Evidence map›Paper›PMID 39828434›Full record

ArticleBMJ global health2025

Alcohol restrictions and suicide rates in South Africa during the COVID-19 pandemic: results of a natural experiment.

Anthony Fish Hodgson, Jason Bantjes, Jane Pirkis, Keith Hawton, Wisdom Basera, Richard Matzopoulos

Erratum issuedAbstract read
In one paragraph

Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

  • Erratum issued
    2025
5 · Who and what money

Authors and funding

6 authors.

Anthony Fish HodgsonSchool of Public Health, University of Cape Town, Cape Town, South Africa.ORCID http://orcid.org/0009-0007-9772-5348
Jason BantjesMental Health, Alcohol, Substance use and Tobacco Research Unit (MAST-RU), South African Medical Research Council, Cape Town, South Africa jason.bantjes@mrc.ac.za.ORCID http://orcid.org/0000-0002-3626-9883
Jane PirkisMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
Keith HawtonCentre for Suicide Research, University of Oxford Department of Psychiatry, Oxford, UK.
Wisdom BaseraBurden of Disease, South African Medical Research Council, Cape Town, South Africa.
Richard MatzopoulosSchool of Public Health, University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlcohol use is a well-established potentially modifiable risk factor for suicide, yet few studies have investigated the impact of alcohol restrictions on suicide rates, particularly in low- and middle-income countries.

methodsWe used data from nationally representative annual surveys of postmortem investigations in 2017 (n=6117) and 2020/21 (n=6586) to estimate changes in suicide rates associated with the COVID-19 pandemic and related alcohol restrictions.

findingsAge standardised suicide mortality rates per 100 000 were 10.91 (10.64, 11.18) in 2017 and 10.82 (10.56, 11.08) in 2020/2021, with approximately 4.4 times more deaths among males than females in both periods. No significant differences were observed between overall suicide rates during the 2020/2021 pandemic period compared with 2017 (risk ratio=1.04 (1.00, 1.07)), but in the 15-24-year age group, suicide rates were 11% higher among males and 31% higher among females than in 2017. Partial alcohol restrictions during the pandemic were not associated with lower suicide risk. However, the shift from partial to full restriction on the sale of alcohol was associated with an 18% (95% CI 10% to 25%) reduction in suicides for both sexes combined and a 22% (95% CI 13% to 30%) reduction in suicides among men, but no significant reduction among women.

interpretationOur findings offer some support for the hypothesis that restricting access to alcohol at a population level is associated with a reduction in suicide rates and suggests that restricted access to alcohol may have been one of the reasons global suicide rates did not increase during the pandemic in some countries.

Indexed as

Alcohol DrinkingCOVID-19SuicideAdolescentAdultAgedFemaleHumansMaleMiddle AgedPandemicsRisk FactorsSARS-CoV-2South AfricaYoung AdultAlcoholsCOVID-19Suicide

Identifiers

PMID39828434
PMCPMC11749723

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.