Report: Smoking bans, cigarette taxes linked to lower suicide rates

SALT LAKE CITY — Utah mental health and public health officials say a new report that links stronger anti-smoking initiatives to lower suicide rates suggests an added benefit of states’ prevention and cessation efforts.

The report, published in the journal Nicotine & Tobacco Research, found that public health interventions, such as raising cigarette taxes and imposing indoor smoking bans, could reduce risk of suicide by as much as 15 percent.

Janae Duncan, coordinator of the Utah Health Department’s Tobacco Prevention and Control Program, said Utah’s Indoor Clean Air Act “is really strong.”

While the state’s rate of adult smoking of 10.6 percent is the lowest in the nation, Utah’s tobacco taxes are relatively low at $1.70 per pack of cigarettes, Duncan said. Utah’s rate is higher than the national average but well below the rates of some East Coast states such as New York, which imposes a tax of $4.35 per pack.

“The study said each dollar increase in cigarette taxes was associated with a 10 percent decrease in (the relative risk of) suicide,” she said. “Even though we have a low tobacco use rate, it may be a good reason to look at raising our excise tax for tobacco.”

Other Utah officials say the report lends credence to mental health and substance abuse treatment practices that encourage wellness across the spectrum.

The state’s 2013 Recovery Plus initiative, for instance, required all publicly funded substance abuse and mental health treatment facilities to be tobacco free by March 2013.

“When we first started talking about doing this, there was a lot of talk such as, ‘You can’t expect someone with substance abuse or mental illness to also give that up. It’s too much on a person.’ They found that’s not the case. It actually helps with their recovery,” said Teresa Brechlin, coordinator in the Utah Department of Health’sViolence and Injury Prevention Program.

Kim Myers, suicide prevention coordinator with the Utah Division of Substance Abuse and Mental Health, said Utah officials have long observed that clients in publicly funded substance abuse and mental health facilities smoke at substantially higher rates than the general population.

The authors of the report noted that clinical and general studies have likewise documented elevated rates of smoking among people with anxiety disorders, alcohol and drug dependence, and schizophrenia, among other diagnoses.

“However, it is also possible that smoking is not merely a marker for psychiatric disorders, but rather directly increases the risk for such disorders, which in turn increases the risk for suicide,” the study’s authors wrote.

Myers said the study raises the question whether nicotine itself raises suicide risk.

“How do we use that information on a population level, but also on an individual level, to reduce someone’s risk, especially when it comes to people who have some of those other risks such as serious mental illness or substance use disorders?” she asked.

The study also determined that smokers’ risk for suicide is two to four times greater than nonsmokers.

Duncan said more research is needed to understand how the link applies to Utah. Utah’s suicide rate has been consistently higher than the national rate for the past decade, according to state health department statistics, while smoking rates are very low.

“The study doesn’t give those clear answers. I think what it does do, it helps us see we should be looking at whole health, and it’s important to look at it across the board, not just issue by issue, but how all these things are tying together,” Duncan said.