The study in the March issue of the Journal of Adolescent Health included 157 girls and boys, ages 12-17, admitted to a hospital in Finland for psychiatric illnesses. Researchers found that adolescents who smoked were four times as likely to attempt suicide as those who did not smoke. Adolescents who smoked also were at three times greater risk for occasional and frequent self-mutilation.

The researchers -- including Dr. Jaakko Lappalainen, assistant professor of psychiatry at the School of Medicine -- say one hypothesis is that some teenagers who smoke have slightly impaired brain function, leading to more impulsive and aggressive behavior. But the researchers say the actual reason for the relationship between smoking, suicide attempts and self-mutilation has not been pinpointed.

"Regular smoking among adolescent psychiatric patients is associated with increased adolescent suicidality and, therefore, easy to notice," says Lappalainen. "Paying attention to smoking may facilitate identification of those adolescents who are at risk for suicide, which may help them to receive professional help in time."

He adds, "It is tempting to speculate that adolescents who smoke may be attempting to 'self-medicate' their feelings of depression, anxiety and impulsivity. But, to our understanding, no conclusive evidence has been presented suggesting that smoking would cause suicide attempts and self-mutilation."

Lappalainen says smoking in adolescence may be one of several other health-risk behaviors or factors in suicide attempts, such as substance abuse and family dysfunction.

The lead author was Dr. Taru Makikyro. Co-authors, in addition to Lappalainen, included Helina Hakko, Dr. Markku Timonen, Risto Ilomaki, Dr. Mauri Marttunen, Dr. Kristian Laksy and Dr. Pirkko Rasanen.

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