Statistical Modelling of Suicidal Ideation in Smokers: A Cross-Sectional Study among the Educated Youth in the Pokhara Valley of Western Nepal

INTRODUCTION:  The objectives of the present study were to find out the prevalence of suicidal ideation among the youth in the Pokhara valley of Western Nepal, and to fit a logistic regression model and assess the strength of the association of smoking and suicidal ideation amongst them. The need of the study also arises as there is no previous study done in Nepal regarding suicidal ideation in smokers.

METHODS:  This cross-sectional survey was conducted among 961 educated youth from Pokhara valley, Nepal from 1^st January 2012 to 31^st April 2012. The study cohort consisted of smokers and non-smokers from both the genders within the age group of 17 to 24 years. We have fitted logistic regression model in the data and calculated the adjusted and crude odds ratios (AOR) and their 95% confidence intervals (95% CI). A p< 0.05 was considered as statistically significant.  

RESULTS:  Of the 961 participants, 30.9% were smokers. 31.2% of the participants parents were smokers. 71.5% of them had at least one friend who smoked tobacco. 12% of them had suicidal ideation. 30.6% of the smokers had suicidal ideation compared to 3.6% of the non-smokers. 46% were aware about the consequences of passive smoking. Males had more suicidal ideation compared to females [AOR 9.474, 95% (CI 4.771, 18.814)]. It was more likely seen in those whose parents were smokers [AOR 2.998, 95% (CI 1.787, 5.028)] and friends were smokers [AOR, 5.575 95% (CI 2.663, 11.671)]. Smokers had [AOR 8.957, 95% (CI 5.245, 15.299)] times more suicidal ideation compared to non-smokers. 

CONCLUSIONS:  Smokers had more thoughts of suicidal ideation when compared to non-smokers. Considering the poor health indicators in Nepal, poor economic situation and an emerging threat of non-communicable disease burden, this issue can be considered by strict enforcement of tobacco-control policies.