A cross-national study of the population-level association between alcohol consumption and suicide rates

Abstract

Introduction: The objective of this study was to explore the association between population-level alcohol consumption and cross-national suicide rates. Suicide mortality rates vary substantially by nation, as do the level and character of alcohol consumption. Only a few prior studies examined this association, however, and they used a small number of nations and failed to test for the multiple hypothesized pathways through which any association may operate.

Material and methods: We obtained data from the World Health Organization for a sample of 83 nations. Controlling for potential structural covariates, we tested four theoretical mechanisms through which population-level alcohol consumption may influence national suicide rates.

Results: Results showed no evidence of threshold effects, nor were risky national drinking patterns associated with higher suicide rates. We found evidence for the most common explanation that total per capita consumption is linearly associated with suicide rates. Our other findings, however, suggested this linear association masks more complex beverage-specific effects. Per capita wine consumption was not associated with male or female suicide rates, per capita spirits consumption was associated with both male and female suicide rates, per capita beer consumption was associated with male suicide rates, and per capita consumption of "other" alcohol types was associated with female suicide rates.

Discussion and conclusions: Testing for only a linear association between total alcohol consumption and suicide rates fails to tell the whole story. Further research requires exploration of beverage-specific effects and other potential mechanisms, and consideration of national alcohol policies to reduce suicide rates.

Keywords: Alcohol consumption; Population-level effects; Suicide.