Smoking and suicide: a brief overview

Drug Alcohol Depend. 2008 Dec 1;98(3):169-78. doi: 10.1016/j.drugalcdep.2008.06.003. Epub 2008 Aug 3.


This article provides a brief overview of the rationales, possible mechanisms and epidemiological data on the association of smoking, smoking cessation and cessation medications with suicide. Current smoking is reliably associated with suicide both in case-control and cohort studies. The three most plausible (but relatively untested) explanations for the association are that smokers have pre-existing conditions that increase their risk for suicide, smoking causes painful and debilitating conditions that might lead to suicide, and smoking decreases serotonin and monoamine oxidase levels. Stopping smoking appears to lead to major depression in some smokers; thus, it could induce suicide; however, smoking cessation has not been associated with suicide in the few studies available. Regulatory agencies have stated bupropion, rimonabant and varenicline appear to be associated with suicide; however, the data for these statements have not been presented in sufficient detail to assess their validity. Most prior data have come from post hoc analyses. Studies that a priori focus on understanding smoking and suicide are now needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Biomarkers
  • Cannabinoids / adverse effects
  • Cannabinoids / therapeutic use
  • Humans
  • Nicotinic Agonists / adverse effects
  • Nicotinic Agonists / therapeutic use
  • Self-Injurious Behavior / psychology
  • Smoking / epidemiology*
  • Smoking Cessation / psychology
  • Suicide / statistics & numerical data*


  • Antidepressive Agents
  • Biomarkers
  • Cannabinoids
  • Nicotinic Agonists