Association Between Mental Health Status and Nicotine Dependence Among Adult Cigarette Smokers Attending Primary Health Care Centers in Taif City, Saudi Arabia.

BACKGROUND

Smoking cigarettes is increasingly becoming a strong focus of concern for public health in Saudi Arabia, especially with the rise in mental health disorders. This research explores how depression, anxiety, and stress are related to the level of dependence on nicotine.

METHODS

This cross-sectional study involved 310 adult smokers and utilized face-to-face interviews to collect data on participants' sociodemographic and lifestyle factors, nicotine dependence through the Fagerstrom Test of Nicotine Dependence (FTND), and mental health status using a validated Arabic version of the short form of the Depression Anxiety Stress Scales (DASS-21).

RESULTS

The study sample consisted mostly of males (n=232, 74.8%), with a mean age of 42.3 years. Nicotine dependence was significantly elevated, with high dependence noted in 52.3% (n=162) of participants. Mental health symptoms were notable and severe among respondents: 44.8% (n=139) reported severe depression, 29.7% (n=92) had severe anxiety, and 38.1% (n=118) experienced stress of considerable severity. Multivariate analysis suggested strong correlations between nicotine dependence and mental health outcomes, noting that high dependence increased the odds of depression by 30.36 times (95% CI: 7.65-120.46) and stress by 27.20 times (95% CI: 6.20-119.39). Having a chronic disease (61.9% of participants, n=192) was significantly associated with poorer mental health outcomes (depression OR = 13.81, 95% CI: 1.24-154.10). Furthermore, participants with income less than 3,000 SAR/month exhibited considerably higher anxiety than their higher income counterparts (OR = 0.16, 95% CI: 0.04-0.75 for the 3,000-6,000 SAR group).

CONCLUSION

This study highlights the relationship between nicotine dependence and mental disorders in Saudi smokers. Such mental disorders were further linked to chronic illnesses and socioeconomic elements such as income. Moreover, there is an apparent need for the Saudi primary healthcare system to incorporate comprehensive mental health services alongside smoking cessation services at the primary care level, advancing healthcare in Saudi Arabia.