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Research Summary

Youth Alcohol Use and Suicide

To explore the influence of substance use on suicidal behaviors, researchers analyzed interview data about childhood mental health from a community sample of 1458 youths (aged 9–17 years) and their parents/guardians.

  • Forty-nine (3%) of the youth reported at least 1 suicide attempt during their lifetimes.
  • In analyses controlling for sociodemographic factors, psychiatric disorders, and suicidal ideation, the following were significantly associated with suicide attempts:
    • smoking at least 1 cigarette per day in the past 6 months (odds ratio, OR, 3.0, compared with not smoking in the past year)
    • alcohol abuse/dependence (OR 9.3, compared with not drinking >=6 times in the past year)
    • drug use in the past year (OR 4.6, compared with no drug use in the past year)
  • In analyses that also adjusted for other substance use and abuse (e.g., infrequent smoking, drug use, drug dependence), smoking at least 1 cigarette per day or having alcohol abuse/dependence, compared with not using any substance, significantly increased odds of suicide attempts (OR 5.0 and 25.2, respectively). Alcohol use alone was not significantly associated with suicide attempt.


Although it lacked a large, nationally representative sample, this study confirms the association between frequent smoking, alcohol use disorders, and suicide attempts in youths. Clinicians should address suicidal behaviors among their young patients with alcohol use disorders, and heavy drinking among those with suicidal behaviors.

Richard Saitz, MD, MPH
Rosanne Guerriero, MPH


Wu P, Hoven C, Liu X, et al. Substance use, suicidal ideation and attempts in children and adolescents. Suicide Life Threat Behav. 2004;34(4):408–420.