Samsun Üniversitesi’nde sigara kullanan öğrencilerde psikolojik sıkıntı düzeyi

Yıl 2025, Cilt: 7 Sayı: 2, 84 - 95, 02.01.2026

Meryem Dilek Acar , İlayda Elitok , Zeynep Yaren Aydın , Burak Emirhan Çalışkan , Nazlı Hilal Ertekin

Öz

Amaç: Sigara kaynaklı serbest radikaller, merkezi sinir sisteminde oksidatif stresin öncülük ettiği hasara neden olmaktadır. Çalışmanın amacı, Samsun Üniversitesi lisans ve lisansüstü öğrencilerinde, sigara kullanımı sonucu gelişmesi muhtemel depresyon ve anksiyete düzeylerinin araştırılmasıdır.

Metod: 17-30 yaş aralığında, sigara içmeyen (n=310, kontrol grubu) ve sigara içen (n=223) öğrencilerin depresyon ve anksiyete düzeyleri, Kessler Psikolojik Sıkıntı Ölçeği-K10 kullanılarak tespit edildi. İstatistiksel analizlerde Shapiro-Wilks testi, Independent Samples T-testi, One-Way ANOVA modeli kullanıldı. Kategorik özellikler arasındaki ilişkiler Pearson ki-kare testiyle incelendi.

Bulgular: Sigara içmeyen öğrencilerin yaş ortalamasının 19,60 ve sigara içen öğrencilerin yaş ortalamasının 20,65 olduğu saptandı. Sigara kullanım oranının erkek öğrencilerde daha fazla olduğu tespit edildi (P <.001). K10’na göre sigara içmeyen grupta ve sigara içen grupta puan ortalamasının sırasıyla 25,31 ve 29,10 olduğu saptandı (P ˂.001). Sigara içmeyenlerde (P =.188) ve sigara içenlerde (P =.209), yaş ile psikolojik sıkıntı puanı arasında anlamlı doğrusal bir ilişki bulunamadı. Sigara kullanım süre (<2 yıl, 2-<5 yıl, ≥5 yıl) (P =.358) ve miktarının (<10, 10-<15, ≥15 sigara/gün) (P =.189) psikolojik sıkıntıya istatistiksel olarak etkisinin olmadığı tespit edildi. Sigara içmeyen ve sigara içen gruplardan depresyon/anksiyete için risk faktörüne sahip olanlar çıkarıldığında, kalan sigara içmeyenlerin (n=222) puanı, sigara içenlerin (n=99) puanından istatistiksel olarak daha düşüktü (P ˂.001). Puan aralıklarına göre incelendiğinde, muhtemel iyilik hali (%32,4) ve muhtemel hafif ruhsal rahatsızlık (%23,9) sigara içmeyenlerde (n=222), muhtemel ağır ruhsal rahatsızlık (%45,5) ise sigara içenlerde (n=99) anlamlı düzeyde daha yüksek oranda saptandı (P <.001). Muhtemel orta düzeyde ruhsal rahatsızlık, iki grupta benzer sıklıkta saptandı.

Sonuç: Depresyon/anxieteye sebep olabilecek farklı durumlar dışlandığında, 17-30 yaş aralığındaki öğrencilerde, sigaranın depresyon ve anksiyete gelişimine öncülük edebileceği saptanmıştır.

Anahtar Kelimeler

anksiyete , depresyon , nörodejenerasyon , sigara

Proje Numarası

Tubitak 2209-A University Students Research Projects Support Program (No:1919B012217842)

Psychological distress level of cigarette user students at Samsun University

Öz

Objective: Free radicals caused by smoking leads oxidative stress-induced damage in central nervous system. The aim of the research was to investigate the possible depression and anxiety levels that may develop as a result of smoking in undergraduate and graduate students at Samsun University.

Method: Depression and anxiety levels of 17-30 years old non-smoker (n=310, control group) and smoker (n=223) students were determined by the Kessler Psychological Distress Scale-K10. The Shapiro-Wilks test, the Independent Samples T-test, the One-Way ANOVA model were used for statistical analyses. Relationships between categorical features were examined by the Pearson chi-square test.

Findings: The mean age of non-smoker students was 19,60 and the mean age of smoker students was 20,65. Smoking rate was higher in man students (P <.001). The average score of non-smokers and smokers were respectively 25,31 and 29,10 points, according to the K10 (P ˂.001). There were no significant linear relationship between age and psychological distress score in non-smokers (P =.188) and in smokers (P =.209). The duration (<2, 2-<5, ≥5 years) (P =.358) and the amount (<10, 10-<15, ≥15 cigarette/day) (P =.189) of smoking did not statistically effect psychological distress. When non-smokers and smokers were excluded who have risk factor for depression/anxiety, the scores of the remaining non-smokers (n=222) were statistically lower than the scores of smokers (n=99) (P ˂.001). Probable well-being (32,4%) and probable mild mental illness (23,9%) were higher in non-smokers (n=222), while probable severe mental illness (45,5%) was higher in smokers (n=99), according to score ranges (P <.001). Probable moderate mental illness was detected with similar frequency in two groups.

Conclusion: When different situations which may cause depression/anxiety were excluded, it was determined that smoking may cause depression and anxiety in students between the ages of 17-30.

Anahtar Kelimeler

anxiety , cigarette , depression , neurodegeneration

Etik Beyan

The Clinical Research Ethics Committee of Samsun University (No: SUKEK-2023 5/2)

Destekleyen Kurum

Tubitak 2209-A

Proje Numarası

Tubitak 2209-A University Students Research Projects Support Program (No:1919B012217842)

Kaynakça

• Alasmari F., Crotty Alexander L. E., Nelson J. A., Schiefer I. T., Breen E., Drummond C. A., et al. (2017). Effects of chronic inhalation of electronic cigarettes containing nicotine on glial glutamate transporters and alpha-7 nicotinic acetylcholine receptor in female CD-1 mice. Prog. Neuropsychopharmacol. Biol. Psychiatry, 77, 1-8. 10.1016/j.pnpbp.2017.03.017.
• Altun, Y. (2018). Psikolojik sıkıntı ölçeğinin (Kessler Psycholocigal distress scale; K10) Türkçe uyarlaması, geçerlilik ve güvenilirlik çalışması. Tıpta Uzmanlık Tezi, Sağlık Bilimleri Üniversitesi Antalya Sağlık Uygulama ve Araştırma Merkezi Aile Hekimliği Kliniği.
• Altun, Y., Özen, M., Kuloğlu, M.M. (2019). Psikolojik Sıkıntı Ölçeğinin Türkçe uyarlaması: Geçerlilik ve güvenilirlik çalışması. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi, 20, 23-31.
• Ariño-Braña, P., Zareba, M. R., Ibáñez Montolio, M., Visser, M., Picó-Pérez, M. (2025). Influence of the HPA Axis on Anxiety-Related Processes: An RDoC Overview Considering Their Neural Correlates. Current Psychiatry Reports, 27(10), 593-611. https://doi.org/10.1007/s11920-025-01633-5.
• Bergink, V., van Megen, H.J., Westenberg, H.G. (2004). Glutamate and anxiety. European Neuropsychopharmacology : The Journal of The European College of Neuropsychopharmacology, 14(3), 175-183. https://doi.org/10.1016/S0924-977X(03)00100-7.
• Bhatt, S., Nagappa, A.N., Patil, C.R. (2020). Role of oxidative stress in depression. Drug Discov Today, 25(7), 1270-1276. doi: 10.1016/j.drudis.2020.05.001.
• Bildik, T. (2013) Ölüm, kayıp, yas ve patolojik yas. Ege Journal of Medicine, 52, 223-229.
• Boden, J.M., Fergusson, D.M. (2011). Alcohol and depression. Addiction, 106(5), 906-14. doi: 10.1111/j.1360-0443.2010.03351.x.
• Bortolato, B., Hyphantis, T.N., Valpione, S., Perini, G., Maes, M., Morris, G., Kubera, M., Köhler, C. A., Fernandes, B. S., Stubbs, B., Pavlidis, N., Carvalho, A. F. (2017). Depression in cancer: The many biobehavioral pathways driving tumor progression. Cancer treatment reviews, 52, 58-70. doi: 10.1016/j.ctrv.2016.11.004.
• Brook, J.S., Schuster, E., Zhang, C. (2004). Cigarette smoking and depressive symptoms: A longitudinal study of adolescents and young adults. Psychological Reports, 95, 159-166. doi: 10.2466/pr0.95.1.159-166.
• Can, B., Piskun, V., Dunn, A., Cartwright-Hatton, S. (2024). The impact of treating parental bipolar disorder and schizophrenia on their children's mental health and wellbeing: an empty systematic review. Frontiers in psychiatry, 15, 1425519. doi: 10.3389/fpsyt.2024.1425519.
• Chellian, R., Behnood-Rod, A., Wilson, R., Lin, K., King, G.W., Bruijnzeel, A.W. (2023). Dopamine D1-like receptor activation decreases nicotine intake in rats with short or long access to nicotine. Addiction biology, 28(8), e13312. https://doi.org/10.1111/adb.13312
• Chinwong, D., Mookmanee, N., Chongpornchai, J., Chinwong, S.A. (2018). Comparison of Gender Differences in Smoking Behaviors, Intention to Quit, and Nicotine Dependence among Thai University Students. J Addict, 8081670. doi: 10.1155/2018/8081670.
• Coe J. W., Brooks P. R., Vetelino M. G., Wirtz M. C., Arnold E. P., Huang J., et al. (2005). Varenicline: an alpha4beta2 nicotinic receptor partial agonist for smoking cessation. J Med Chem, 48, 3474-3477. 10.1021/jm050069n
• Çökmen, A., Yılmaz, K., Akkoyun Sert, Ö. (2023). The Effect of Smoking Duration and Daily Consumption on Anxiety and Sleep Quality in Smokers. H.Ü. Sağlık Bilimleri Fakültesi Dergisi, Cilt: 10, Sayı: 1. doi: 10.21020/husbfd.1142261.
• Dickinson, B.C., Chang, C.J. (2011). Chemistry and biology of reactive oxygen species in signaling or stress responses. Nat Chem Biol, 7(8), 504-11. doi: 10.1038/nchembio.607.
• Dome, P., Lazary, J., Kalapos, M.P., Rihmer, Z. (2010). Smoking, nicotine and neuropsychiatric disorders. Neurosci Biobehav Rev, 34, 295-342. doi: 10.1016/j.neubiorev.2009.07.013.
• Dwivedi Y. (2009). Brain-Derived Neurotrophic Factor: Role in Depression and Suicide. Neuropsychiatr Dis Treat, 5, 433-449. doi: 10.2147/NDT.S5700.
• Eskin, S.G., Kırag, N., Gözüm, S. (2021). Comparative Turkish Adaptation of The Kessler Psychological Distress Scale in Cancer Caregivers: A Validity And Reliability Study. Electronic Turkish Studies, 16(4), 1221-1233. https://dx.doi.org/10.7827/TurkishStudies.50752.
• Fedoce, A.G., Frederico, F., Bota, R.G., et al. (2018). The role of oxidative stress in anxiety disorder: cause or consequence? Free Radical Research. doi: 10.1080/10715762.2018.1475733.
• Götze, H., Brähler, E., Gansera, L., Schnabel, A., Gottschalk-Fleischer, A., Köhler, N. (2018). Anxiety, depression and quality of life in family caregivers of palliative cancer patients during home care and after the patient's death. Eur J Cancer Care (Engl), 27(2), e12606. doi: 10.1111/ecc.12606.
• Gül, M. (2021). Pandemi döneminde bireylerin yaşadığı Covid-19 fobisi, psikolojik iyi oluşları ve psikolojik sıkıntılarının incelenmesi. Yüksek Lisans Tezi, İstanbul Gelişim Üniversitesi Lisansüstü Eğitim Enstitüsü.
• Hahad, O., Daiber, A., Michal, M., Kuntic, M., Lieb, K., Beutel, M., Münzel, T. (2021). Smoking and Neuropsychiatric Disease-Associations and Underlying Mechanisms. Int J Mol Sci, 22, 7272. doi: 10.3390/ijms22147272.
• Hassan, M.S., Hossain, M.K., Khan, H.T.A. (2019). Prevalence and predictors of tobacco smoking among university students in Sylhet Division, Bangladesh. Int Health, 1, 11(4), 306-313. doi: 10.1093/inthealth/ihy091.
• He, Y., Liu, Y., Zhang, M. (2025). The beneficial effects of curcumin on aging and age-related diseases: from oxidative stress to antioxidant mechanisms, brain health and apoptosis. Front Aging Neurosci, 17, 1533963. doi: 10.3389/fnagi.2025.1533963.
• Johnson, J.G., Cohen, P., Pine, D.S., Klein, D.F., Kasen, S., Brook, J.S. (2000). Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. JAMA, 284(18), 2348-2351. doi: 10.1001/jama.284.18.2348.
• Ji, N., Lei, M., Chen, Y., Tian, S., Li, C., Zhang, B. (2023). How Oxidative Stress Induces Depression? ASN neuro, 15, 17590914231181037. https://doi.org/10.1177/17590914231181037.
• Kamis, C., Stolte, A., Copeland, M. (2022). Parental Death and Mid-adulthood Depressive Symptoms: The Importance of Life Course Stage and Parent's Gender. J Health Soc Behav, 63(2), 250-265. doi: 10.1177/00221465211061120.
• Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein, J.F., Gfroerer, J.C., Hiripi, E., Howes, M.J., Normand, S.L., Manderscheid, R.W., Walters, E.E. Zaslavsky, A.M. (2003). Screening for serious mental illness in the general population. Archives of general psychiatry, 60(2), 184-189. doi: 10.1001/archpsyc.60.2.184.
• Knackstedt L. A., LaRowe S., Mardikian P., Malcolm R., Upadhyaya H., Hedden S., et al. (2009). The role of cystine-glutamate exchange in nicotine dependence in rats and humans. Biol Psychiatry, 65, 841–845. 10.1016/j.biopsych.2008.10.040.
• Lima Giacobbo B., Doorduin J., Klein H., Dierckx R., Bromberg E., de Vries E. Brain-Derived Neurotrophic Factor in Brain Disorders: Focus on Neuroinflammation. Mol Neurobiol, 56, 3295-3312. doi: 10.1007/s12035-018-1283-6.
• Liu S., Hu W., Zhang W., Yang L., Li Y., Xiao Z., Zhang M., He Z. (2019). Paeoniflorin Attenuates Impairment of Spatial Learning and Hippocampal Long-Term Potentiation in Mice Subjected to Chronic Unpredictable Mild Stress. Psychopharmacology, 236, 2823-2834. doi: 10.1007/s00213-019-05257-5.
• McEwen B., Nasca C., Gray J. (2015). Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsychopharmacology, 41, 3-23. doi: 10.1038/npp.2015.171.
• Mandil, A., BinSaeed, A., Ahmad, S., Al-Dabbagh, R., Alsaadi, M., Khan, M. (2010). Smoking among university students: a gender analysis. J Infect Public Health, 3(4), 179-87. doi: 10.1016/j.jiph.2010.10.003.
• Majeed, M., Nagabhushanam, K., Murali, A., Vishwanathan, D.T., Mamidala, R.V., Mundkur, L. (2024). A Standardized Withania somnifera (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomized, Placebo-Controlled Study. Journal of Integrative and Complementary Medicine, 30(5), 459-468. https://doi.org/10.1089/jicm.2023.0279.
• Miao Z., Wang Y., Sun Z. (2020) The Relationships between Stress, Mental Disorders, and Epigenetic Regulation of BDNF. Int. J Mol Sci, 21, 1375. doi: 10.3390/ijms21041375.
• Mirowsky, J. and Ross, C.E. (2002). Selecting outcomes for the sociology of mental health: Issues of measurement and dimensionality. Journal of Health and Social Behavior, 43,152-170.
• Morrell, H.E.R., Cohen, L.M., Bacchi, D., West, J. (2005). Predictors of smoking and smokeless tobacco use in college students: A preliminary study using web-based survey methodology. Journal of American College Health, 54(2), 108-115. doi: 10.3200/JACH.54.2.108-115.
• Motaghinejad M., Farokhi N., Motevalian M., Safari S. (2020). Molecular, histological and behavioral evidences for neuroprotective effects of minocycline against nicotine-induced neurodegeneration and cognition impairment: Possible role of CREB-BDNF signaling pathway. Behav. Brain Res, 386, 112597. 10.1016/j.bbr.2020.112597.
• Munafo`, M.R. and Araya, R. (2010). Cigarette smoking and depression:a question of causation. The British Journal of Psychiatry, 196, 425-426. doi: 10.1192/bjp.bp.109.074880.
• Nerurkar, L., Siebert, S., McInnes, I.B., Cavanagh, J. (2019). Rheumatoid arthritis and depression: an inflammatory perspective. The Lancet Psychiatry, 6(2), 164-173. doi: 10.1016/S2215-0366(18)30255-4.
• Nunez, K., Kay, J., Krotow, A., Tong, M., Agarwal, A. R., Cadenas, E., de la Monte, S.M. (2016). Cigarette Smoke-Induced Alterations in Frontal White Matter Lipid Profiles Demonstrated by MALDI-Imaging Mass Spectrometry: Relevance to Alzheimer's Disease. Journal of Alzheimer's disease: JAD, 51(1), 151-163. doi: 10.3233/JAD-150916.
• Öğüt, S. and Atay, E. (2012). Yaşlılık ve oksidatif stres. Medical journal of Süleyman Demirel University, 19(2), 68-74.
• Özel, Y. and Özkan, B. (2020). Kayıp ve Yasa Psikososyal Yaklaşım. Psikiyatride Güncel Yaklaşımlar, 12(3), 352-367. doi:10.18863/pgy.652126.
• Pasco, J.A., Williams, L.J., Jacka, F.N., et al. (2008). Tobacco smoking as a risk factor for major depressive disorder: population-based study. British Journal of Psychiatry, 193(4), 322-326. doi:10.1192/bjp.bp.107.046706.
• Polosa R., Benowitz N.L. (2011). Treatment of nicotine addiction: present therapeutic options and pipeline developments. Trends Pharmacol Sci, 32, 281-289. 10.1016/j.tips.2010.12.008
• Pratt, L.A. (2018). QuickStats: Percentage of Adults Aged ≥18 Years With or Without Psychological Distress† Who Were Current Smokers,§ by Age Group and Level of Distress - National Health Interview Survey,¶ 2014-2016. MMWR Morb Mortal Wkly Rep, 67(23), 672. doi: 10.15585/mmwr.mm6723a6.
• Quintanilla, M.E., Morales, P., Ezquer, F., Ezquer, M., Herrera-Marschitz, M., Israel, Y. (2021). Administration of N-acetylcysteine Plus Acetylsalicylic Acid Markedly Inhibits Nicotine Reinstatement Following Chronic Oral Nicotine Intake in Female Rats. Frontiers in behavioral neuroscience, 14, 617418. https://doi.org/10.3389/fnbeh.2020.617418
• Rice, F. (2022). The Intergenerational Transmission of Anxiety Disorders and Major Depression. Am J Psychiatry, 179(9), 596-598. doi: 10.1176/appi.ajp.20220570.
• Rollema H., Chambers L. K., Coe J. W., Glowa J., Hurst R. S., Lebel L. A., et al. (2007). Pharmacological profile of the alpha4beta2 nicotinic acetylcholine receptor partial agonist varenicline, an effective smoking cessation aid. Neuropharmacology, 52, 985-994. 10.1016/j.neuropharm.2006.10.016.
• Roy, T. and Lloyd, C.E. (2012). Epidemiology of depression and diabetes: a systematic review. J Affect Disord, 142 Suppl, S8-21. doi: 10.1016/S0165-0327(12)70004-6.
• Saki, M., Shadmanpour, M., Zarif Najafi, H. (2021). Are individuals with orofacial pain more prone to psychological distress during the COVID-19 pandemic? Dent Med Probl, 58(1), 17-25. doi:10.17219/dmp/131683.
• Salim, S. (2017). Oxidative Stress and the Central Nervous System. The Journal of pharmacology and experimental therapeutics, 360(1), 201-205. doi: 10.1124/jpet.116.237503.
• Scott, A.J., Correa, A.B., Bisby, M.A., Dear, BF. (2023). Depression and Anxiety Trajectories in Chronic Disease: A Systematic Review and Meta-Analysis. Psychother Psychosom, 92(4), 227-242. doi: 10.1159/000533263.
• Seo, Y.S., Park, J.M., Kim, J.H., Lee, M.Y. (2023). Cigarette Smoke-Induced Reactive Oxygen Species Formation: A Concise Review. Antioxidants (Basel), 12(9), 1732. doi: 10.3390/antiox12091732.
• Sullman, M.J.M., Gras, M.E., Kagialis, A., Papageorgi, I., Font-Mayolas, S. (2020). Cigarette, E-Cigarette and Waterpipe Use among Young Adults: Differential Cognitions about These Three Forms of Smoking. Int J Environ Res Public Health, 17(11), 3787. doi: 10.3390/ijerph17113787.
• Toledano A., Alvarez M. I., Toledano-Diaz A. (2010). Diversity and variability of the effects of nicotine on different cortical regions of the brain-therapeutic and toxicological implications. Cent. Nerv. Syst. Agents Med. Chem, 10, 180-206. 10.2174/1871524911006030180.
• Zhang, B., El-Jawahri, A., Prigerson, H.G. (2006). Update on bereavement research: Evidence based guidelines for diagnosis and treatment of complicated bereavement. J Palliative Med, 9(5), 1188-203.