Alcohol and suicide at the population level--the Canadian experience.

Studies suggest that the population level link between alcohol and suicide differs across countries and between men and women. The aim of this paper was to estimate the relationship between alcohol consumption and suicide in Canada and to put the results in a comparative perspective. The relationship was elucidated for whole Canada, different provinces and also separately for men and women. The total suicide rate in Canada increased significantly by around 4% as alcohol consumption increased by one litre per capita, suggesting that approximately 25 - 30% of Canadian suicides were related to alcohol. The relationship was stronger for women than for men. A significant effect was found in all provinces except from Quebec, but the overall regional variation was not statistically significant. In an international perspective, the relationship for women was somewhat weaker than in Sweden and Norway, but larger than in Finland, the United States and Southern European countries. For men, the association was similar to what is found in the United States and Finland, weaker than in Sweden, Norway and Russia but stronger than in Southern European countries. The results only partly support the idea that intoxication frequency explains national differences in this relationship. Possible explanations for the stronger association among women are also discussed.