The DOI matches its Crossref record; 103 of the 105 references it cites were found in a registry or an index.
Smoking and suicide: A brief overview
Open accessAbstract
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.
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“The underlying mechanism for this increased risk is unclear, although confounding by alcohol misuse and mental illness seems to explain some, but certainly not all, of the association.1”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Although active smokers have been reported to have twofold to threefold increased risk of suicidality when compared to nonsmokers,1–4”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [1]
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Smoker Suicide Rates and Risks in the United States and Frankfurt, Germany
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Chapter 19. College and University Students
Ash, P. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg19
Chapter 15. Outpatient Treatment of the Suicidal Patient
West, J. C., Hamaoka, D., & Ursano, R. J. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg15
Fernando, A. T., & Kennedy, K. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg13
Hanson, A. L. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg17
Chapter 22. Military Personnel and Veterans
Joshi, K. G., Writer, B. W., & Ritchie, E. C. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg22
Chapter 12. Personality Disorders
Carballo, J., Padierna, Stanley, B., Brodsky, B. S., & Oquendo, M. A. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg12
Chapter 14. Emergency Services
Louie, D., & Ravindranath, D. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg14
Chapter 11. Schizophrenia and Other Psychotic Disorders
Brandt, K., Schrimpf, L., & Lauriello, J. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg11
Chapter 7. Depressive Disorders
Holliday, R. P., Monteith, L. L., Nazem, S., & Wortzel, H. S. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg07
Chapter 2. Psychopharmacology and Neuromodulation
Trestman, R. L., & Kablinger, A. S. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg02
Chapter 4. Psychodynamic Treatment
Seritan, A. L., Straznickas, K. A., & Gabbard, G. O. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg04
Chapter 28. The Psychological Autopsy and Retrospective Evaluation of Suicidal Intent
Scott, C. L., & Resnick, P. J. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg28
Chapter 26. Physician-Assisted Dying
Fairman, N. P. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg26
Chapter 29. Suicide and Firearms
Gold, L. H. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg29
Chapter 6. Cultural Humility and Structural Competence in Suicide Risk Assessment
How, P. C., Kho, C., & Shim, R. S. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg06
Balon, R. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg05
Chapter 27. Suicide Risk Management
Vanderpool, D. L. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg27
Chapter 8. Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder
Ostermeyer, B. K., Funk-Lawler, R., & Perdue, J. J. (2020) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375288.lg08
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Drug-associated bipolar disorder: A disproportionality analysis of the FAERS database
Du, P., Chen, X., Zhang, W., Zhou, Y., & Xu, Y. (2026) · Psychiatry Research · doi:10.1016/j.psychres.2026.117375
Metadata
- Authors
- Hughes, J. R.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Hughes, John R.
- ORCID
- Hughes, John R.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 98
- Issue
- 3
- Pages
- 169-178
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC2585177
- OpenAlex
- W2062560594
- Cited by
- 236
- References
- 105
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 1 · 2022: 4 · 2021: 12 · 2020: 39 · 2019: 12 · 2018: 13 · 2017: 7 · 2016: 12 · 2015: 16 · 2014: 18 · 2013: 14 · 2012: 15
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (DA00490, K05DA000490)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking, suicide, smoking cessation, smoking cessation medication, bupropion, rimonabant, varenicline, major depressive disorder, serotonin, monoamine oxidase, suicide risk factors, suicide epidemiology
- MeSH terms
- Antidepressive Agents, Cannabinoids, Humans, Smoking, Suicide, Biomarkers, Smoking Cessation, Self-Injurious Behavior, Nicotinic Agonists
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