The Association Between Nicotine Dependence and Mental Health in the General Population of Saudi Arabia: A Cross-Sectional Analytical Study

Background: High prevalence of mental disorders is associated with psychoactive substances, significantly contributing to morbidity, disability, and premature mortality. Worldwide, individuals who use electronic-cigarettes (EC) and have a mental health diagnosis are more likely to experience stress, depression, and drug use. This study aims to measure the prevalence of both EC use and mental health disorders namely, anxiety and depression additionally to investigate the association between EC use and mental health status among the general population of Saudi Arabia. Methods: A cross-sectional analytical study was conducted across Saudi Arabia from November 2022 to May 2023. The survey was divided into three sections. The first section focuses on the demographics, while the second part asked about both conventional and EC smoking and their frequency. The third section assessed mental health status using a Patient Health Questionnaire with a 9-item depression scale (PHQ-9) and a 7-item Generalized Anxiety Disorder scale (GAD-7). Results: The study revealed 21.1% reporting EC use in the past thirty days. While 19.8% reported smoking tobacco one or more days within the last thirty days. Regarding mental health, 36.6% of individuals had minimal anxiety, while 42.4% experienced mild anxiety. Moreover, most of the participant were considered to have mild followed by minimal depression accounting for 36.7% and 31.9%, respectively. The results indicated a positive and significant correlation between perceived depression scores and nicotine dependence among EC users. Additionally, there was a strong relationship between gender and nicotine dependence, with men being more inclined than women. Conclusion: There is a correlation between nicotine use and mental health outcomes; people who use nicotine products are more likely to experience anxiety and depression.