The Digital Anxiety–Tobacco Link: Anxiety Mediates the Relationship Between Cyberchondria and Tobacco Dependence in University Students – A Cross-Sectional Study
Harshit Srivastava, Naganandini S, Kumar Gaurav Chhabra, Pankaj Chaudhary, Nimisha Srivastava, Shweta Dangi, Amit RecheBackground
Excessive health information seeking on the internet has become commonly known as cyberchondria, and it is accepted that cyberchondria is associated with maladaptive behaviors including tobacco use. This paper examined the relationship between cyberchondria, generalized anxiety and tobacco dependence and evaluated whether anxiety statistically mediates this association among young adults.
Methods
A cross-sectional survey design was used to survey 380 university students who were recruited through a stratified multi-site approach from the outpatient department of Public Health Dentistry, university dental camps, and targeted classroom outreach. The Cyberchondria and anxiety, and tobacco dependence were measured on the Cyberchondria Severity Scale-12 (CSS-12), Generalized Anxiety Disorder Scale (GAD-7), Fagerstrom Test for Nicotine Dependence (FTND) and Severson Smokeless Tobacco Dependence Scale (S-STDS). The scores of tobacco dependencies were standardized (Z-scores). The analysis of data was performed with respect to Kruskal Wallis H tests, Spearman correlation, multiple linear regression, and bootstrapped-mediation analysis (5,000 samples).
Results
Participants who used both smoked and smokeless tobacco reported greater level of cyberchondria, anxiety and tobacco dependence as compared to participants who used only one product type. There was a positive correlation between cyberchondria and anxiety, and both of them were linked to tobacco dependence. The regression analysis found out that anxiety and gender were both important predictors of tobacco dependence but cyberchondria was not independent of anxiety. Mediation analysis showed that anxiety statistically accounted for the association between cyberchondria and tobacco dependence (indirect effect B = 0.018, 95% CI = 0.011, 0.026).
Conclusion
Anxiety emerged as a key psychological correlate linking cyberchondria and tobacco dependence. These findings highlight anxiety as a shared vulnerability and supports integration of anxiety reduction and digital health literacy into tobacco cessation strategies.