Combined Influence of Smoking Frequency and Intensity on Suicidal Ideation and Attempts in Korean High School Students

Abstract

Purpose: The purpose of this study was to investigate the combined influence of the frequency and the intensity of smoking on suicidal ideation and attempts in Korean high school students. Methods: This cross sectional study used secondary data from the 2014 Adolescent Health Behavior Online Survey. A total of 35,094 high school students were included in the study. The study set up two categories for the frequency of smoking - intermittent and daily - and another two for the intensity of smoking - heavy and light. Complex samples logistic regression was used to analyze the combined influence of smoking frequency and intensity on suicidal ideation and attempts. Results: Regardless of frequency and intensity, smoking was more likely to increase suicidal ideation and attempts than non-smoking. Among smokers, intermittent heavy smokers (suicidal ideation: Adjusted Odds Ratio [AOR]: 1.406, 95% Confidence Interval [CI]: 1.015~2.161, p=.012; suicidal attempts: AOR: 2.977, 95% CI: 1.814~4.886, p<.001) or daily heavy smokers (suicidal ideation: AOR: 1.274, 95% CI: 1.017~1.596, p=.035; suicidal attempts: AOR: 1.717, 95% CI: 1.250~2.359, p=.001) had significantly higher odds of suicidal ideation and attempts than intermittent light smokers. Conclusion: Based on the results, smoking prevention and cessation are essential to preventing suicides in adolescents. Especially, smoking intervention programs are needed to reduce smoking intensity in smokers.