Cannabis use doubled the odds of suicide attempts among 86,000 adolescents across 21 countries
In a study of 86,254 adolescents from 21 low- and middle-income countries, both past-month and lifetime cannabis use were independently associated with approximately doubled odds of suicide attempts, even after adjusting for confounders.
Quick Facts
What This Study Found
Past 30-day cannabis use was significantly associated with suicide attempts (OR 2.03, 95% CI 1.42-2.91) after multivariable adjustment. Lifetime cannabis use showed an even stronger association (OR 2.30, 95% CI 1.74-3.04). These associations held across 21 countries with widely varying cannabis prevalence rates.
Key Numbers
86,254 adolescents from 21 countries. Mean age 13.7. Past 30-day cannabis: 2.8% (range 0.5% Laos to 37.6% Samoa). Lifetime cannabis: 3.9%. Suicide attempts past year: 10.5%. Adjusted OR: 2.03 (30-day) and 2.30 (lifetime).
How They Did This
Cross-sectional analysis of the Global School-based Student Health Survey data from 86,254 adolescents (mean age 13.7) in 21 low- and middle-income countries. Multivariable logistic regression adjusted for potential confounders.
Why This Research Matters
This is one of the largest studies examining the cannabis-suicide association, and the first to systematically assess it across multiple low- and middle-income countries. The consistency of the finding across vastly different cultural contexts strengthens the case for a real association.
The Bigger Picture
The cannabis-suicide link has been primarily studied in high-income countries. This study shows the association extends to low- and middle-income countries with very different cannabis use patterns, healthcare systems, and cultural contexts, suggesting a robust relationship.
What This Study Doesn't Tell Us
Cross-sectional design cannot establish causation. Self-reported measures in school settings. Students not in school were excluded. Cultural differences in reporting both cannabis use and suicidality may affect comparisons. Specific confounders like mental health treatment availability could not be assessed.
Questions This Raises
- ?Is the relationship causal or confounded by shared risk factors?
- ?Would prospective studies confirm these cross-sectional findings?
- ?Does the association vary by cannabis potency or type of use?
Trust & Context
- Key Stat:
- 2x suicide attempt risk
- Evidence Grade:
- Rated strong because this is a very large multi-country study using standardized methodology, though the cross-sectional design limits causal inference.
- Study Age:
- Published in 2019 using Global School-based Student Health Survey data.
- Original Title:
- Cannabis use and suicide attempts among 86,254 adolescents aged 12-15 years from 21 low- and middle-income countries.
- Published In:
- European psychiatry : the journal of the Association of European Psychiatrists, 56, 8-13 (2019)
- Authors:
- Carvalho, Andre F, Stubbs, Brendon(3), Vancampfort, Davy, Kloiber, Stefan, Maes, Michael, Firth, Joseph, Kurdyak, Paul A, Stein, Dan J, Rehm, Jürgen, Koyanagi, Ai
- Database ID:
- RTHC-01972
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Is cannabis use linked to suicide in teens?
In 86,254 adolescents across 21 countries, cannabis use was associated with roughly double the odds of suicide attempts, even after adjusting for other risk factors.
Does this apply to all countries?
The association was consistent across 21 low- and middle-income countries with cannabis prevalence ranging from 0.5% to 37.6%, suggesting it is not specific to any one cultural context.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-01972APA
Carvalho, Andre F; Stubbs, Brendon; Vancampfort, Davy; Kloiber, Stefan; Maes, Michael; Firth, Joseph; Kurdyak, Paul A; Stein, Dan J; Rehm, Jürgen; Koyanagi, Ai. (2019). Cannabis use and suicide attempts among 86,254 adolescents aged 12-15 years from 21 low- and middle-income countries.. European psychiatry : the journal of the Association of European Psychiatrists, 56, 8-13. https://doi.org/10.1016/j.eurpsy.2018.10.006
MLA
Carvalho, Andre F, et al. "Cannabis use and suicide attempts among 86,254 adolescents aged 12-15 years from 21 low- and middle-income countries.." European psychiatry : the journal of the Association of European Psychiatrists, 2019. https://doi.org/10.1016/j.eurpsy.2018.10.006
RethinkTHC
RethinkTHC Research Database. "Cannabis use and suicide attempts among 86,254 adolescents a..." RTHC-01972. Retrieved from https://rethinkthc.com/research/carvalho-2019-cannabis-use-and-suicide
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.