Jung Myoungjee
Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do 26426, Republic of Korea.
J Affect Disord. 2019 Feb 1;244:164-170. doi: 10.1016/j.jad.2018.09.077. Epub 2018 Sep 22.
Considering the rising suicide risk rate, we investigated the associations between alcohol abuse, smoking, and suicide risk.
Participants were 21,654 (male: 9,729, female: 11,925) responders of the National Nutrition Survey from 2013 to 2015 in Korea. Associations between alcohol, smoking, and suicide risk were analyzed using logistic regression and path analysis. The Alcohol Use Disorder Identification Test (AUDIT) measured alcohol consumption levels.
Among participants, 1,718 (male: 602, female: 1,116) presented a suicide risk related to alcohol and smoking. Men's odds ratio of suicide ideation was the highest among those reporting current smoking and AUDIT scores ≥ 20, at 83.75 (95% confidence interval [CI] = 48.07-145.94); that of suicide ideation was the highest for men reporting current smoking and AUDIT scores ≥ 20, at 121.49 (CI = 48.92-301.67); and that of suicide attempts was the highest for men reporting current smoking and AUDIT scores of 16-19, at 256.341 (CI = 77.12-852.05). Women's odds ratio of suicide ideation was the highest for those reporting current smoking and AUDIT scores ≥ 20, at 21.92 (CI = 7.19-66.80); that of suicide ideation was the highest for women reporting current smoking and AUDIT scores ≥ 20, at 19.26 (CI = 4.52-82.17); and that for suicide attempts was the highest for those reporting past smoking and AUDIT scores 8-15, at 104.64 (CI = 10.32- < 999.99). As a result of the path analysis, six paths were fully adopted. Smoking status had a statistically significant positive effect on attempted suicide (t = 146.50, p < .001). AUDIT scores were found to have a significant positive effect on attempted suicide (t = 2503.74, p < .001).
Results must be interpreted within the study design context. Suicidality does not assess any depressive episode. the sample did not include persons who had committed suicide. As suicidal ideation, plans, and attempts are on a spectrum it is difficult to find valid and appropriate, as well as culturally-sensitive, screening questions for suicidal risk that are comparable across international studies. The data used in this study were based on self-reports of smoking, drinking, and suicide risk.
The combination of alcohol use and smoking was associated with greater suicide risk than were alcohol and smoking separately.
鉴于自杀风险率不断上升，我们调查了酒精滥用、吸烟与自杀风险之间的关联。
研究对象为2013年至2015年韩国全国营养调查的21654名应答者（男性9729名，女性11925名）。使用逻辑回归和路径分析来分析酒精、吸烟与自杀风险之间的关联。酒精使用障碍识别测试（AUDIT）用于衡量酒精消费水平。
在参与者中，1718人（男性602人，女性1116人）存在与酒精和吸烟相关的自杀风险。在报告当前吸烟且AUDIT评分≥20的人群中，男性自杀意念的比值比最高，为83.75（95%置信区间[CI]=48.07-145.94）；在报告当前吸烟且AUDIT评分≥20的男性中，自杀意念的比值比最高，为121.49（CI=48.92-301.67）；在报告当前吸烟且AUDIT评分为16-19的男性中，自杀未遂的比值比最高，为256.341（CI=77.12-852.05）。在报告当前吸烟且AUDIT评分≥20的女性中，自杀意念的比值比最高，为21.92（CI=7.19-66.80）；在报告当前吸烟且AUDIT评分≥20的女性中，自杀意念的比值比最高，为19.26（CI=4.52-82.17）；在报告过去吸烟且AUDIT评分为8-15的女性中，自杀未遂的比值比最高，为104.64（CI=10.32-<999.99）。路径分析结果显示，六条路径被完全采纳。吸烟状况对自杀未遂有统计学显著的正向影响（t=146.50，p<.001）。发现AUDIT评分对自杀未遂有显著的正向影响（t=2503.74，p<.001）。
研究结果必须在研究设计背景下进行解读。自杀倾向未评估任何抑郁发作情况。样本未包括已自杀的人群。由于自杀意念、计划和未遂处于一个连续谱上，因此很难找到有效且合适的、以及具有文化敏感性的、在国际研究中具有可比性的自杀风险筛查问题。本研究使用的数据基于吸烟、饮酒和自杀风险的自我报告。
与单独的酒精使用和吸烟相比，酒精使用与吸烟的组合与更高的自杀风险相关。
