Impact of Cigarette Policies on Suicide Rates

impact-of-cigarette-policies-on-suicide-rates_medium_smallThe Question
Can tobacco-related policies have an impact on suicide rates?

Smoking has been shown to be associated with suicide, with smokers having two to four times greater risk for suicide than nonsmokers. Nicotine and smoking are also associated with increased risk for mental health conditions and problems with alcohol and drugs. This association is critical for suicide prevention, since nine out of ten people who die by suicide have at least one diagnosable and potentially treatable mental health condition. Cigarette taxes and smoke-free air policies have been shown to decrease smoking.

The Study
The study linked information on state-level cigarette taxes and smoke-free air policies from the three sources:

  • State Cancer Legislative Database.
  • Estimates of demographic characteristics (such as age and sex) derived from survey data.
  • Death rates from the US Multiple Causes of Death files from 1990-2004.

Data were combined in 6-year intervals to account for the impact of past and present policies.


  • A $1 increase in taxes was associated with a 12.4% reduction in suicide rates among 18-65 year olds.
  • A 1-point increase in severity of smoke-free air policies, using a 6-point scale, was associated with a 3% reduction in suicide rates in the same age group.
  • When both variables were combined (and accounting for overlap), there was a 12% reduction.
  • Age groups with the highest smoking rates showed the highest reductions in suicide. Those over 65 with the lowest smoking rates had the lowest reduction in suicide.


  • A $1 cigarette tax might save approximately 4,000 adults, according to data from 2012.
  • Reducing smoking and nicotine intake can decrease mental health problems.
  • Public policy can impact suicide rates.
  • Since smoking is a modifiable behavior, smoking makes for a prime target for suicide prevention efforts.

Publication from AFSP grant
Grucza RA, Plunk AD, Krauss MJ, Cavazos-Rehg PA, Deak J, Gebhardt K, Chaloupka FJ, Bierut LJ. (2014). Probing the Smoking–Suicide Association: Do Smoking Policy Interventions Affect Suicide Risk? Nicotine Tob Res.2014 Nov;16(11):1487-94. doi: 10.1093/ntr/ntu106. Epub 2014 Jul 16.

Richard Grucza, PhD, MEP is an Assistant Professor in the Department of Psychiatry at the School of Medicine, Washington University in St. Louis. Click here to read more about Dr. Grucza’s AFSP Standard Research Grant.


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