Associations between the Type of Tobacco Products and Suicidal Behaviors: A Nationwide Population-Based Study among Korean Adolescents

Abstract

The relationships between multiple tobacco products, such as heated tobacco products (HTPs), electronic cigarettes (ECs), and combustible cigarettes (CCs), and suicide-related behaviors among adolescents have not been extensively researched. This study examined the associations between the type of tobacco products used and suicidal thoughts, plans, and attempts among Korean adolescents. Data from the 2019 Korea Youth Risk Behavior Web-Based Survey were analyzed, and participants included 57,069 individuals aged 13-18 years. A multivariable logistic regression analysis was performed. Of the total participants, 13.0%, 4.0%, and 2.9% reported suicidal thoughts, suicidal plans, and suicidal attempts, respectively. After adjusting for confounding variables, all tobacco product users showed a greater likelihood of having suicidal behavior. However, compared with never users, dual users of CCs and HTPs were not significantly associated with having suicidal thoughts and attempts. Among tobacco product users, dual users of ECs and HTPs and triple users of CCs, ECs, and HTPs showed a greater likelihood of having suicidal behavior. Considering the prevalence of suicide and the increasing trend of using multiple tobacco products among Korean adolescents, tobacco control policies should monitor the effects of different products.