Can depression, anxiety and stress predict smoking? An analysis of mental health correlates university young adults in Saudi Arabia.

Shah, Mohammad; Aboalshamat, Khalid; Badri, Hatim M; Khan, Wahaj; Banah, Osama A; Elamin, Mohamed O; Quronfulah, Baraa S · J Family Med Prim Care · 2026

cross_sectional · Level IV

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Abstract

Smoking remains prevalent among young university students in Saudi Arabia, with psychological factors potentially influencing tobacco use. This cross-sectional study surveyed 655 university students aged 18-26 years using validated depression, anxiety and stress scale. Logistic regression assessed the association between mental health and smoking status. Anxiety has significantly predicted smoking (OR: 1.16), while stress was inversely associated (OR: 0.94). Depression showed no significant association. Male gender and unemployment were additional predictors of smoking. Anxiety plays a key role in smoking among university students. Interventions should prioritize anxiety management in order to control smoking prevalence in this population.