Association of Tobacco Use and Suicidal Ideation among Adults with Metal Health Issues




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Purpose: People with mental health disorders are at higher risk of tobacco use. Studies have demonstrated higher prevalence of tobacco use among people with mental health disorders. We aimed to examine the association between tobacco use and suicidal ideation (SI) among adults with major depressive episode (MDE) and serious psychological distress (SPD) using data from the 2021 National Survey on Drug Use and Health (NSDUH).

Methods: Weighted multiple logistic regression modeling and descriptive analyses were conducted on a representative sample of 47,291 from the US general population. Respondents were classified as having past-year SI if they answered yes to SI or suicide planning in the past year. Past-year SPD was defined as a score of 13 or higher on the K6 scale of nonspecific psychological distress. MDE was defined based on the diagnostic criteria from DSM-5. Self-reported data on the use of tobacco products was used. Models were adjusted for sex, age category, and race/ethnicity.

Results: Tobacco use was significantly associated with SI among adults with past-year MDE and SPD after accounting for covariates. Among adults with past-year MDE, individuals using/having used tobacco products were more likely to have SI (aOR 1.474; 95% CL 1.107, 1.962). Among adults with past-year SPD, adults using/having used tobacco products were more likely to have SI (aOR= 1.268; 95% CL 1.031, 1.558) compared to adults with no tobacco use history.

Conclusion: Findings suggest the need to screen tobacco use as a risk factor in suicidal risk factors among adults with mental health disorders.