The Relationship between Smoking Behavior and the Incidence of Generalized Anxiety Disorder (GAD) in Students
Abstract
Generalized Anxiety Disorder (GAD) is a psychological disorder characterized by excessive worry and uncontrollable responses that persist continuously and can be experienced by both men and women. The Ministry of Health indicates that 47.7% of Indonesian adolescents experience anxiety disorders. Based on data from the National Adolescent Mental Health Survey (I-NAMHS) in 2022, it was revealed that in the past year, 155 million adolescents in Indonesia suffered from mental health disorders such as anxiety disorders. This study aims to identify the correlation between smoking behavior and GAD cases among students at Muhammadiyah University Surakarta from the 2021 to 2024 cohorts. This is a quantitative study using a cross-sectional approach. The sample consists of 240 active male students at UMS. The sampling technique used was stratified random sampling. The instrument used was a standardized questionnaire from the Anxiety and Depression Association of America (ADAA), which has been translated into Indonesian and tested for validity and reliability. The questionnaire demonstrated validity and reliability with a Cronbach's Alpha value 0.938. The research data were analyzed using univariate analysis to determine the characteristics of the respondents, such as age, class, and faculty. Bivariate analysis was performed using the Chi-square test. Bivariate analysis was conducted on the dependent and independent variables, namely the relationship between smoking behavior and GAD, as well as an additional test on the variable of the number of cigarettes consumed per day. The statistical test results indicate that there is no significant correlation between smoking behavior and GAD incidence with a value of (P = 0.090). Meanwhile, the test results on the relationship between the number of cigarettes consumed per day and GAD incidence show a weak correlation with a value of (P = 0.010).
References
Abdullah, A., Alhashim, A., Alghannam, A. A., Almakhayitah, I. H., Ali, A., Alhammadi, Y. M., Alkatali, N. A., Alsaqer, S. K., Ahmed, M., Alzahrani, R. M., & Alessa, J. A. (2025). Anxiety and Depression among Smoker among University Students : A Systematic Review Journal of Chemical Health Risks. 15, 574–582.
Aini, N., Nasution, R. S., Efendy, I., & Fitria, A. (2024). MAHASISWA DI KAMPUS X ACEH SELATAN Factors Influencing Smoking Behavior In Students at Campus X Aceh Selatan. 10(2), 446–460.
Al Mubarok, M., Nadhirah, N. A., & Saripah, I. (2022). General Anxiety Disorder Dalam Intensitas Penggunaan Smartphone Pada Remaja. Jurnal Bimbingan Konseling Islam, 4(2), 139–147.
Asfour, N. M. (2024). Cognitive Deficits in Generalized Anxiety Disorder : Impairments in Attention , Executive Functioning , and Cognitive Flexibility Among Young Adults. Jurnal of Angiotherapy, 8(11), 1–7.
Banushi, B., Brendle, M., Ragnhildstveit, A., Murphy, T., Moore, C., Egberts, J., & Robison, R. (2023). Breathwork Interventions for Adults with Clinically Diagnosed Anxiety Disorders: A Scoping Review. Brain Sciences, 13(2). https://doi.org/10.3390/brainsci13020256
Burke, C., Freeman, T. P., Sallis, H., Wootton, R. E., Burnley, A., Lange, J., Lees, R., Sawyer, K., & Taylor, G. (2023). Associations of cannabis use, tobacco use and incident anxiety, mood, and psychotic disorders: a systematic review and meta-analysis. MedRxiv. https://www.embase.com/search/results?subaction=viewrecord&id=L2023737500&from=export%0Ahttp://dx.doi.org/10.1101/2023.03.17.23287299
Byeon, H. (2015). Association among smoking, depression, and anxiety: Findings froma representative sample of Korean adolescents. PeerJ, 2015(10), 1–11. https://doi.org/10.7717/peerj.1288
Bilsky, S. A., Luber, M. J., Cloutier, R. M., Dietch, J. R., Taylor, D. J., & Friedman, H. P. (2021). Cigarette use, anxiety, and insomnia from adolescence to early adulthood: A longitudinal indirect effects test. Addictive Behaviors, 120. https://doi.org/10.1016/j.addbeh.2021.106981
Cahyadi, A. T., & Sulistyaningtyas, N. (2025). Analysis of Final Semester Students ’ Level of Academic Anxiety Disorder Regarding Thesis. 2020, 255–258.
Cho, S., Park, J.-H., Kim, D.-H., Choi, H., Park, Y., Kim, H.-J., Lee, A.-N., Shin, J., & Ha, J. (2024). Association between Combustible Cigarettes and Noncombustible Nicotine or Tobacco Products and Generalized Anxiety Disorder Based on Data from the 8th Korea National Health and Nutrition Examination Survey 2021. Korean Journal of Family Medicine, 317–323. https://doi.org/10.4082/kjfm.23.0172
Erskine, H. E., Maravilla, J. C., Wado, Y. D., Wahdi, A. E., Loi, V. M., Fine, S. L., Li, M., Ramaiya, A., Wekesah, F. M., Odunga, S. A., Njeri, A., Setyawan, A., Astrini, Y. P., Rachmawati, R., Hoa, D. T. K., Wallis, K., McGrath, C., Shadid, J., Enright, M. E., … Scott, J. G. (2024). Prevalence of adolescent mental disorders in Kenya, Indonesia, and Viet Nam measured by the National Adolescent Mental Health Surveys (NAMHS): a multi-national cross-sectional study. The Lancet, 403(10437), 1671–1680. https://doi.org/10.1016/S0140-6736(23)02641-7
Fadia, S. H., Shifanidha, Y. T., Hidayat, I., Anggraini, O. D., Fitrianto, W. C., Nabillah, R., Nurahmad, Y. A., Karyadi, V. A., Kirana, K. C., & Pratiwi, B. I. (2023). Peningkatan Pengetahuan Bahaya Merokok dengan Edukasi pada Siswa Sekolah Dasar Negeri 2 Tawang Kabupaten Sukoharjo. Prosiding Seminar Nasional Kesehatan Masyarakat Universitas Muhammadiyah Surakarta, 220–229.
Fiana, F. K., & Indarjo, S. (2024). Analisis Faktor-Faktor yang Memengaruhi Kejadian Hipertensi. HIGEIA (Journal of Public Health Research and Development), 8(1), 1–11. https://doi.org/10.15294/higeia.v8i1.67857
Firdaus, E., Widiyawati, W., Fitrianur, W. L., & Suminar, E. (2024). The Correlation Between Social Comparison and Depression in Adolescents Aged 12-24 Years in Suci Village , Manyar District , Gresik. 17(3), 221–230. https://doi.org/10.23917/jk.v17i3.5414
Fitri, A. (2023). Program Preventif Bunuh Diri Untuk Mengurangi Ide Dan Percobaan Bunuh Diri Pada Mahasiswa. Journal of Clinical, Industrial, Social and Educational Psychology, 12–22.
Goodwin, R. D., Lewinsohn, P. M., & Seeley, J. R. (2005). Cigarette smoking and panic attacks among young adults in the community: The role of parental smoking and anxiety disorders. Biological Psychiatry, 58(9), 686–693. https://doi.org/10.1016/j.biopsych.2005.04.042
Hendra Setyoko, K., Puspita, S., & Nuraminudin Aziz, A. (2024). Hubungan Tingkat Stres Dengan Perilaku Merokok Pada Remaja Di Desa Banjargondang Kec. Bluluk, Kab. Lamongan. Prima Wiyata Health, 5(1), 1–10. https://doi.org/10.60050/pwh.v5i1.56
Husna, C., & Jannah, S. R. (2019). Kecemasan Dan Perilaku Merokok Pada Remaja. Idea Nursing Journal, 10(1), 32–36.
Johnson, J. G., Cohen, P., Pine, D. S., Klein, D. F., Kasen, S., & Brook, J. S. (2000). Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. Journal of the American Medical Association, 284(18), 2348–2351. https://doi.org/10.1001/jama.284.18.2348
Kim, N., & Justin Kim, M. (2021). Altered task-evoked corticolimbic responsivity in generalized anxiety disorder. In International Journal of Molecular Sciences (Vol. 22, Issue 7). https://doi.org/10.3390/ijms22073630
Laksmiwati, E. D., & Tondok, M. S. (2023). Perceived Social Support, Academic Self-Efficacy, and Anxiety among Final Year Undergraduate Students: A Mediation Analysis. Bulletin of Counseling and Psychotherapy, 5(2), 173–182. https://doi.org/10.51214/00202305514000
Liem, A. (2010). PENGARUH NIKOTIN TERHADAP AKTIVITAS DAN FUNGSI OTAK SERTA HUBUNGANNYA DENGAN GANGGUAN PSIKOLOGIS PADA PECANDU ROKOK. BULETIN PSIKOLOGI, 18(2), 37–50.
Luo, Z., Xu, W., Jiang, S., Zhou, Q., Guan, Y., Li, L., Liu, S., Zhou, H., Yin, X., Wu, Y., & Chen, J. (2023). The mediating role of negative emotions in the relationship between smoking and health-related quality of life among Chinese individuals: A cross-sectional study. Tobacco Induced Diseases, 21(October), 1–12. https://doi.org/10.18332/tid/171355
Ma, R., Zhang, Q., Zhang, C., & Xu, W. (2024). Longitudinal associations between family functioning and generalized anxiety among adolescents: the mediating role of self-identity and cognitive flexibility. BMC Psychology, 12(1), 1–10. https://doi.org/10.1186/s40359-024-01908-1
Mayah, I. C. (2021). Hubungan Stress dengan Kebiasaan Merokok pada Komunitas Pendaki Indonesia Korwil Yogyakarta. Jurnal Keperawatan Terpadu (Integrated Nursing Journal), 2(2), 156. https://doi.org/10.32807/jkt.v2i2.83
Mishra, A. K., & Varma, A. R. (2023). A Comprehensive Review of the Generalized Anxiety Disorder. Cureus, 15(9). https://doi.org/10.7759/cureus.46115
Moon, Y., & Woo, H. (2024). Key risk factors of generalized anxiety disorder in adolescents: machine learning study. Frontiers in Public Health, 12(January), 1–9. https://doi.org/10.3389/fpubh.2024.1504739
Moylan, S., Jacka, F. N., Pasco, J. A., & Berk, M. (2012). Cigarette smoking, nicotine dependence and anxiety disorders: A systematic review of population-based, epidemiological studies. BMC Medicine, 10(1), 123. https://doi.org/10.1186/1741-7015-10-123
Mubasyiroh, R., Suryaputri, I. Y., & Tjandrarini, D. H. (2017). Determinan Gejala Mental Emosional Pelajar SMP-SMA di Indonesia Tahun 2015. Buletin Penelitian Kesehatan, 45(2), 103–112. https://doi.org/10.22435/bpk.v45i2.5820.103-112
Nashihuddin, W., Fathoni, L., & Aulianto, D. R. (2015). Manajemen Penerbitan Jurnal Sistem OJS. Prosiding Lokakarya Nasional Dokinfo PDII-LIPI, 1–10.
Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay, L. G. (2011). Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). Differential Diagnosis and Comorbid Disorders. In: Canadian ADHD Practice Guidelines. Third Edition. Toronto: CADDRA. Barlow 1988, 275–297. https://doi.org/10.1146/annurev-clinpsy-050212-185544.Worry
Nurhasanah, T., & Kurnia, S. I. (2023). The Relationship Between Knowledge About The Dangers Of Cigarettes And Smoking Behavior In Junior High School Students. Jurnal Keperawatan, 15(S4), 413–422. http://journal.stikeskendal.ac.id/index.php/Keperawatan
Nurjannah, D., Oktavia Hidayati, N., & Shalahuddin, I. (2023). Gambaran Pengetahuan, Sikap Tentang Rokok, dan Status Perokok pada Siswa Sekolah Menengah Pertama Negeri 1 Tanjungsari Kabupaten Sumedang. Jurnal Kesehatan, 16(3), 213–223. https://doi.org/10.23917/jk.v16i3.2022
Octaviani, P., & Sunarti. (2020). Drug Prescribing Pattern (Generalized Anxiety Disorder) in Banyumas General Hospital. Advances in Health Sciences Research, 20(Icch 2019), 82–85. https://doi.org/10.2991/ahsr.k.200204.019
Pamungkas, K. B., R. Maramis, Franckie. R., & Tucunan, A. A. T. (2020). Perilaku Mahasiswa Terhadap Penerapan Kebijakan Kawasan Tanpa Rokok DI Fakultas Kesehatan Masyarakat Universitas Samratulangi. Jurnal KESMAS, 9(7), 1–8.
Philian Goszal, irene Miracle, H. A. S. M. (2023). Hambatan Yang Dialami Oleh Mahasiswa Dalam Mengelola Kesehatan Mental Selama Pandemi Covid-19. Jurnal Inovasi Penelitian, 3(8), 7307–7316. https://jurnal.umt.ac.id/index.php/jt/article/view/10648
Pinaria, A. S., Manampiring, A. E., & Umboh, A. (2023). Hubungan antara Kebiasan Merokok, Konsumsi Alkohol dan Faktor Sosiodemografis dengan Kualitas Hidup Remaja di Kabupaten Minahasa Utara. E-CliniC, 12(1), 96–106. https://doi.org/10.35790/ecl.v12i1.45748
Santomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., Bang-Jensen, B. L., Bertolacci, G. J., Bloom, S. S., Castellano, R., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R. M., Collins, J. K., … Ferrari, A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet, 398(10312), 1700–1712. https://doi.org/10.1016/S0140-6736(21)02143-7
Sebtiana, E., Sudaryanto, A., Kesehatan, F. I., Surakarta, U. M., Merokok, P., & Laki-laki, R. (2025). Hubungan pengetahuan bahaya merokok dan perilaku merokok siswa 1,2. 7(1), 38–45.
Sma, D., Don, K., & Lembean, B. (2024). Edukasi Tentang Bahaya Merokok Pada Kalangan Remaja. 5(2), 2489–2496.
Soen, C. C., Hardjasasmita, I. M., & Ulitua, A. E. (2022). Generalized Anxiety Disorder: Diagnosis and Treatment. Jurnal Muara Medika Dan Psikologi Klinis, 1(2), 133. https://doi.org/10.24912/jmmpk.v1i2.14865
Tan, G. P. P., Teo, O., & van der Eijk, Y. (2022). Residential secondhand smoke in a densely populated urban setting: a qualitative exploration of psychosocial impacts, views and experiences. BMC Public Health, 22(1), 1–11. https://doi.org/10.1186/s12889-022-13561-7
Warsyena, R., & Wibisono. (2021). Insomnia: Suatu Analisis Terhadap Faktor Penyebab, Dampak Dan Penanganannya. Nusantara Hasana Journal, 1(7), 132–137.
Copyright (c) 2025 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
