Content Warning: This press release contains discussions about suicide. If you or someone you know is in crisis or needs support, please use this link to find an international helpline: www.findahelpline.com .
Governments put up railings and barriers and regulate supplies of certain drugs to prevent people from dying by suicide. But other products associated with fatal self-harm, such as firearms, pesticides, and alcohol remain widely available and publicly promoted. The difference in approach to regulation needs to be addressed to make progress in preventing suicide, according to an analysis published June 10 in the open access journal PLOS Global Public Health by May van Schalkwyk from the University of Edinburgh, United Kingdom, and colleagues.
Every year more than 720,000 people die from suicide, the majority in low- and middle-income countries. In some cases, governments and societies have been willing to act to prevent suicide by changing the environment or restricting the sale of some products, such as placing barriers to prevent jumping, or preventing access to large amounts of pharmaceuticals, approaching the products as problematic. But for other products known to be associated with suicide, such as gambling, firearms, and alcohol, and highly hazardous pesticides (HHPs), access remains much less restricted. The products are seen as safe when used appropriately, and people who use the products are considered the potential problem. To draw attention to these different approaches, which they argue is undermining effective suicide prevention globally, the authors explored the ways that common approaches to the regulation of gambling, alcohol, opiates, firearms and HHPs, create situations that are unsafe but favourable to the commercial actors who profit from the sale of these products while blame is shifted on to the so-called "misuse" or "abuse" of the products.
The authors show that gambling and alcohol use are actively promoted in many countries with sophisticated marketing as well as the power these industries hold over regulatory agencies, while the public is blamed for misuse. In the case of opioids, the industries backing the drugs downplayed addiction risk and emphasized people's misuse of the drugs as the problem. More people die from firearms in the U.S. than all other self-harm methods combined, but the firearms industry lobbies for access, and mental health is blamed for self-harm. Finally, pesticide poisoning is one of the most common forms of fatal self-harm, particularly in low- and middle-income countries, while the industries manufacturing them claim they are safe if used correctly, and that they are necessary in the countries where they are commonly used.
While the authors note that different factors can contribute to someone's self-harm, and access to these products does not explain all suicides, they suggest that treating known harmful products as "safe if used correctly" deserves more scrutiny, and that prevention of fatal self-harm requires viewing products linked with suicide as the problem, not the people who use them.
Lead author Dr May van Schalkwyk summarizes: "Many products are known to be associated with suicide but the way that they are regulated varies. For example, to save lives, barriers are erected, and restrictions are placed on the sale of pharmaceuticals. But when it comes to some commercial products including gambling, alcohol, pesticides, opioids and firearms, a different approach is taken. People, rather than products, are presented as the problem, and industries are encouraged to 'self regulate' rather than being subjected to effective restrictions on product design, marketing and availability. Our article explores this variation and suggests that a more consistent approach could save lives."
Co-author Dr. Duleeka Knipe adds: "Suicidal or self-harm behaviour is often driven by the interaction of several factors, some of which operate at an individual level, whereas others are at a population level. In the field of suicide prevention, we have historically overlooked the importance of commercial drivers for suicide. Whilst there is an increasing awareness of the significance of commercial influences, there still needs to be more attention given to this within the field. We have chosen to highlight certain industries within this article but there are others, such as social media, which we have not been covered."
In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://plos.io/4wOH2jH
Citation: van Schalkwyk MCI, Knipe D, Cassidy R, Tyrell K, Collin J, Eddleston M (2026) Seeing the similarities: Applying a coherent lens to harmful products as drivers of suicide. PLOS Glob Public Health 6(6): e0006437. https://doi.org/10.1371/journal.pgph.0006437
Author Countries: United Kingdom
Funding: MvS's position is supported by the National Institute for Health and Care Research (ACORDS, grant number NIHR156820 Addressing the Commercial Determinants of Health in Sub-Saharan Africa) and by the Centre for Pesticide Suicide Prevention which is funded by Coefficient Giving on the recommendation of Good Ventures Foundation. JC is supported by the ACORDS project (grant number NIHR156820). MvS has funding through and JC is a co-investigator in the SPECTRUM consortium which is funded by the UK Prevention Research Partnership (UKPRP), a consortium of UK funders [UKRI Research Councils: Medical Research Council (MRC), Engineering and Physical Sciences Research Council (EPSRC), Economic and Social Research Council (ESRC) and Natural Environment Research Council (NERC); Charities: British Heart Foundation, Cancer Research UK, Wellcome and The Health Foundation; Government: Scottish Government Chief Scientist Office, Health and Care Research Wales, National Institute of Health Research (NIHR) and Public Health Agency (NI)]. DK receives a research grant (salary funds) from the Centre for Pesticide Suicide Prevention which is funded by Coefficient Giving on the recommendation of Good Ventures Foundation. DK also receives funds from the American Foundation for Suicide Prevention (salary support and research funds). KT's position is supported by the Centre for Pesticide Suicide Prevention which is funded by Coefficient Giving on the recommendation of Good Ventures Foundation. ME is director of the Centre for Pesticide Suicide Prevention which is funded by Coefficient Giving on the recommendation of Good Ventures Foundation. RC does not currently receive any outside funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
