The evolution of the characteristics of charcoal-burning suicide in Hong Kong, 2002-2013

Background: The use of barbecue charcoal gas for suicide led to more than 50,000 deaths in Asia since the rise of its use from 1998. Little is known whether the profile of charcoal-burning suicides changed over time. Methods: Hong Kong's suicide data (2002-2013) were extracted from the Coroner's files. The detailed characteristics were compared between suicide by charcoal-burning and non-charcoal-burning methods, and between charcoal-burning suicides of different periods (2002-2005 vs 2006-2009 vs 2010-2013). Results: People who died by suicide using charcoal burning (n = 2,188) were more likely to be male, aged 30-49 years, married (2002-2005 only), have debt, or live alone, and were less likely to have past or current psychiatric treatment or medical illness than non-charcoal-burning suicides (n = 9,666) across the three four-year periods. By contrast, compared to charcoal-burning suicides in 2002-2005, those in more recent periods (2006-2009 and 2010-2013) were more likely to be aged 50+, non-married, live alone (2006-2009 only), or have current psychiatric treatment or medical illness, and were less likely to be male (2006-2009 only), unemployed, or have debt. Limitations: There could be under-reporting of certain characteristics for charcoal-burning suicides in the Coroner's files. Conclusion: Charcoal-burning suicides persistently showed a distinguishable profile in Hong Kong, whilst changes in certain characteristics suggested a 'diffusion' of the method to some other groups such as older individuals. Responsible media reporting and restricting online information about new suicide methods could be potentially important prevention strategies in the early stage, whilst other strategies are needed when the methods become more commonly used.