ArticleMolecular psychiatry2021
A genetically informed study on the association of cannabis, alcohol, and tobacco smoking with suicide attempt.
Article in Molecular psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis.BMC psychiatry · 2024Pooled it
- A phenome-wide association and Mendelian randomization study for suicide attempt within UK Biobank.Molecular psychiatry · 2026Article
- Associations between cannabis use frequency and suicidal thoughts and behaviors: A clinical longitudinal sibling study.Addictive behaviors reports · 2025Article
- Hazardous Drinking and Cannabis Use in Military Veterans: Comparative Associations with Risk for Suicidal and Non-Suicidal Self-Injury.International journal of mental health and addiction · 2025Article
- Cannabis Vaping Is Associated With Past 30-Day Suicide Attempts and Suicidal Ideation Among Adolescents in a Psychiatric Inpatient Setting.JAACAP open · 2024Article
- Identifying behaviour-related and physiological risk factors for suicide attempts in the UK Biobank.Nature human behaviour · 2024Article
- Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Article
- Association of chronic pain with suicide attempt and death by suicide: a two-sample Mendelian randomization.Molecular psychiatry · 2024Article
- Floods and cause-specific mortality in the UK: a nested case-control study.BMC medicine · 2024Article
- Use of Tobacco Products and Suicide Attempts Among Elementary School-Aged Children.JAMA network open · 2024Article
- Shared genetic and environmental etiology between substance use disorders and suicidal behavior.Psychological medicine · 2023Article
- School performance and genetic propensities for educational attainment and depression in the etiology of self-harm: a Danish population-based study.Nordic journal of psychiatry · 2023Article
- The genetic aetiology of cannabis use: from twin models to genome-wide association studies and beyond.Translational psychiatry · 2022Review
- Association of parental death and illness with offspring suicidal ideation: cross-sectional study in a large cohort of university students.Social psychiatry and psychiatric epidemiology · 2022Article
- Investigating the causal risk factors for self-harm by integrating Mendelian randomisation within twin modelling.Behavior genetics · 2022Article
- Sleep duration trajectory during the transition to adolescence and subsequent risk of non-suicidal self-harm.European child & adolescent psychiatry · 2022Article
- Examining Risk Factors in the Cannabis-Suicide Link: Considering Trauma and Impulsivity among University Students.International journal of environmental research and public health · 2022Article
- Associations between cannabis use, cannabis use disorder, and mood disorders: longitudinal, genetic, and neurocognitive evidence.Psychopharmacology · 2022Review
- Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors.Biological psychiatry · 2022Article
- Association of Genome-Wide Polygenic Scores for Multiple Psychiatric and Common Traits in Preadolescent Youths at Risk of Suicide.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
Use of substances such as cannabis, alcohol, and tobacco, has been associated with increased risk of suicide attempt in several observational studies. However, establishing whether these associations are causal is challenging when using observational designs. To evaluate the potential causal contributions of cannabis use, alcohol use, and tobacco smoking to suicide attempt, we applied two-sample Mendelian randomization, an instrumental variable approach using single-nucleotide polymorphisms (SNPs) as instrumental variables for three exposures: lifetime cannabis use (yes/no; 42 instrument SNPs; GWAS sample size [N] = 162,082), alcohol use (drinks-per-week; 53 instrument SNPs; N = 941,280), and tobacco smoking (initiation, yes/no; 156 instrument SNPs; N = 1,232,091; heaviness; 27 instrument SNPs; N = 337,334). The main outcome was suicide attempt measured from hospital records (N = 50,264). All data come from publicly available summary statistics of genome-wide association studies of participants of European ancestry. We found evidence supporting a possible causal role of cannabis (OR = 1.18; 95% CI = 1.01-1.37, P = 0.032), alcohol (OR = 1.95; 95% CI = 1.15-3.32, P = 0.013), and smoking (initiation, OR = 1.90; 95% CI = 1.54-2.34, P < 0.001; heaviness, OR = 2.13; 95% CI = 1.13-3.99; P = 0.019) on suicide attempt. Using multivariable Mendelian randomization, we found that only cannabis showed a direct pathway to suicide attempt (P = 0.001), suggesting that the effect of alcohol and smoking was mediated by the other substance use phenotypes. No evidence was found for reverse causation, i.e., associations of suicide attempt on cannabis (P = 0.483), alcohol (P = 0.234), smoking initiation (P = 0.144), and heaviness (P = 0.601). In conclusion, evidence from this quasi-experimental study based on genetic data from large-scale GWASs are consistent with a causal role of cannabis, alcohol, and tobacco smoking on suicide attempt.
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Registered trials
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