide among working-age Russian males.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Data are from the Izhevsk Family Study (IFS), a population-based case-control study of premature mortality among working-age Russian men. The present study used two sets of cases: all men aged 25-54 years living in Izhevsk who, during October 2003-October 2005, (i) died of suicide (n = 120) or (ii) died of suicide or of injuries of undetermined intent (n = 231). Controls were selected at random from a city population register. Drinking data were obtained from proxy informants living in the same household as cases and controls. Drinking exposures were defined by liters of ethanol consumed as a continuous variable, liters of ethanol as a categorical variable, frequency of consumption of non-beverage alcohol (e.g. colognes, medicines, cleaning fluids) and a measure of problem drinking based on behavioral indicators. The association between hazardous drinking and suicide was estimated by mortality odds ratios, adjusting for age, marital status, education and smoking status.

FINDINGS

A total of 57% of cases and 20% of controls were problem drinkers. Men who drank 20+ liters of ethanol in the prior year were 2.7 times more likely [95% confidence interval (CI) = 1.5-5.0] to die from suicide than moderate drinkers. Men who drank non-beverage alcohols one to two times/week were 3.9 times more likely (95% CI, 1.3-11.0) to die from suicide than men who rarely or never drank them. Problem drinkers were 3.7 times more likely (95% CI, 2.5-5.6) to die from suicide relative to non-problem drinkers. Forty-three per cent of suicides were attributed to hazardous drinking (problem drinking or consuming non-beverage alcohol at least once/week or both).

CONCLUSIONS

Hazardous drinking substantially increases the risk of suicide among working-age Russian males, with nearly half of all suicides attributed to this drinking pattern.