The Effects of Smoking on Sleep Quality, Fatigue and Perceived Stress in University Students: A Comparison Study

Tobacco use is a major cause of death resulting from cancer, cardiovascular diseases, and pulmonary disorders. It is also a risk factor for respiratory and other infections, osteoporosis, diabetes, reproductive disorders, adverse surgical outcomes and delayed wound healing, as well as duodenal and gastric ulcers [1]. Studies project that the number of deaths due to smoking will rise to 8.4 million by 2030 [2]. According to the Tobacco Atlas, in Turkey, 83,100 people die each year due to smoking-related causes.

The negative effects of smoking are not limited to chronic diseases; it can also affect the quality of daily life. In a study involving 3,516 participants, it was reported that both male and female smokers experienced significantly greater difficulty falling asleep compared to non-smokers. They also suffered from non-restorative sleep, frequent awakenings during the night, and difficulty falling back asleep [3]. Furthermore, literature has demonstrated a significant relationship between smoking and perceived stress [4]. Perceived stress is defined as "the feelings or thoughts an individual has about how much stress they are under during a particular period" [5]. Although smoking may temporarily alleviate perceived stress, studies suggest it may actually lead to negative emotional states or exacerbate stress in the long run [6, 7]. In addition, it has been found that smokers tend to feel more tired and become fatigued more quickly compared to non-smokers [8, 9].

The majority of smokers begin smoking during adolescence [10]. In their study, Burt et al. reported that 71% of smokers started smoking at or before the age of 18 [11]. The university period is a critical phase in young individuals' lives, and habits formed during this time can have long-term health consequences. Smoking can affect not only health but also academic performance [12]. Factors such as stress [13], sleep quality [14], and fatigue [15], which have previously been studied in smokers, have also been shown to negatively impact academic achievement. Although academic success will not be directly evaluated in our study, considering the target population, the potential secondary effect of smoking on academic performance further underscores the significance of our research.

This study is designed to compare university students who smoke and those who do not in terms of sleep quality, fatigue, and perceived stress levels. Although there are existing studies that examine these parameters individually or in different populations, to our knowledge, no study has simultaneously assessed all of these factors in a university student sample. Most studies in this field focus on the general population; however, university students represent a specific group due to their stressful academic lives, social pressures, and lifestyle changes. The originality of our study lies in its focus on university students and its comprehensive approach to examining multiple variables concurrently. In this context, the planned research will provide more specific and detailed insights into the factors associated with nicotine dependence and their interrelationships.