1. In a cohort of US children aged 9-10, those who used tobacco products had a greater risk of suicide attempts (SAs) but not nonsuicidal self-injury (NSSI), or suicidal ideation (SI).

Evidence Rating Level: 2 (Good)

Tobacco use has been on the rise in adolescents and children, and it has become an increasing public health concern. Smoking has negative effects on the health of individuals, especially on mental health outcomes such as diminished neurocognition and increased risk of poor social behaviours. Specifically, previous studies have found that there is a 2-5 greater risk of self-injurious thoughts and behaviours (SITBs) activity in adolescent smokers than in adult smokers, although this association is poorly characterized. In this cohort study, researchers included data from September 1, 2022 to Septermber 5, 2023, from the Adolescent Brain Cognitive Development study to further assess this link. Bivariate analyses along with multivariate logistic regressions were performed to understand the data. Included in the study were 8988 youths, with the median age being 9.8 years (8.9-11.0) and 4301 girls (47.9%). Of these individuals, 101 (1.1%) reported ever using tobacco at baseline, while the other 8887 (98.9%; 4259 girls [47.9%]; median age, 9.8 years [range, 8.9-11.0]) did not report using any tobacco products at baseline. The prevalence of SITBs at baseline was: Nonsuicidal self-injury (NSSI), 4.8% (n=428); suicidal ideation (SI), 12.8% (n=1151); and suicidal attempts (SAs), 1.7% (n=227), whereas the values at year 1 were: NSSI, 5.7% (n=508); SI, 16.2 (n=1454), and SAs, 2.5% (n=227), and the values at year 2 were: NSSI, 6.2% (n=560); SI, 20.6% (n=1853); and SAs 3.6% (n=321). Significant associations were found between tobacco use and SAs and SI at all times. Youth that used tobacco products had an increased risk of SAs by 3-5 times (baseline: n=153 [adjusted odds ratio (OR), 4.67; 95% CI, 2.35-9.28; false discovery rate (FDR)-corrected P<.001]; year 1: n=227 [adjusted OR, 4.25; 95% CI, 2.33-7.74; FDR-corrected P<.001]; and year 2: n=321 [adjusted OR, 2.85; 95% CI, 1.58-5.13; FDR-corrected P=.001]). Overall, tobacco use was associated with an increased risk of SAs among elementary school-aged children. Although further research will be required to characterize this association, this serves as another warning on the possible deleterious effects of smoking and vaping.

Click to read the study in JAMA Network Open

Image: PD

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