Comparison of Suicide Attempts/Behaviors Following Smoking Cessation Treatments Among Schizophrenic Smokers

Abstract

Background: Smoking cessation may lead to depression in some smokers and result in increased risk of suicide.

Objective: To compare the risk of suicide attempts/behaviors associated with different smoking cessation medications among schizophrenic patients.

Methods: A retrospective cohort study was conducted using General Electric (GE) medical record database (1995-2011). The first day of being prescribed a smoking cessation medication defined as index date. Patients were followed up to one year from index date. Patients' suicide behaviors or attempts were identified through ICD-9 codes and E-codes. Cox proportional hazards model was applied to examine the association between smoking cessation medication and suicidal/self-injurious behaviors.

Results: Our cohort consisted of 3925 patients with diagnosis of schizophrenia or schizoaffective disorder who initiated cessation medication. Among them, 104 (2.65%) had suicide attempts or behavior within one-year follow up. However, statistically significant difference in the risk of suicide attempts/behaviors was not detected across cessation regimens in the Cox proportional hazard analysis. Only comorbidity index was found to be associated with suicide, which showed that higher Charlson comorbidity index was associated with higher risks of suicide behaviors within one year (HR=1.15, 95% CI=1.04-1.27).

Conclusion: There were no significant differences in suicide attempts/behaviors with different cessation medications.