NEW YORK (Reuters Health) - Men who smoke at least 15 cigarettes a day may be four times more likely than nonsmoking men to commit suicide, researchers report.

The study, published in the May issue of the American Journal of Public Health, the journal of the American Public Health Association, found that the risk of suicide increased with the number of cigarettes smoked daily. The relationship between smoking and suicide remained constant regardless of age, marital status, body mass index, exercise habits, history of cancer, and consumption of alcohol and coffee. The researchers explain that the relationship between smoking and suicide is indirect, since men who smoke tend to have other risk factors for suicide. For example, smokers are more likely to suffer from depression and schizophrenia and to use alcohol and drugs. Smokers are also more likely than nonsmokers to develop cancer and remain unmarried and socially isolated, study findings have shown. These characteristics may ``predispose individuals to both suicide and smoking,'' write Dr. Matthew Miller of the Harvard School of Public Health in Boston, Massachusetts, and colleagues. More than 50,000 men participated in the 8-year study. Most of the men were white Americans with professional careers. The study results indicate that smokers were more likely to be unmarried, drink coffee, consume heavy amounts of alcohol, forego exercise and to develop cancer than nonsmokers. These tendencies were the most pronounced among current smokers and the least pronounced among former smokers. But the researchers note that their findings should be interpreted cautiously, since suicide is relatively infrequent and smoking is relatively common in the United States. Therefore, ``it would be inappropriate to interpret smoking per se as a clinically important predictor of suicide,'' Miller and colleagues write.

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