Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey

IntroductionSuicide is a significant global public health concern influenced by diverse factors. Smoking is associated with an increased risk of suicide-related behaviors, yet age- and sex-specific risks remain unclear. This study examined the association between smoking status and suicide-related b...

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Main Authors: Jae Han Kim, Taesic Lee, Hyo Jin Park, Seon Mee Kim, Jin-Wook Kim
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1440792/full
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author Jae Han Kim
Taesic Lee
Hyo Jin Park
Seon Mee Kim
Jin-Wook Kim
Jin-Wook Kim
author_facet Jae Han Kim
Taesic Lee
Hyo Jin Park
Seon Mee Kim
Jin-Wook Kim
Jin-Wook Kim
author_sort Jae Han Kim
collection DOAJ
description IntroductionSuicide is a significant global public health concern influenced by diverse factors. Smoking is associated with an increased risk of suicide-related behaviors, yet age- and sex-specific risks remain unclear. This study examined the association between smoking status and suicide-related behaviors, with specific estimates for different age and sex groups.MethodsThis study investigated the association between smoking status (never-smoker, ex-smoker, and current smoker) and suicide-related behaviors (suicidal ideation, planning, and attempts). We extracted the data from the Korea National Health and Nutrition Examination Survey database between January 1st, 2015, and December 31st, 2021. A total of 32,837 participants were included in this study, with a mean (SD) age of 52.3 (0.09) years. Multivariable logistic regression was adjusted for age, sex, BMI, income level, education level, active physical activity, alcohol consumption, and comorbid conditions (perceived stress, perceived symptoms of depression, hypertension, diabetes mellitus, and dyslipidemia). We explored the potential dose-response relationship by stratifying the analysis based on participants’ smoking intensity, as measured by pack-years. We also performed the subgroup analysis for the following variables: age groups, sex, income level, alcohol consumption, active physical activity, perceived stress, and perceived symptoms of depression. Statistical significance was set at P < 0.05. Statistical analyses were done using R software, version 4.2.3.ResultsCurrent smokers demonstrated significantly elevated risks for suicidal ideation (OR 2.022, 95% CI 1.913–2.137), planning (OR 2.138, 95% CI 1.930–2.368), and attempts (OR 2.082, 95% CI 1.942–2.232). Ex-smokers also exhibited increased risks for suicidal ideation (OR 1.553, 95% CI 1.467–1.644) and attempts (OR 1.567, 95% CI 1.458–1.684), though not for planning (OR 1.087, 95% CI 0.963–1.228). Our findings suggested the potential dose-dependent relationship. Notably, males aged 40–59 were found to be the most vulnerable group for suicide-related behaviors.ConclusionThis study underscores the significant association of smoking with increased risks of suicidal behaviors, particularly among current smokers. Males aged 40 to 59 emerged as a high-risk group. Findings emphasize the critical role of smoking cessation in suicide prevention, necessitating targeted interventions. Prospective studies should delve into causal pathways to inform effective prevention strategies.
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spelling doaj-art-9e5cbccd4a294e6fb9d86f9295be9dd92025-08-20T02:32:34ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-06-011610.3389/fpsyt.2025.14407921440792Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional surveyJae Han Kim0Taesic Lee1Hyo Jin Park2Seon Mee Kim3Jin-Wook Kim4Jin-Wook Kim5Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of KoreaDepartment of Family Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of KoreaDepartment of Family Medicine, Ewha Woman’s University Seoul Hospital, Ewha Woman’s University College of Medicine, Seoul, Republic of KoreaDepartment of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of KoreaDepartment of Family Medicine, Korea University College of Medicine, Seoul, Republic of KoreaHippocrata Clinic, Seoul, Republic of KoreaIntroductionSuicide is a significant global public health concern influenced by diverse factors. Smoking is associated with an increased risk of suicide-related behaviors, yet age- and sex-specific risks remain unclear. This study examined the association between smoking status and suicide-related behaviors, with specific estimates for different age and sex groups.MethodsThis study investigated the association between smoking status (never-smoker, ex-smoker, and current smoker) and suicide-related behaviors (suicidal ideation, planning, and attempts). We extracted the data from the Korea National Health and Nutrition Examination Survey database between January 1st, 2015, and December 31st, 2021. A total of 32,837 participants were included in this study, with a mean (SD) age of 52.3 (0.09) years. Multivariable logistic regression was adjusted for age, sex, BMI, income level, education level, active physical activity, alcohol consumption, and comorbid conditions (perceived stress, perceived symptoms of depression, hypertension, diabetes mellitus, and dyslipidemia). We explored the potential dose-response relationship by stratifying the analysis based on participants’ smoking intensity, as measured by pack-years. We also performed the subgroup analysis for the following variables: age groups, sex, income level, alcohol consumption, active physical activity, perceived stress, and perceived symptoms of depression. Statistical significance was set at P < 0.05. Statistical analyses were done using R software, version 4.2.3.ResultsCurrent smokers demonstrated significantly elevated risks for suicidal ideation (OR 2.022, 95% CI 1.913–2.137), planning (OR 2.138, 95% CI 1.930–2.368), and attempts (OR 2.082, 95% CI 1.942–2.232). Ex-smokers also exhibited increased risks for suicidal ideation (OR 1.553, 95% CI 1.467–1.644) and attempts (OR 1.567, 95% CI 1.458–1.684), though not for planning (OR 1.087, 95% CI 0.963–1.228). Our findings suggested the potential dose-dependent relationship. Notably, males aged 40–59 were found to be the most vulnerable group for suicide-related behaviors.ConclusionThis study underscores the significant association of smoking with increased risks of suicidal behaviors, particularly among current smokers. Males aged 40 to 59 emerged as a high-risk group. Findings emphasize the critical role of smoking cessation in suicide prevention, necessitating targeted interventions. Prospective studies should delve into causal pathways to inform effective prevention strategies.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1440792/fullsmokingsuicidal ideationsuicidal planningsuicide attemptSouth Korea
spellingShingle Jae Han Kim
Taesic Lee
Hyo Jin Park
Seon Mee Kim
Jin-Wook Kim
Jin-Wook Kim
Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
Frontiers in Psychiatry
smoking
suicidal ideation
suicidal planning
suicide attempt
South Korea
title Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
title_full Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
title_fullStr Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
title_full_unstemmed Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
title_short Association between smoking status and suicidal ideation, planning, and attempts among adults in South Korea: a population-based cross-sectional survey
title_sort association between smoking status and suicidal ideation planning and attempts among adults in south korea a population based cross sectional survey
topic smoking
suicidal ideation
suicidal planning
suicide attempt
South Korea
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1440792/full
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