Investigation of Psychological Dependence on Smoking, Cognitive Flexibility and Resilience in University Students

Year 2025, Volume: 13 Issue: 36, 1 - 16, 31.08.2025

Mehmet Enes Sağar

https://doi.org/10.52528/genclikarastirmalari.1421260

Abstract

This study aims to examine how cognitive flexibility and psychological resilience variables predict the levels of psychological dependence on smoking among university students. The universe of this study consisted of Turkish university students in Turkey. This study was conducted with a total of 243 university students, 116 (47.7%) male and 127 (53.3%) female, studying at universities in Afyon province in the 2023-2024 academic year. Although the age range of the study group varied between 20 and 30, the mean age was determined to be 23.42±2.93 (years). The Psychological Dependency on Smoking Assessment Scale, Cognitive Flexibility Inventory, Brief Resilience Scale and Personal Information Form were used as data collection tools in the study. Multiple linear regression analysis (stepwise) method was used to analyze the data of the study. In the study, it was determined that there was a significant negative correlation between the psychological dependence on smoking and cognitive flexibility (r=-.611, p<.01) and resilience (r=-.543, p<.01). It was determined that the cognitive flexibility and resilience variables together explain approximately 40% of the variance in psychological dependence on smoking (R=.632; R2 =.400, p<.01; F2/240=79.96; p<.01). The beta coefficient of the cognitive flexibility variable was found to be -.454 and the beta coefficient of the resilience variable was found to be -.226. It was determined that the t test results regarding the significance of the beta coefficient were significant (tC.F.=-6.48, p<.01; tR.=-3.22, p<.05). In the multiple linear regression analysis, it was determined that the cognitive flexibility and resilience variables significantly predicted the psychological dependence on smoking. In the multiple linear regression analysis, it was determined that the cognitive flexibility and resilience variables significantly predicted the psychological dependence on smoking. As a result of this study, it was found that the psychological dependence on smoking was significantly predicted by the variables of "cognitive flexibility" and "psychological resilience".

Keywords

Psychological Dependence on Smoking , Cognitive Flexibility , Resilience , University Student

Üniversite Öğrencilerinde Sigaranın Psikolojik Bağımlılığı, Bilişsel Esneklik ve Psikolojik Sağlamlığın İncelenmesi

Abstract

Bu araştırmada, bilişsel esneklik ve psikolojik sağlamlık değişkenlerinin üniversite öğrencilerinde sigaranın psikolojik bağımlılığı düzeylerini ne kadar yordadığını incelemek amaçlanmaktadır. Bu çalışma 2023-2024 eğitim öğretim yılında Afyon ilindeki üniversitelerde öğrenim görmekte olan 116’sı (%47.7) erkek ve 127’si (%53.3) kız toplamda 243 üniversite öğrencisi ile yapılmıştır. Araştırma grubunun yaş aralığı 20-30 arasında değişmekle birlikte yaş ortalamaları 23.42±2.93 (yıl) olduğu tespit edilmiştir. Araştırmada veri toplama araçları olarak Sigaranın Psikolojik Bağımlılığını Değerlendirme Ölçeği, Bilişsel Esneklik Envanteri, Kısa Psikolojik Sağlamlık Ölçeği ve Kişisel Bilgi Formu kullanılmıştır. Araştırmanın verilerinin analizinde çoklu doğrusal regresyon analiz (adımsal) yöntemi kullanılmıştır. Araştırmada sigaranın psikolojik bağımlılığı ile bilişsel esneklik (r=-.611, p<.01) ve psikolojik sağlamlık (r=-.543, p<.01) arasında negatif yönde anlamlı düzeyde birer ilişkinin olduğu tespit edilmiştir. Bilişsel esneklik ve psikolojik sağlamlık değişkenlerinin birlikte sigaranın psikolojik bağımlılığının yaklaşık olarak %40’ını açıkladığı belirlenmiştir (R=.632; R2 =.400, p<.01; F2/240=79.96; p<.01). Bilişsel esneklik değişkeninin beta katsayısı -.454 ve psikolojik sağlamlık değişkeninin beta katsayısı -.226 olarak bulunmuştur. Beta katsayısının anlamlılığına ilişkin t testi sonuçlarının anlamlı düzeyde olduğu tespit edilmiştir (tB.E.=-6.48, p<.01; tP.S.=-3.22, p<.05). Yapılan çoklu doğrusal regresyon analizinde bilişsel esneklik ve psikolojik sağlamlık değişkenlerinin sigaranın psikolojik bağımlılığını anlamlı düzeyde yordadığı belirlenmiştir. Bu araştırma sonucunda, sigaranın psikolojik bağımlılığını sırası ile “bilişsel esneklik” ve “psikolojik sağlamlık” değişkenlerinin anlamlı düzeyde yordadığına ulaşılmıştır.

Keywords

Sigaranın Psikolojik Bağımlılığı , Bilişsel Esneklik , Psikolojik Sağlamlık , Üniversite Öğrencisi

Ethical Statement

Etik kurul belgesi sisteme yüklenmiştir.

Supporting Institution

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Thanks

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References

• Abdelkader, R., Maabreh, R. S., Al-Dgheim, R., Altarawneh, N. S., Alrabab’a, M. H., Zaiton, H., Abdelmaksoud, A. S., Almagharbeh, W. T., Alnawafleh, K. A., Alfanash, H. A., Saleh, Z. T. ve Elshatarat, R. A. (2024). The impact of tobacco use and nicotine addiction on health: A literature review of nursing interventions for smoking cessation. Journal of Integrative Nursing, 6(4), 218-230. https://doi.org/10.4103/jin.jin_110_24
• Akbulut, Y. (2010). Sosyal bilimlerde SPSS uygulamaları. İdeal Kültür Yayıncılık.
• Alpers, S. E., Druckrey-Fiskaaen, K. T., Madebo, T., Vold, J. H., Pallesen, S., Skogen, J. C., Lunded, L. H., Maeland, S. ve Fadnes, L. T. (2024). The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: A two-year longitudinal cohort study. BMC Public Health, 24(1), 1-12. https://doi.org/10.1186/s12889-024-17943-x
• Al-Rawi, S. ve H. İbrahim, A. (2023). Uncovering the smoking Habits of undergraduate university students: A comprehensive assessment of different varieties tobacco use. Journal of Population Therapeutics and Clinical Pharmacology, 30(9), 248-257. http://eprints.tiu.edu.iq/id/eprint/1275
• American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). American Psychiatric Publishing.
• Angres, D. H. ve Benson, W. H. (1985). Cocainism--a workable model for recovery. Psychiatric Medicine, 3(4), 369-388. PMID: 3870754
• Arshad, A., Matharoo, J., Arshad, E., Sadhra, S. S., Norton-Wangford, R. ve Jawad, M. (2019). Knowledge, attitudes, and perceptions towards waterpipe tobacco smoking amongst college or university students: A systematic review. BMC Public Health, 19, 1-11. https://doi.org/10.1186/s12889-019-6680-x
• Asad, M. J. ve Majeed, H. M. (2024). Relationship between cigarette smoking and anxiety level among nurses. The Malaysian Journal of Nursing (MJN), 16(1), 149-158. https://doi.org/10.31674/mjn.2024.v16i01.015
• Ateş, B. ve Sağar, M. E. (2021). Üniversite öğrencilerinde bilişsel esneklik ve duygu düzenleme becerilerinin internet bağımlılığı üzerindeki yordayıcı rolü. Uşak Üniversitesi Eğitim Araştırmaları Dergisi, 7(1), 87- 102. https://doi.org/10.29065/usakead.887799
• Bardakçı M., Öztora, S. ve Dağdeviren, H. N. (2021). The reliability and validity analysis of the Turkish version of the test to assess the psychological dependence on smoking. Eurasian Journal of Family Medicine, 10(2), 100–106. https://doi.org/10.33880/ejfm.2021100208
• Başpınar, M. M., Akıllı, I. K. ve Kamat, S. (2023). Structural relationship among mindfulness, perceived stress level, and psychological dependence on smoking. The Turkish Journal on Addictions, 11(2), 143–149. https://doi.org/10.5152/ADDICTA.2024.23098
• Berg, C. J., Haardörfer, R., McBride, C. M., Kilaru, V., Ressler, K. J., Wingo, A. P., Saba, N. F., Payne, J. B. ve Smith, A. (2017). Resilience and biomarkers of health risk in Black smokers and nonsmokers. Health Psychology, 36(11), 1047–1058. https://doi.org/10.1037/hea0000540
• Büyüköztürk, Ş. (2011). Sosyal bilimler için veri analizi el kitabı. (15. Baskı). Pegem Akademi Yayıncılık.
• Connor, K. M. ve Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113.
• Creswell, J. W. (2012). Educational research: Planning, conducting, and evaluating quantitative and qualitative (4. Baskı). Prentice Hall.
• Cunha, P. J., Nicastri, S., de Andrade, A. G. ve Bolla, K. I. (2010). The frontal assessment battery (FAB) reveals neurocognitive dysfunction in substance-dependent individuals in distinct executive domains: Abstract reasoning, motor programming, and cognitive flexibility. Addictive Behaviors, 35(10), 875-881. https://doi.org/10.1016/j.addbeh.2010.05.005
• Dennis, J. P. ve Vander Wal, J. S. (2010). The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognitive Therapy and Research, 34(3), 241-253. https://doi.org/10.1007/s10608-009-9276-4
• Deressa Guracho, Y., Addis, G. S., Tafere, S. M., Hurisa, K., Bifftu, B. B., Goedert, M. H. ve Gelaw, Y. M. (2020). Prevalence and factors associated with current cigarette smoking among Ethiopian university students: A systematic review and meta-analysis. Journal of Addiction, 1-10. https://doi.org/10.1155/2020/9483164
• Doğan, T. (2015). Kısa Psikolojik Sağlamlık Ölçeği’nin Türkçe uyarlaması: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being, 3(1), 93-102.
• Dupont, P., Tack, V., Blecha, L., Reynaud, M., Benyamina, A., Amirouche, A. ve Aubin, H. J. (2015). Smoker’s identity scale: Measuring identity in tobacco dependence and its relationship with confidence in quitting. The American Journal on Addictions, 24(7), 607-612. https://doi.org/10.1111/ajad.12272
• Earvolino-Ramirez, M. (2007, April). Resilience: A concept analysis. In Nursing forum (Vol. 42, No. 2, pp. 73-82). Blackwell Publishing Inc. https://doi.org/10.1111/j.1744-6198.2007.00070.x
• El-Sherbiny, N. A. ve Elsary, A. Y. (2022). Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study. Journal of Family & Community Medicine, 29(1), 1-9. https://doi.org/10.4103/jfcm.jfcm_290_21
• Fraenkel J. R., Wallen, N.E. ve Hyun, H. H. (2011). How to desing and avaluate research in education. Mc Graw Hill.
• Guillon, M. S., Crocq, M. A. ve Bailey, P. E. (2007). Nicotine dependence and self-esteem in adolescents with mental disorders. Addictive Behaviors, 32(4), 758-764. https://doi.org/10.1016/j.addbeh.2006.06.018
• Habib, M. A., Islam, M. S., Sifat, I. K., Khondaker, M. E. A., & Kibria, M. K. (2024). Exploring the impact of smoking on mental health: A cross-sectional analysis in a district-level university in Bangladesh. Public Health Toxicology, 4(1), 1-9. https://doi.org/10.18332/pht/189225
• Hatsukami, D. K., Stead, L. F. ve Gupta, P. C. (2008). Tobacco addiction. The Lancet, 371(9629), 2027-2038.
• Hezer, H. ve Karalezli, A. (2019). Sigaraya psikolojik bağımlılığın sigara içme arzusu ve nikotin yoksunluk semptomlarına etkisi. Ankara Medical Journal, 19(4), 700-707. https://doi.org/10.17098/amj.651955
• Karasar, N. (2016). Bilimsel araştırma yöntemi. (31. Basım). Nobel Akademik Yayıncılık.
• Kasatura, İ. (1998). Gençlik ve bağımlılık. Evrim Yayınları.
• Kennedy, B., Chen, R., Fang, F., Valdimarsdottir, U., Montgomery, S., Larsson, H. ve Fall, K. (2019). Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life. J Epidemiol Community Health, 73(6), 496-501. https://doi.org/10.1136/jech-2018-211815
• Kesim, M. D. (2004). Sigara ve gebelik. Şişli Etfal Hastanesi Tıp Bülteni, 38(2), 7-14. Kesim, Y. ve Tür, A. (1995). Sigaranın farmakolojik etkileri. Sigaranın sağlığa etkileri ve bırakma yöntemleri (ss. 29–53) içinde. Logos Yayıncılık Tic. AŞ.
• Kock, L., Brown, J., Cox, S., McNeill, A., Robson, D., Shahab, L., Tattan-Birch, H. ve Brose, L. S. (2023). Association of psychological distress with smoking cessation, duration of abstinence from smoking, and use of non-combustible nicotine-containing products: A cross-sectional population survey in Great Britain. Addictive Behaviors, 138, 1-9. https://doi.org/10.1016/j.addbeh.2022.107570
• Lappan, S., Thorne, C. B., Long, D. ve Hendricks, P. S. (2020). Longitudinal and reciprocal relationships between psychological well-being and smoking. Nicotine and Tobacco Research, 22(1), 18-23. https://doi.org/10.1093/ntr/nty185
• Littleton, J. ve Little, H. (1994). Current concepts of ethanol dependence. Addiction, 89(11), 1397-1412. https://doi.org/10.1111/j.1360-0443.1994.tb03736.x
• Martin, M. M. ve Anderson, C. M. (1998). The cognitive flexibility scale: Three validity studies. Communication Reports, 11(1), 1-9. https://doi.org/10.1080/08934219809367680
• Martin, M. M. ve Rubin, R. B. (1995). A new measure of cognitive flexibility. Psychological reports, 76(2), 623-626. https://doi.org/10.2466/pr0.1995.76.2.623
• Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227-238. https://doi.org/10.1037/0003-066X.56.3.227
• Masten, A. S., Best, K. M. ve Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2(04), 425-444. https://doi.org/10.1017/S0954579400005812
• Murphy, L. B. (1987). Further reflections on resilience. E. J. Anthony ve B. J. Cohler (Ed.), The invulnerable child (ss. 84–105) içinde. Guilford Press.
• Naganandini, S., Seemadevi, T., Luke, A. M. ve Ingafou, M. S. H. (2024). Smoking trends and awareness among Indian university students: A qualitative study. Heliyon, 1–17. https://doi.org/10.1016/j.heliyon.2024.e41078
• Naghavi, M., Nakhaee, N. ve Ward, K. (2021). Associations between childhood abuse, resilience, mindfulness, and waterpipe smoking: Implications for cessation interventions. Journal of smoking cessation, 1-6. https://doi.org/10.1155/2021/6648779
• Nesic, J., Rusted, J., Duka, T. ve Jackson, A. (2011). Degree of dependence influences the effect of smoking on cognitive flexibility. Pharmacology Biochemistry and Behavior, 98(3), 376-384. https://doi.org/10.1016/j.pbb.2011.01.015
• Notebaert, L., Clarke, P. J., Meeten, F., Todd, J. ve Van Bockstaele, B. (2025). Cognitive flexibility and resilience measured through a residual approach. Anxiety, Stress, & Coping, 38(1), 125-139. https://doi.org/10.1080/10615806.2024.2353654
• Paz-Ballesteros, W. C., Zavala-Arciniega, L., Gutiérrez-Torres, D. S., Ponciano-Rodríguez, G., ve Reynales- Shigematsu, L. M. (2019). Evaluación de la dependencia física y psicológica al tabaco en fumadores mexicanos adultos, Encodat 2016. Salud Pública de México, 61, 136–146. https://doi.org/10.21149/9858
• Peker, A. ve Çukadar, F. (2016). Bilişsel esneklik ile sosyal medyayı kullanmaya yönelik tutum arasındaki ilişkinin incelenmesi. Sakarya University Journal of Education, 6(2), 66-79. http://dx.doi.org/10.19126/suje.03104.
• Pradhan, S. ve Dutta, S. N. (Eds.). (1977). Drug abuse: Clinical and basic aspects. The CV Mosby Company.
• Rezvanfard, M., Ekhtiari, H., Mokri, A., Djavid, G. E. ve Kaviani, H. (2010). Psychological and behavioral traits in smokers and their relationship with nicotine dependence level. Archives of Iranian Medicine, 13(5), 395-405. PMID:20804306.
• Robbins, A., Kaye, E. ve Catling, J.C. (2018). Predictors of student resilience in higher education. Psychology Teaching Review, 24(1), 44-52.
• Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57(3), 316-331. https://doi.org/10.1111/j.1939-0025.1987.tb03541.x
• Sağar, M. E. (2021). Predictive role of cognitive flexibility and self-control on social media addiction in university students. International Education Studies, 14(4), 1-10. https://doi.org/10.5539/ies.v14n4p1
• Sapmaz, F. ve Doğan, T. (2013). Bilişsel esnekliğin değerlendirilmesi: Bilişsel Esneklik Envanteri Türkçe versiyonunun geçerlik ve güvenirlik çalışmaları. Ankara Üniversitesi Eğitim Bilimleri Fakültesi Dergisi, 46(1), 143-161.
• Scott, W. (1962). Cognitive complexity and cognitive flexibility. Sociometry, 25(4), 405–414. https://doi.org/10.2307/2785779
• Sepahvand, T. (2020). Cognitive flexibility of smokers in the context of social anxiety. Avicenna Journal of Neuro Psycho Physiology, 7(2), 93-99. http://ajnpp.umsha.ac.ir/article-1-316-en.html
• Söğütlü, L. ve Göktaş, S. Ş. (2021). Relationship among smoking addiction, psychological flexibility, and impulsivity in university students. Addicta: The Turkish Journal on Addictions, 8(1), 16–22. https://doi.org/10.5152/ADDICTA.2021.21026
• Spiro, R. ve Jehng, J. (1990). Cognitive flexibility and hypertext: Theory and technology for the non-linear and multidimensional traversal of complex subject matter. D. Nix ve R. Spiro (Eds.), Cognition, education and multimédia: Exploring ideas in high technology (ss. 163-205) içinde. Lawrence Erlbaum Associates.
• Stevens, A. D. (2009). Social problem-solving and cognitive flexibility: Relations to social skills and problem behavior of at-risk young children. Unpublished doctoral thesis Available from ProOuest Dissertations and Theses database. (UMI No.3359050).
• Uzdil, N. (2022). Sigara içen bireylerde nikotin bağımlılığı, psikolojik sağlamlık ve öz kontrol arasındaki ilişkinin incelenmesi. 5th International Congress of Multidisciplinary Studies in Medical Sciences, Ankara, Turkey, ss. 12–13.
• Vargo, C., Hopp, T., Gangadharbatla, H. ve Pritha, A. (2025). From ads to addiction: The role of online gambling advertising spend in problem gambling search trends over a decade. Proceedings of the 58th Hawaii International Conference on System Sciences, 2356- 2365. https://hdl.handle.net/10125/109128
• Wagnild, G. ve Young, H. M. (1990). Resilience among older women. IMAGE: The Journal of Nursing Scholarship, 22(4), 252-255. https://doi.org/10.1111/j.1547-5069.1990.tb00224.x
• Wagnild, G. M. ve Young, H. M. (1993). Development and psychometric evaluation of the resilience scale. Journal of Nursing Measurement, 1(2), 165-178.
• Wang, Y., Chen, X., Gong, J. ve Yan, Y. (2016). Relationships between stress, negative emotions, resilience, and smoking: Testing a moderated mediation model. Substance Use & Misuse, 51(4), 427-438. https://doi.org/10.3109/10826084.2015.1110176
• World Health Organization [WHO]. (2008). WHO report on the global tobacco epidemic, 2008: The MPOWER package. World Health Organization.
• Xiong, H., Ma, F., Tang, D. ve Liu, D. (2024). Correlations among nicotine dependence, health-related quality of life, and depression in current smokers: a cross-sectional study with a mediation model. Frontiers in Psychiatry, 15, 1-12. https://doi.org/10.3389/fpsyt.2024.1455918
• Yıldırım, S., Çulha, Y., Büyükyılmaz, F. ve Ergin, E. (2024). Investigation of the loneliness perceptions and psychological dependence on smoking in elderly individuals living in nursing homes: Descriptive and relationship seeking study. Türkiye Klinikleri Journal of Nursing Sciences, 16(2), 441. https://doi.org/10.5336/nurses.2023-100705
• Yıldız, A. (2025, 22–23 February). The relationship between nicotine addiction and exercise and dietary habits: Does income level have an effect? 4th International Conference on Contemporary Academic Research, Konya, Turkey.