The impact of hazardous drinking on suicide among working-age Russian males: an individual-level analysis

Abstract

To estimate the association between hazardous drinking and suicide among working-age Russian males. Data are from the Izhevsk Family Study (IFS), a population-based case-control study of premature mortality among working-age Russian men. The present study used two sets of cases: all men aged 25-54 years living in Izhevsk who, during October 2003-October 2005, (i) died of suicide (n = 120) or (ii) died of suicide or of injuries of undetermined intent (n = 231). Controls were selected at random from a city population register. Drinking data were obtained from proxy informants living in the same household as cases and controls. Drinking exposures were defined by liters of ethanol consumed as a continuous variable, liters of ethanol as a categorical variable, frequency of consumption of non-beverage alcohol (e.g. colognes, medicines, cleaning fluids) and a measure of problem drinking based on behavioral indicators. The association between hazardous drinking and suicide was estimated by mortality odds ratios, adjusting for age, marital status, education and smoking status. A total of 57% of cases and 20% of controls were problem drinkers. Men who drank 20+ liters of ethanol in the prior year were 2.7 times more likely [95% confidence interval (CI) = 1.5-5.0] to die from suicide than moderate drinkers. Men who drank non-beverage alcohols one to two times/week were 3.9 times more likely (95% CI, 1.3-11.0) to die from suicide than men who rarely or never drank them. Problem drinkers were 3.7 times more likely (95% CI, 2.5-5.6) to die from suicide relative to non-problem drinkers. Forty-three per cent of suicides were attributed to hazardous drinking (problem drinking or consuming non-beverage alcohol at least once/week or both). Hazardous drinking substantially increases the risk of suicide among working-age Russian males, with nearly half of all suicides attributed to this drinking pattern.