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The diffusion of a new method of suicide: charcoal-burning suicide in Hong Kong and Taiwan

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

In the late 1990s, an epidemic rise in suicides by carbon monoxide poisoning from burning barbecue charcoal began in Hong Kong and Taiwan. This study investigates the diffusion of this new method of suicide.

Method

Official mortality data for 1998–2010 in Taiwan and 1998–2009 in Hong Kong were collected; overall and method-specific suicide rates in different socio-demographic subgroups over the study period were compared. Multiple logistic regression analyses were conducted to assess the socio-demographic risk factors for charcoal-burning vs. non-charcoal-burning suicide.

Results

In Hong Kong, the incidence of charcoal-burning suicide increased steeply within 1 year of the first reported cases, but its use has declined from 24.2 % of all suicides during the peak period (2002–2004) to 17.1 % (2007–2009); in Taiwan, the pace of diffusion was slower in onset, but it remains a popular method accounting for 31.0 % of all suicides in 2008–2010. The early adopters in both places tended to be young- and middle-aged men. As the epidemic progressed, the method has also been gradually adopted by older age groups and women, particularly in Taiwan, but in 2009/10, the method still accounted for <8 % of suicides in those aged >60 years in both areas.

Conclusions

Common features of the epidemic in both places were the greater levels of early uptake by the young- and middle-aged males. The different course of the charcoal-burning suicide epidemic may reflect social, geographic and media reporting differences. Surveillance to identify the emergence of new suicide methods is crucial in suicide prevention.

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Acknowledgements

This work was supported by the University of Hong Kong [Grant Number HKU784210M to P.S.F.Y.], the Ministry of Science and Technology, Taiwan [Grant Number 101-2314-B-532-005-MY2 to Y.Y.C.], the National Health Research Institute, Taiwan [Grant Number NHRI-EX100-10024PC to Y.Y.C.] and the Ministry of Science and Technology, Taiwan [Grant Number NSC 99-2410-H-002-137-MY3 to K.C.C.W.]. DG is an NIHR Senior Investigator.

Conflict of interest

Non-declared.

Author information

Authors and Affiliations

  1. Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan

    Ying-Yeh Chen

  2. Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan

    Ying-Yeh Chen

  3. Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China

    Paul SF Yip & Carmen KM Lee

  4. Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China

    Paul SF Yip & Carmen KM Lee

  5. School of Social and Community Medicine, University of Bristol, Bristol, UK

    David Gunnell

  6. Department of Social Medicine, National Taiwan University College of Medicine School of Medicine, 2nd Floor, Medical Humanity Building, No. 1 Ren-Ai Road Sec. 1, Taipei, 100, Taiwan

    Kevin Chien-Chang Wu

  7. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan

    Kevin Chien-Chang Wu

Authors
  1. Ying-Yeh Chen
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  2. Paul SF Yip
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  3. Carmen KM Lee
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  4. David Gunnell
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  5. Kevin Chien-Chang Wu
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Corresponding author

Correspondence to Kevin Chien-Chang Wu.

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Chen, YY., Yip, P.S., Lee, C.K. et al. The diffusion of a new method of suicide: charcoal-burning suicide in Hong Kong and Taiwan. Soc Psychiatry Psychiatr Epidemiol 50, 227–236 (2015). https://doi.org/10.1007/s00127-014-0910-4

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  • DOI: https://doi.org/10.1007/s00127-014-0910-4

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