Perceptions towards charcoal-burning suicide and the surge of this lethal method in Taiwan.

Yi-Ju Pan,I-Chih Cheng,Mei-Xian Loi,Chun-Lin Chen,Yin-Hsiang Lan,John J. Mann

doi:10.1371/journal.pone.0262384

Abstract

ObjectiveWhether sociocultural perceptions of charcoal-burning suicide have influenced its rapid increase in prevalence is unclear. We aimed to explore perceptions of Taiwan’s general population regarding charcoal-burning suicide, their personal belief in life after death, and related feelings of thoughts associated with those who attempt charcoal-burning suicide.MethodsAn online web-based survey, focussing on sociocultural attitudes towards death, as well as perceptions towards charcoal-burning suicide, and those who attempt charcoal-burning suicide, was conducted from 14 January to 14 June 2016.ResultsIn total, 1343 adults completed the online survey (mean age of 33.46; 66.6% women). Notably, 90.3% of participants considered charcoal burning to be an easily accessible suicide method. Multivariable analyses revealed that among the examined factors, the perceived ‘painlessness’ of charcoal-burning suicide was associated with an over seven-fold increased risk of choosing charcoal-burning suicide (OR = 7.394; p < 0.001; 95% CI: 2.614–20.912).ConclusionAs reflected in this study, charcoal-burning suicide is perceived as easily accessible and painless. The perceived ‘painlessness’ may be the factor that distinguishes the choice of charcoal-burning suicide from that of other suicide methods. Future efforts to target these perceptions regarding charcoal-burning suicide may be warranted in both media reporting and suicide prevention programmes.

Highlights

The perceived ‘painlessness’ may be the factor that distinguishes the choice of charcoal-burning suicide from that of other suicide methods
The first report of charcoal burning as a suicide method in Hong Kong in November 1998 resulted in a suicide epidemic in the local area, and charcoal burning quickly evolved into a contagious suicide method in the Chinese communities of Macau in coastal southern China and in Taiwan [1, 2]
In Japan, the charcoal-burning suicide epidemic led to an increase of more than 10% in the overall suicide rate among individuals aged 25–44 years, without an apparent decrease in other methods of suicide [3], which indicated the possibility that charcoal burning appealed to many individuals who might not have used other highly lethal methods if charcoal burning had not been an accessible method

Summary

Introduction

The first report of charcoal burning as a suicide method in Hong Kong in November 1998 resulted in a suicide epidemic in the local area, and charcoal burning quickly evolved into a contagious suicide method in the Chinese communities of Macau in coastal southern China and in Taiwan [1, 2]. A charcoal-burning suicide epidemic occurred in Japan from 2003 to 2007 [3] and subsequently in Korea from 2007 to 2011 [4, 5] During these epidemics, charcoal burning became a leading suicide method in Taiwan, among the younger population [6]. Apart from the general sociocultural factors, the public’s perception of charcoal-burning suicide may influence the preference for or adoption of this lethal method. An interview-based study of suicide survivors in Taiwan revealed that individuals who had attempted charcoal-burning suicide were more likely than those who had attempted other methods of suicide to report that their choice of method was influenced by the media, the portrayal of charcoal burning as ‘a peaceful way of dying’ [10]. Few studies have researched into sociocultural perceptions of charcoal-burning suicide and their potential impacts

Methods

Discussion

Conclusion