More than 10% of the current sample was classified as suicidal and feeling sad/hopeless with these adolescents having a 50% chance of reporting at least one or more suicide attempt. Black youth are more likely selleck chem to report feeling sad/hopeless and one or more suicide attempts than White youth (29.2% vs. 26.2% and 7.7% vs. 5.6%), respectively (CDC, 2011). Suicidal behaviors among Black youth have historically been lower than that of their White counterparts (CDC, 1995). These findings in conjunction with other recent epidemiological findings indicate that an increasingly substantial proportion of Black youth experience suicidality (Joe et al., 2009; NCHS, 2009). It is important to note, however, that the hypothesis regarding whether or not Black youth would be likely to express attempts without ideation was not supported.

It may be that factors related to overall increases in suicidality among Black youth also contribute to increasing the likelihood of reporting suicidal thoughts in this population. The findings from this study and others may indicate a shift in the qualitative (endorsement of ideation and plans to harm oneself) and quantitative (higher rates compared with their White counterparts) expression of suicidality among Black youth (CDC, 2011; Joe et al., 2009). With respect to the co-occurrence of tobacco use and suicidality, it is known that smoking increases the release of dopamine and serotonin (Benowitz, 2001), which are associated with mood elevation. Former smoking significantly increased the likelihood of any suicidality compared with nonsmokers.

Thus in our sample of Black youth, former smokers may be experiencing nicotine withdrawal symptoms associated with a decrease in the mood elevating neurotransmitters associated with smoking, since a defining characteristic of the mild suicidality class was an increase in the probability of feeling sad/hopeless. Light current smoking and frequent current smoking were significantly associated with predicting being classified as suicidal but not mild suicidality. In this instance, current smokers may be self-medicating and only those with more severe symptoms as characterized by the suicidal class are distinguishable from nonsuicidal respondents compared with mild suicidality. Finally, Blacks may be less likely to obtain treatment for either tobacco dependence or mental health problems (Fiore et al.

, 2000; Neighbors et Brefeldin_A al., 2007), and given the increase in suicidality and consistency of disparate health outcomes, the manifestation of these risks require exploration. Despite prior research, the direction of causality between substance use and negative mental health (depression and suicidality) has yet to be determined conclusively in the literature. The extant research literature is equivocal on the mechanism by which tobacco use is positively associated with an increased risk for suicide.