Anxiety and Depression among Smoker among University Students: A Systematic Review

Abstract

Objectives: To systematically evaluate and synthesize existing evidence on the association between depression and smoking among University students.

Methods: A comprehensive search across four databases identified 624 publications. Duplicates were removed using Rayyan QCRI, and relevance screening reduced the selection to 35 full-text articles. After further review, nine studies met the inclusion criteria.

Results: We included nine studies with a total of 9050 participants and more than half of the,]m 4753  (52.5%) were males. Heavy smoking worsens psychological distress and mental health, with depressive symptoms mediating its impact on reduced quality of life. Smoking, often used as a coping mechanism, contributes to dependence and worsened symptoms. Gender disparities show males, especially medical students, are more likely to smoke. Current smokers report higher levels of stress, anxiety, and depression than non-smokers, highlighting the urgent need for targeted interventions in university populations.

Conclusion: This review highlights the strong link between smoking and mental health issues, particularly anxiety and depression, among university students. Smoking worsens these conditions, creating a cycle of dependency and distress. There is an urgent need for integrated mental health and smoking cessation programs that address psychological drivers, such as stress and emotional regulation, while considering demographic and cultural factors. Future research should focus on longitudinal studies to determine causality and evaluate intervention effectiveness. Addressing smoking and mental health together can significantly improve students' well-being and academic outcomes.