Li Lian, Zhao Yuanzhi, Shi Meijun, Wang Yucheng
Ningbo Kangning Hospital, Ningbo, China.
Front Psychol. 2021 Nov 11;12:753824. doi: 10.3389/fpsyg.2021.753824. eCollection 2021.
Preventing suicide among adolescents is an urgent global public-health challenge, especially in Africa. Accordingly, the aim of this study was to examine the relationship between the early initiation (< 12 years old) of substance use (cigarette smoking, alcohol use, and drug use) and attempted suicide among in-school adolescents in seven African countries. Data on the early initiation of substance use and on attempted suicide among in-school adolescents over the previous 12 months in Benin, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and the United Republic of Tanzania were collected from Global School-based Student Health Surveys and were pooled to determine the overall prevalence of these behaviors in adolescents. Univariate and multivariate logistic regressions were then performed to evaluate country-specific associations between the early initiation of substance use and attempted suicide in these adolescents, followed by meta-analyses to evaluate overall pooled associations. In the abovementioned seven African low- or middle-income countries (LMICs), overall weighted prevalences of attempted suicide and early initiation of cigarette smoking, alcohol use, and drug use among in-school adolescents were 16.05, 7.76, 17.68, and 3.48%, respectively. Multivariate logistic regression analyses revealed that relative to non-smoking, the early initiation of smoking was significantly associated with attempted suicide in these adolescents [OR (95% CI) = 1.783 (1.219-2.348)]. Additionally, the relationship between early initiation of cigarette smoking and attempted suicide is mostly driven by a higher association in girls [OR (95% CI) = 1.867 (1.031-2.703)] than boys [OR (95% CI) = 1.392 (0.995-1.789)]. Moreover, relative to not using other drugs, the early and later initiation of other drug use were also significantly associated with attempted suicide in these adolescents [ORs (95% CIs) = 2.455 (1.701-3.208) and 1.548 (1.198-1.898)]. Programs that can eliminate or decrease the early initiation of substance use among adolescents should be implemented in African LMICs to prevent subsequent suicide attempts, especially among adolescent girls.
预防青少年自杀是一项紧迫的全球公共卫生挑战，在非洲尤为如此。因此，本研究的目的是调查七个非洲国家在校青少年中物质使用（吸烟、饮酒和吸毒）的早期开始（<12岁）与自杀未遂之间的关系。从全球学校学生健康调查中收集了贝宁、利比里亚、毛里求斯、莫桑比克、纳米比亚、塞舌尔和坦桑尼亚联合共和国在校青少年在过去12个月内物质使用早期开始情况和自杀未遂的数据，并将其汇总以确定这些行为在青少年中的总体患病率。然后进行单变量和多变量逻辑回归，以评估这些青少年中物质使用早期开始与自杀未遂之间的国家特定关联，随后进行荟萃分析以评估总体汇总关联。在上述七个非洲低收入或中等收入国家（LMIC）中，在校青少年自杀未遂以及吸烟、饮酒和吸毒早期开始的总体加权患病率分别为16.05%、7.76%、17.68%和3.48%。多变量逻辑回归分析显示，相对于不吸烟，吸烟的早期开始与这些青少年的自杀未遂显著相关[比值比（95%置信区间）=1.783（1.219 - 2.348）]。此外，吸烟早期开始与自杀未遂之间的关系在女孩中[比值比（95%置信区间）=1.867（1.031 - 2.703）]比男孩中[比值比（95%置信区间）=1.392（0.995 - 1.789）]更为明显。此外，相对于不使用其他药物，其他药物的早期和晚期使用开始也与这些青少年的自杀未遂显著相关[比值比（95%置信区间）=2.455（1.701 - 3.208）和1.548（1.198 - 1.898）]。非洲低收入和中等收入国家应实施能够消除或减少青少年物质使用早期开始的项目，以预防随后的自杀未遂行为，尤其是在青少年女孩中。
