Background. Diverse socioeconomic and cultural developments between geographic regions and cities/counties have resulted in different physical availability and socio-cultural acceptability of certain methods of suicide. This study examined the changes in distribution of the leading methods of suicide across cities/counties in Taiwan between 2002-04 and 2006-08. Methods. Mortality data for all deaths classified as suicide or as of undetermined intent from 2002 through 2008 were extracted for analysis. The number of deaths and proportion of completed suicides by four main methods were calculated in order to identify the leading lethal methods in each city/county. Results. Hanging was the leading method of suicide in 18 out of 22 cities/counties in 2002-04 but decreased to 10 out of 22 in 2006-08. On the other hand, charcoal burning was not the leading method in any city/county in 2002-04 but increased to 10 out of 22 in 2006-08. The younger the age of the deceased, the more likely the leading method of suicide changed from 2002-04 to 2006-08. Charcoal burning was the most often used method in most cities/counties among those aged 15-44; however, hanging was most frequent for those aged 45 or above. Pesticides were the leading method for the elderly in five counties with a high percentage of agricultural population in 2006-08. Conclusion. The leading method of suicide varied by age group and changed from 2002-04 to 2006-08 in Taiwan. This was due primarily to changes in socio-cultural acceptability of the use of charcoal burning as a method for suicide by younger age groups.
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