Psychological factors associated with smoking and quitting: addiction map of Turkey study

BACKGROUND: Smoking is the most important modifiable factor in increased morbidity and premature mortality. This study aims to examine the psychological factors associated with smoking and quitting in a broad, nationally representative sample. PARTICIPANTS AND METHODS: The sample included a total of 24.494 adult individuals. Participants were divided into three groups as smokers, non-smokers, and “ex-smokers” who had stopped smoking since at least last one year. For the current smokers, cigarettes per day also noted. Brief Symptom Inventory, Toronto Alexithymia Scale (TAS), Personal Well-Being Index Adult Form, Positive and Negative Affect Schedule, Experiences in Close Relationships-Revised Scales were used. RESULTS: 43.6% (n=10,672) of the participants were smokers; 5.7% (1386) were ex-smokers; 50.7% (n=12,414) were non-smokers. A higher number of daily smoked cigarettes was related to all subscales of Brief Symptom Inventory, TAS - Difficulty in Recognition of emotions, TAS - Difficulty in Expressing Emotions, Positive Affect Score, Negative Affect Score, Avoidance and Anxious Attachment scores (p<0.05). Externally oriented thinking is found to be significantly higher among ex-smokers than current smokers and non-smokers (p<0.05). CONCLUSION: The results of the present study indicate that smokers have more psychopathological characteristics in the psychometric evaluation, whereas ex-smokers are found to have similar scores to non-smokers. The higher percentage of externally oriented-thinking style in ex-smokers may suggest that this alexithymic characteristic can help the individual to deal with psychological addiction throughout quitting. On the other hand this result could also be related that stopping smoking leads to greater externally orientated thinking and other changes in psychological characteristics.