Alcohol and suicide in 14 European countries.

AIMS: To test the hypothesis that a positive population-level relationship between alcohol and suicide is more likely to be found in dry drinking cultures (as indicated by consumption level) than in wet drinking cultures.
DESIGN: Gender- and age-specific suicide rates in 14 western European countries were analysed in relation to per capita alcohol consumption employing the Box-Jenkins technique for time series analysis. The country-specific estimates were pooled into low-, medium- and high-consumption countries. MEASUREMENTS: Suicide mortality data for 5-year age groups were converted into gender- and age-specific mortality rates. Alcohol sales expressed as litres of 100% alcohol per year and inhabitants 15 years and older were used as a measure of alcohol consumption.
FINDINGS: A positive and significant relationship between per capita consumption and gender- and age-specific suicide rates was revealed most often in northern Europe and found least often in southern Europe. A stronger absolute alcohol effect for men was found only in northern Europe, whereas the relative alcohol effect was somewhat stronger for women in both northern and central Europe. Also, the suicide rate in younger age groups was more often significantly related to per capita consumption than suicide among the elder in northern and central Europe but not in southern Europe.
CONCLUSIONS: The population-level association between alcohol and suicide is conditioned by cultural factors. In general, the suicide rate tends to be more responsive to changes in alcohol consumption in drinking cultures characterized by a low post-war per capita consumption compared to drinking cultures with higher consumption levels. The findings give support to the hypothesis derived from previous theoretical and empirical work, suggesting that suicide and alcohol is more closely connected in dry cultures than in wet cultures.