Abstract
BACKGROUND: Smoking remains prevalent among young university students in Saudi Arabia, with psychological factors potentially influencing tobacco use. METHOD: 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. RESULTS: 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. CONCLUSION: Anxiety plays a key role in smoking among university students. Interventions should prioritize anxiety management in order to control smoking prevalence in this population.