Reply to Is Smoking Associated With Suicide in Bipolar Patients?

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Sir: We thank Drs. Neves and Correa for their thoughtful response to our article. We do not in our paper state that smoking is an "independent risk factor for suicide" in patients with bipolar disorder; we have no data to support such a conclusion, nor do we suggest it.¹ We agree that an impulsivity/aggression factor may be a common pathway to both smoking and suicide attempts and may be more prevalent in patients with bipolar disorder who are smokers, and, indeed, we suggested as much in our article.’ ‹