Current cigarette smoking has been shown to be dose-dependently associated with increased rates of suicide, an association not found in ex-smokers (5). Whether this association can withstand adjustment for psychiatric and addiction confounding factors has also been debated (6, 7). Several mechanisms have been proposed to explain this association (5—7): the toxic effects of nicotine, monoamine oxidase activity inhibition, the high prevalence of psychiatric comorbidity and consequent suicide risk, and smoking-induced serious physical illness with pain and disability resulting in negative mood response. Smoking could also be an inadequate self-medication for psychological symptoms, themselves causing suicide, and finally the association could be due to a third underlying factor associated with both smoking and suicide. To our knowledge, hypoxia has not yet been hypothesized as a possible mechanism for the association of current smoking and suicide. The suggestion by Kim et al. (1) that hypoxemia may have a role in inducing suicide can particularly be applied for the current smoking-suicide relationship and would merit further investigations.