Modern Care Journal

en Investigation of the Prevalence of Stress, Anxiety, and Depression and Their Association with Self-Reported Tobacco Use among Students Community and Health Education پژوهشي Research Article <div style="text-align: justify;">Introduction: Tobacco use and psychological disorders remain major public‑health challenges worldwide, particularly among young adults. University students may be uniquely vulnerable due to academic pressures and social transitions. Objectives: This study assessed the prevalence of stress, anxiety, and depression among university students in Qaen, Iran, and examined their associations with self-reported tobacco use. Methods: A cross-sectional study was conducted among 226 students enrolled at five universities in Qaen County, South Khorasan Province, Iran, in 2023. Participants were selected using multistage random sampling proportional to university enrollment. Psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale, and demographic, academic, health-related, and tobacco-use information was collected using a structured questionnaire. Factors associated with self-reported tobacco use were examined using multivariable logistic regression. Results: Of the 226 participants, 57.1% were male, and the mean age was 22.41 ± 4.39 years. The prevalence of any level of depression, anxiety, and stress symptoms was 61.5%, 83.6%, and 34.1%, respectively. Self-reported tobacco use was reported by 23.0% of students, with hookah being the most commonly reported form. In the multivariable logistic regression analysis, male sex (adjusted odds ratios [AOR] = 3.29, 95% confidence interval [CI]: 1.06–10.14), older age (AOR = 1.14, 95% CI: 1.02–1.29), history of physical or mental illness (AOR = 5.77, 95% CI: 1.56–21.28), and moderate (AOR = 10.75, 95% CI: 1.15–100.03) and severe anxiety symptoms (AOR = 24.76, 95% CI: 2.32–264.44) were significantly associated with self-reported tobacco use. Conclusions: Psychological distress, particularly anxiety, was significantly associated with self-reported tobacco use among university students. These findings suggest that students reporting higher levels of psychological distress may be considered a priority group for mental health support and tobacco-use prevention programs. However, the cross-sectional nature of this study does not allow causal inferences.</div> Anxiety, Depression, Stress, Students, Tobacco use 1 11 http://mcj.bums.ac.ir/browse.php?a_code=A-10-61-1&slc_lang=en&sid=1 ali dashgard dashtgard_1349@yahoo.com 0889013896 10031947532846006847 No Instractor, Department of nursing, Qaen School of Nursing and Midwifery, Birjand University of Medical Sciences, Qaen, Iran mohammad alinegad mohammadalinegad23@yahoo.com 0889024707 10031947532846006848 No Instructor, Qaen School of Nursing, Birjand University of Medical Sciences, Qaen, Iran masumeh daliri daliri96@yahoo.com 0923759913 10031947532846006849 No PhD Candidate in Epidemiology, Student Research Committee, Kerman University of Medical Sciences, Kerman poriya khajavi robayat khajavi.robayat@yahoo.com 0640768113 0009-0000-2029-7823 No Operating room student, Student Research Committee, Qaen School of Nursing and Midwifery, Birjand University of Medical Sciences, Qaen, Iran narjes khaton taheri NarjesTaheri_1361@yahoo.com 0889056757 10031947532846006851 Yes Assistant Professor, Department of Nursing, Qaen School of Nursing and Midwifery, Birjand University of Medical Sciences, Qaen, Iran