Association of Nicotine Dependence and Smoking Behavior with Quality of Life in Ankara

The use of cigarettes and tobacco products is one of the leading preventable causes of morbidity and mortality worldwide and significantly affects quality of life. In Türkiye, approximately 30% of the adult population uses tobacco products. This study aimed to evaluate the relationship between tobacco and nicotine product use, nicotine dependence, smoking behavior, and quality of life among individuals attending family health centers in Ankara. This cross-sectional study included 713 participants. Data were collected using a questionnaire including sociodemographic variables, the Fagerström Test for Nicotine Dependence (FTND), the Glover–Nilsson Smoking Behavioral Questionnaire (GN-SBQ), and the Short Form-12 Health Survey (SF-12). Face-to-face interviews were conducted in March 2026. Mann–Whitney U, Kruskal–Wallis, chi-square, and Spearman correlation tests were used. Of the participants, 60.6% reported using tobacco and/or nicotine products. Median scores of both FTND and GN-SBQ were significantly higher in men compared to women (p < 0.001). Participants with a majority of smokers in their social circle had higher median scores on both FTND and GN-SBQ compared to those without (p < 0.001). Additionally, participants who were considering quitting tobacco and/or nicotine use had lower median scores on both FTND and GN-SBQ compared to those who were not considering quitting (p < 0.001). Participants who used tobacco and/or nicotine products had lower mental health subscale scores on the SF-12 compared to non-users (p = 0.031). Weak negative correlations were observed between SF-12 physical and mental health subscale scores and FTND scores. Similarly, a weak negative correlation was found between GN-SBQ scores and the SF-12 mental health subscale. It was determined that the physical and behavioral dimensions of nicotine dependence are interrelated and that increasing levels of dependence negatively affect quality of life.

Key messages

• It was determined that the physical and behavioral dimensions of nicotine dependence are interrelated and that increasing levels of dependence negatively affect quality of life.

• Comprehensive interventions targeting the multidimensional nature of nicotine dependence are recommended.