Tobacco use disorder and the risk of suicide mortality
Tobacco use disorder and the risk of suicide mortality
复制标题
DOI：
10.1111/add.12381
复制
发表时间：
2014-01-01
期刊：
影响因子：
6
通讯作者：
Katz, Ira R.
中科院分区：
文献类型：
--
作者：
Bohnert, Kipling M.;Ilgen, Mark A.;Katz, Ira R.
背景和目的烟草使用可能是自杀死亡率的一个危险因素;然而，先前的研究产生了模棱两可的结果，并受到样本量相对较小的限制，无法研究罕见的自杀事件，以及缺乏对其他重要因素的调整，包括精神疾病。我们估计了烟草使用障碍与自杀死亡率风险之间的预测关联，调整其他重要变量。设计一项前瞻性队列研究。设置美国退伍军人健康管理局（VHA）。所有在2005财政年度（FY）接受VHA服务并在2006财政年度开始时存活的个体（n=4863086）。通过2004-05财年VHA国家患者护理数据库记录评估烟草使用障碍。自杀死亡率的结果进行了评估，从2006财政年度开始到2008财政年度结束的随访期间，使用国家死亡指数records.FindingsOf 4863086人在研究中，4823人死于自杀在随访期间。在未校正的模型中，烟草使用障碍与自杀风险增加相关[风险比（HR）=1.88; 95%置信区间（CI）=1.76，2.02]。调整模型协变量后，协会仍然具有统计学意义，虽然衰减（HR=1.36，95%CI =1.27，1.46）。精神疾病可能部分解释烟草使用障碍和自杀之间的关系。
Background and aimsTobacco use may be a risk factor for suicide mortality; however, prior research has produced equivocal findings and has been limited by relatively small sample sizes to study the rare event of suicide, as well as a lack of adjustment for other important factors, including psychiatric illness. We estimate the predictive association between tobacco use disorder and the risk of suicide mortality, adjusting for other important variables.DesignA prospective cohort study.SettingThe United States Veterans Health Administration (VHA).ParticipantsAll individuals who received VHA services in fiscal year (FY) 2005 and were alive at the start of FY 2006 (n=4863086).MeasurementsTobacco use disorder was assessed via FYs 2004-05 VHA National Patient Care Database records. The outcome of suicide mortality was assessed during the follow-up interval from the beginning of FY 2006 to the end of FY 2008 using National Death Index records.FindingsOf the 4863086 individuals in the study, 4823 died by suicide during the follow-up interval. In the unadjusted model, tobacco use disorder was associated with an increased risk of suicide [hazard ratio (HR)=1.88; 95% confidence interval (CI)=1.76, 2.02]. After adjustment for model covariates, the association remained statistically significant, although attenuated (HR=1.36, 95% CI=1.27, 1.46).ConclusionsTobacco use disorder may confer a modest excess risk of death by suicide. Psychiatric disorders may partially explain the relationship between tobacco use disorder and suicide.