Evidence Hub

Depression and anxiety symptoms, health behavior–related personal factors, and tobacco smoking problem: a secondary data analysis

Fátima Méndez-López, B. Oliván-Blázquez, M. Domínguez-García, Yolanda López-Del-Hoyo, Verónica Casado-Vicente, R. Martí-Lluch, R. Magallón-Botaya

Frontiers in Public Health, 2026

391 participants · 1 citation

Abstract

Smoking is a growing public health problem that has a significant impact on psychosocial functioning and quality of life. The presence of certain personal factors on health-promoting behavior influences mental well-being and less dependence on tobacco in the population.

The purpose of this study is to explore the association between tobacco abuse, affective disorders (depression and anxiety) and personal factors related to health behavior. We also aimed to analyze how affective problems can mediate the association between personal factors related to health behavior and tobacco abuse.

Descriptive, bivariate, multivariate and mediation analyzes of data from 391 participants of 35–74 years old in primary health care centers located in Aragón (Spain) were performed between July 2021 and July 2022. The primary variable was tobacco consumption, evaluated qualitatively (presence or absence) and quantitatively, as consumption measured through the number of cigarettes.

Higher patient activation and health literacy were associated with lower odds of tobacco smoking problem and lower daily cigarette consumption. Conversely, being without a partner and having more severe depressive symptoms were associated with higher odds of tobacco smoking problem and higher daily cigarette consumption. The mediation analyses suggested indirect statistical associations involving depressive symptoms in the relationships between health literacy, patient activation, and tobacco smoking outcomes. However,…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 391 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free