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Cigarette Smoking and Suicide: A Prospective Study of 300,000 Male Active-duty Army Soldiers

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Publication Date: November 2000

Publisher(s): American Journal of Epidemiology

Author(s): Matthew Miller, MD, MPH, ScD; David Hemenway, PhD; Paul J. Amoroso; Michelle M. Yore; Nicole S. Bell


Special Collection: The Joyce Foundation

Topic: Government (Government agencies and bodies)
Health (Diseases and disorders)
Social conditions (Alcohol and drug addiction and trafficking)

Keywords: suicide; smoking ; Male Soliders ; Army deaths

Type: Report

Coverage: United States


In the United States, suicide is the third leading cause of death among adult men aged 18-44 years in the military, where it accounts for 13 percent of all fatalities. Several risk factors for suicide are more common in smokers than in nonsmokers, including depression, alcohol consumption, social isolation, cancer, and being white.

The authors examined the relation between cigarette smoking and suicide by conducting a cohort study of 300,000 male U.S. Army personnel followed prospectively from January 1987 through December 1996 for 961,657 person-years. They found that the risk of suicide increased significantly with the number of cigarettes smoked daily. In multivariable-adjusted analyses, smokers of more than 20 cigarettes a day, compared with never smokers, were more than twice as likely to commit suicide. For male active-duty army personnel, the dose-related association between smoking and suicide was not entirely explained by the greater tendency of smokers to be white, drink heavily, have less education, and exercise less often.