Tobacco and alcohol use; suicide ideation, plan, and attempt among adolescents; and the role of legal purchase age restrictions: a pooled population-based analysis from 58 countries

作者：Manman Chen, Xijie Wang, Din Son Tan, Huan Wang, Jianhui Guo, Jing Li, Zhiyong Zou, Yu Jiang, Wannian Liang · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-03983-6 · 被引用次数：4 · 研究领域：Suicide and Self-Harm Studies、Smoking Behavior and Cessation、Substance Abuse Treatment and Outcomes

We aimed to evaluate the potential independent and interactive associations of tobacco and alcohol use with suicide ideation, plan, and attempt among adolescents, and the role of legal purchase age restrictions among these associations. A pooled cross-sectional analysis was conducted with data from the Global School-based Student Health Survey (GSHS) (2013–2019), the US Youth Risk Behavior Surveillance System (YRBSS) (2021), and a Chinese school-based health survey (2017). Self-reported use of tobacco and alcohol during the past 30 days, and suicide ideation, plan, and attempt during the past year, were collected from questionnaires. Country-level purchase age restrictions on tobacco and alcohol products were obtained from official government websites. Among the 211,022 adolescents from 58 countries, 46.7% were boys. Compared with adolescents who used neither tobacco nor alcohol, those who used both tobacco and alcohol had the highest odds of suicide ideation (boys: 2.42 [95% CI: 2.25–2.61]; girls: 3.19 [95% CI: 2.98–3.40]; P difference < 0.001), suicide plan (boys: 2.39 [95% CI: 2.21–2.58]; girls: 3.33 [95% CI: 3.11–3.57]; P difference < 0.001), and suicide attempt (boys: 3.24 [95% CI: 3.00–3.51]; girls: 4.03 [95% CI: 3.75–4.33]; P difference < 0.001). In countries with higher suicide plan prevalence, boys who use tobacco and who live in countries with tobacco purchase age restrictions had lower odds of suicide plan (1.86 [95% CI: 1.64–2.12]) than those who lived in countrie...