Smoking and Suicide – the Undeniable Correlation Between the Two

• Daily smokers were diagnosed with psychosis on the average of one year earlier than non-smokers
• 57% of patients treated for their first psychotic episode were smokers
• Patients suffering from psychosis were three times more likely to smoke than those without mental illness

Since the link between smoking and psychosis is only a statistical one, more research is needed. Scientists speculate that the cause could be the link between smoking and dopamine. Dopamine is a neurochemical that plays a vital role in how we experience emotion. Nicotine increases the release of dopamine in the brain, which can trigger mental illness such as psychosis and schizophrenia.

How Does Smoking Affect Dopamine Levels in the Brain?

The nicotine delivered to the brain from smoking changes the structure of the brain. Nicotine activates receptors that release dopamine, a powerful neurochemical that causes a feeling of pleasure. This pleasure response plays a critical role in nicotine addiction. As a smoker continues to smoke, the number of nicotine receptors increases. Habitual smokers have billions more of these receptors than nonsmokers.

Withdrawal

When an addicted smoker tries to stop, the receptors do not receive the stimulation to release dopamine from nicotine, and the pleasure response stops. For addicts, nicotine levels drop and withdrawal symptoms can appear. These include cravings for a cigarette, irritability, depression, anxiety,  increased hunger, sleeplessness, and difficulty concentrating. All of those, especially the depression and anxiety could be factors that connecting smoking and suicide. The easiest way to ease these feelings is to smoke a cigarette, thus the vicious cycle of addiction continues.

To compound these withdrawal symptoms, the normal daily behavior of smokers can trigger cravings for a cigarette, long after the smoker has quit. For example, if a former smoker usually had a cigarette with a drink, or after a meal, then having a drink or eating can trigger a craving for a cigarette. Once a smoker has quit, the number of nicotine receptors in the brain will eventually return to normal, and cravings will weaken and even stop altogether.

Smoking and the Central Nervous System

Cigarettes stimulate the central nervous system, affecting many neurotransmitters including serotonin, norepinephrine, GABA, acetylcholine, and dopamine. Commercially produced cigarettes contain more than 600 documented additives, at least 100 of which have been demonstrated to have pharmacological effects on the central nervous system.

Anxiety

Cigarette smoking has a substantial effect on the neurotransmitters associated with anxiety and a state of well being. Significantly higher rates of clinical anxiety occur in smokers than in nonsmokers, possibly because of the effect tobacco exerts on GABA, a neurotransmitter responsible for the sense of well being. It has been observed that the largest contributing factors in smoking-related anxiety include the level of addiction, smoking to deal with anxiety, to wake up, and to deal with low self-esteem.

Depression

Smoking has also been linked to depression. Nicotine and other chemicals found in commercial tobacco have a negative impact on dopamine and serotonin levels in the system, both associated with depression and mental health. Smoking may temporarily help smokers feel better, but the following nicotine withdrawal may be the root cause of depression. Further symptoms include restlessness, difficulty focusing, and nervousness.

Additional Effects

Smoking, especially long-term, has a serious impact on cognition. The neurotransmitters responsible for cognition, learning, and memory are affected by nicotine and other additives found in commercial cigarettes. Smoking is also associated with dementia. In addition, mothers who smoke and expose their children to secondhand smoke increase the children’s risk for neurodevelopmental issues.

All of the mental issues could substantiate a link between smoking and suicide.

Commonly Known Dangers of Smoking

Smoking increases the risk of developing heart disease, stroke, and lung cancer. It also causes diminished overall health, lost time at work, and higher medical bills.

Smoking increases the risk of both stroke and coronary heart disease 2 to 4 times. These are among the leading causes of death in the U.S. Even light habitual smokers (those who smoke less than five cigarettes per day) can show early signs of cardiovascular disease. Smoking causes these issues by damaging blood vessels and narrowing them. This increases heart rate and blood pressure and can cause blood clots. A stroke occurs when a clot blocks the blood flow to a part of the brain, and can also occur when blood vessels in the brain rupture.

Additionally, smoking causes respiratory disease such as COPD (which includes chronic bronchitis and emphysema) and lung cancer. It also increases the risk of lung cancer about 25 times in both men and women and is responsible for most cases of lung cancer. Smoking can trigger asthma attacks and make them more severe.

Smoking and Cancer

In addition to lung cancer, smoking can cause cancer in almost every part of the body. This includes cancer of the blood, bladder, colon, and rectum, cervix, esophagus, kidney, ureter, liver, mouth, throat, larynx, pancreas, stomach, and trachea. Struggling with cancer can leave a person feeling helpless, viewing suicide as the easiest way out.

Smoking and Other Health Risks

Smoking can make it more difficult for a woman to get pregnant. It can also affect the baby’s health. Smoking increases the risk of premature birth, stillbirth, low birthweight, sudden infant death syndrome (SIDS), ectopic pregnancy, and orofacial clefts in infants. It can also affect men’s sperm, reducing fertility and increasing the risk of birth defects.

In menopausal women, smoking can affect bone health, weakening bones and increasing the risk of fractures.

Smoking can also:

• Cause dental problems and tooth loss;
• Cause type 2 diabetes mellitus and make it harder to control;
• Increase inflammation;
• Decrease functions of the immune system;
• Cause rheumatoid arthritis.

Statistics on Smoking-Related Deaths

According to the CDC, cigarette smoking causes more than 480,000 deaths every year, accounting for nearly 20% of all deaths in the United States. Smoking causes about 90% of all lung cancer deaths, with more women dying from lung cancer every year than from breast cancer. In addition to lung cancer, smoking causes about 80% of all deaths from chronic obstructive pulmonary disease (COPD) which includes emphysema and chronic bronchitis.

Smoking and Suicide

According to the CDC, suicide is the 10th leading cause of death in the United States. In 2010, there were 38,364 suicides.

Some of the neurochemicals released while smoking are considered to be psychoactive, and can modulate behavior. This issue is the basis of a new study which demonstrates that smoking may cause psychosis, according to The Lancet Journal of Psychiatry. This reasoning supports the mounting evidence which suggests that smoking actually increases the risk of suicide. It has been well-documented in the past that there is a strong relationship between smoking and mental disorders, however, it was previously assumed that those already suffering from mental disorders were more attracted to smoking. This new evidence demonstrates that there is an opposite relationship where smoking actually creates the risk of psychiatric disorders. Increasing the risk of worsening psychiatric disorders, it also increases the risk of suicide.

The Likelihood of Suicide

According to Richard Grucza, PhD, “Like any other addicting drug, people start using nicotine to feel good, but eventually, they need it to feel normal. And as with other drugs, that chronic use can contribute to depression or anxiety, and that could help to explain the link to suicide.”

Canadian researchers conducted a statistical analysis (published in 2012 in the Journal of Psychiatric Research) and concluded that smokers were 81% more likely to commit suicide than nonsmokers.

More and more studies are finding that the changes to the brain caused by nicotine can lead to depression and suicidal behavior. Researchers concluded that female smokers were 4.4 times more likely to commit suicide than women who never smoked. Male smokers were 3.2 times more likely to kill themselves than nonsmokers.

Suicide and Smoking Related Laws

Supporting these statistics is a study by researchers at Washington University School of Medicine which suggests that suicide rates are significantly lower in states where higher cigarette taxes and tough laws on smoking in public places were implemented. Conversely, the study found that suicide rates were significantly higher in states where there were lower cigarette taxes and more relaxed laws in regard to public smoking. In fact, as cigarette taxes rose and nonsmoking laws became tougher, suicide rates dropped accordingly.

“Our analysis showed that each dollar increase in cigarette taxes was associated with a 10 percent decrease in suicide risk,” said Richard A. Grucza, PhD, associate professor of psychiatry. This startling discovery remained a constant throughout the entire nation – in every state.

From 1990 to 2004, the suicide rate in the United States was about 14 deaths per 100,000 people. During that period, states that enforced their tobacco-control policies experienced a decrease in suicide rates in comparison to the national average. The opposite was observed in states with weaker tobacco policies and lower tax rates. In those states, suicide rates increased up to six percent.

Benefits of Quitting

• Quitting smoking sharply reduces cardiovascular risks.
• Within 5 years of quitting smoking, the risk of stroke may be reduced to that of a nonsmoker.
• Within 5 years of quitting smoking, the risk of developing cancer of the mouth, throat, esophagus, and bladder drop by half.
• Ten years after quitting smoking, the risk of lung cancer drops by half.