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Alcohol restrictions and suicide rates in South Africa during the Covid-19 pandemic

Results of a natural experiment

Bibliographic Data

ID21881691
AuthorsAnthony Fish Hodgson (0009-0007-9772-5348, University of Cape Town), Jason Bantjes (0000-0002-3626-9883, South African Medical Research Council), Jane Pirkis (0000-0002-2538-4472, The University of Melbourne), Keith Hawton (0000-0003-4985-5715, University of Oxford), Wisdom Basera (0000-0002-4006-1858, South African Medical Research Council), Richard Matzopoulos (0000-0001-9063-6210, South African Medical Research Council)
Year2025
Volume10
Issue1
Pagese017171
Publication date2025-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-017171
PMID39828434
OpenAlexW4406593213
LanguageEN
Citations received1
References cited39

BACKGROUND: Alcohol use is a well-established potentially modifiable risk factor for suicide, yet few studies have investigated the impact of alcohol restrictions on suicide rates, particularly in low- and middle-income countries. METHODS: We used data from nationally representative annual surveys of postmortem investigations in 2017 (n=6117) and 2020/21 (n=6586) to estimate changes in suicide rates associated with the COVID-19 pandemic and related alcohol restrictions. FINDINGS: Age standardised suicide mortality rates per 100 000 were 10.91 (10.64, 11.18) in 2017 and 10.82 (10.56, 11.08) in 2020/2021, with approximately 4.4 times more deaths among males than females in both periods. No significant differences were observed between overall suicide rates during the 2020/2021 pandemic period compared with 2017 (risk ratio=1.04 (1.00, 1.07)), but in the 15-24-year age group, suicide rates were 11% higher among males and 31% higher among females than in 2017. Partial alcohol restrictions during the pandemic were not associated with lower suicide risk. However, the shift from partial to full restriction on the sale of alcohol was associated with an 18% (95% CI 10% to 25%) reduction in suicides for both sexes combined and a 22% (95% CI 13% to 30%) reduction in suicides among men, but no significant reduction among women. INTERPRETATION: Our findings offer some support for the hypothesis that restricting access to alcohol at a population level is associated with a reduction in suicide rates and suggests that restricted access to alcohol may have been one of the reasons global suicide rates did not increase during the pandemic in some countries

Disease · Environmental health · Injury prevention · Occupational safety and health · Pandemic · Poison control · Population · Public health · Suicide prevention · COVID-19 and Mental Health · Demography · Employment and Welfare Studies · Medicine · Suicide and Self-Harm Studies · Internal Medicine

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Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 1
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