It is well documented that mental disorders and suicidal behavior are associated with tobacco smoking. However, investigations in which there is a distinction between high and low nicotine dependence are more recent. The purpose was to evaluate correlates associated with high nicotine dependence such as psychiatric morbidity, suicidal behavior, practice physical exercise and use of caffeine, alcohol and illegal drug.

The analysis was based on sample of 290 participants, ages varying from 18 to 65, in a primary health service of Granada (south of Spain). All of them were assessed with the Fagerström Test for Nicotine Dependence and with the General Health Questionnaire.

The prevalence of current smoking was 34,5% and the prevalence of high nicotine dependence was 9,3%. Psychiatric morbidity (GHQ-28>6), previous suicide attempts, lack of physical exercise, high caffeine intake and consumption of illegal drugs were significantly associated with high nicotine dependence. These results remained after controlling for gender or substance abuse. Also there was significant relationship between high nicotine dependence and antecedents of suicide attempts (OR=3,53; IC 95%:1,53–25,98). In the logistic regression model, after adjusting for sex and age, the differences remained statistically significant (OR=8,17; IC 95%:1,96–34,03), as well as the protective effect of married status (OR=0.08; IC 95%:0.01–0.72).

Smokers with high nicotine dependence should be distinguished from other smokers in evaluating health status populations. Serial cross-sectional and longitudinal studies of nicotine dependence are needed to determine whether certain groups are especially vulnerable to nicotine dependence when they start smoking.