Impulsivity and smoking status among adults in Türkiye: a matched case-control study

Le résumé fourni par la source

Tobacco use remains a major public health concern in Türkiye. Impulsivity has been associated with smoking behavior, but the temporal direction of this relationship remains unclear. This study compared multidimensional impulsivity between adult current smokers and never-smokers and examined associations between nicotine dependence and impulsivity among current smokers. A matched case-control study was conducted among 446 adult current smokers and 446 never-smokers aged 30–65 years recruited from Family Health Centers in Kayseri, Türkiye. The groups were frequency-matched by sex and age group. All participants completed the 20-item short version of the UPPS-P Impulsive Behavior Scale, whereas current smokers also completed the Fagerström Test for Nicotine Dependence (FTND). Statistical analyses included Mann–Whitney U tests, effect-size calculations, Spearman’s rank correlation analysis, and multivariable binary logistic regression. The median UPPS-P total score was higher among current smokers than among never-smokers (42.00 [Q1–Q3: 35.00–49.00] vs. 38.00 [32.00–44.00], respectively; p < 0.001; r = 0.191). Current smokers also had higher scores for lack of premeditation, positive urgency, negative urgency, and lack of perseverance, although the corresponding effect sizes were small. Sensation-seeking scores did not differ significantly between the groups ( p = 0.055; r = 0.064). Among current smokers, FTND scores showed a statistically significant but very weak positive correlation with the UPPS-P total score (ρ = 0.154, 95% CI: 0.062–0.243, p = 0.001). In the fully adjusted logistic regression model, lack of premeditation was the only UPPS-P dimension independently associated with current smoking status. Current smoking status was associated with higher total impulsivity and higher scores in several UPPS-P dimensions, although the observed differences were small. Lack of premeditation was the only impulsivity dimension that remained independently associated with current smoking status after adjustment for selected demographic variables. Associations between nicotine dependence and impulsivity among current smokers were very weak and of limited practical magnitude. Because the case-control design does not establish temporal sequence, the findings cannot determine whether impulsivity precedes smoking, changes following nicotine exposure, or reflects shared underlying factors. Prospective longitudinal studies are needed to clarify the direction of these associations.

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