Association between alcohol consumption per capita and suicide mortality rate across 30 European countries.

BACKGROUND

Suicide was the cause of 86 000 deaths in Europe in 2021. Accordingly, suicide prevention has been designated as a serious public health concern by the World Health Organization (WHO). Alcohol use is a causal risk factor for suicide and may be a cost-effective target for prevention efforts. Globally, the United Nations' Sustainable Development Goals have set a target of a 20% reduction in alcohol consumption per capita (APC). However, evidence on the utility of APC as a metric in relation to the prevention of alcohol-attributable suicides is currently limited.

OBJECTIVE

To evaluate the association between APC and suicide mortality rate across 30 European countries.

METHODS

Suicide mortality rates were obtained for 27 European Union countries as well as the UK, Switzerland and Norway for 1991-2021 from the Institute of Health Metrics and Evaluation. APC data was obtained from the WHO Global Information System on Alcohol and Health. Linear mixed effects models with random intercepts for country and first-order autoregressive errors were used to test the association between APC and suicide mortality rate. Tests of interaction were conducted to examine the impact of sex, country-level drinking patterns and the 2008 global economic recession. All models were adjusted for relevant population-level confounders.

FINDINGS: On average, a 1 L increase in total APC was associated with a 0.39% increase in the suicide mortality rate (95% CI 0.03% to 0.76%; p value=0.03) among males, and a 0.59% increase in the suicide mortality rate (95% CI 0.12% to 1.06%; p value=0.01) among females. There was no evidence of a significant sex difference, nor was there evidence of a modifying effect of country-level drinking patterns or 2008 global economic recession on the respective association.

CONCLUSIONS

National suicide prevention strategies should consider incorporating APC as an indicator for monitoring and assessing the impact of interventions targeting alcohol use on suicide.