Direct Estimation of Alcohol-Attributable Fractions for Suicide in the United States, 2021.

Objectives. To estimate the alcohol-attributable fraction (AAF) for suicide in the United States. Methods. Using restricted-access data from the National Violent Death Reporting System for 2021, we estimated the sex-specific AAF for suicide, among those 15 years of age and older, by sociodemographic characteristics and suicide means. An alcohol-attributable suicide was defined as that for which the decedent had a blood alcohol concentration of 0.10 grams per deciliter or higher. Results. In 2021, the AAF for suicide for males (20.2%) was significantly higher than that for females (17.8%; P < .001). The AAF for suicide was higher for both males and females who used a firearm as the means of suicide (23.4% and 22.8%, respectively) compared with their counterparts who used other means (16.5% and 15.9%, respectively). Conclusions. Despite some variation, AAFs for suicide were consistently high, with about 1 in 5 suicides being attributable to alcohol use. Therefore, suicide prevention initiatives in the United States should also target excessive alcohol use. (Am J Public Health. 2025;115(3):364-368. https://doi.org/10.2105/AJPH.2024.307910).