Children who use tobacco products have significantly higher odds of suicide attempts up to 2 years following use. Children who report the use of tobacco products — including e-cigarettes and vaping — have a 3 to 5 times increased risk for suicide attempts (SAs), according to study results published in JAMA Network Open. New tobacco products (ie, e-cigarettes, vapes, hookahs) have become increasingly popular in the United States, particularly among children and adolescents. Although it is well-documented that adolescents and adults who smoke cigarettes have an increased likelihood of suicidality, it is unclear whether this heightened risk applies to children who use tobacco products.
The findings suggest that smoking tobacco products may be a modifiable risk factor that can be addressed in suicide prevention efforts, especially among children.
To address this knowledge gap, researchers conducted a cross-sectional cohort study from September 1 to September 5, 2022. The researchers used data from the Adolescent Brain Cognitive Development (ABCD) study, a nationally representative cohort of 11,868 US children enrolled at 9 and 10 years of age. The objective of the current study was to investigate the correlation between tobacco product use and the incidence of nonsuicidal self-injury (NSSI), suicidal ideation (SI), and SAs among preadolescent children. Substance use was evaluated using the ABCD Youth Substance Use Interview and hair toxicology tests at baseline, a 6-month follow-up, and then yearly. The researchers assessed suicidality using children and caregiver reports of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-5).
The researchers included data from 8988 children (median age, 9.8 years; 47.9% girls). At baseline, 1.1% of children reported ever using tobacco products, and this prevalence rose significantly to 1.7% at the 18-month follow-up. The researchers observed no statistical difference in smoking experience by sex or race/ethnicity; however, tobacco-using children generally came from more socioeconomically disadvantaged backgrounds, had greater prenatal smoking exposure, and were more likely to have parents with a history of depression, alcohol issues, and behavioral or suicide-related problems, relative to children who did not use tobacco products.
