1. Stress in College Students
The Factors That Contribute to Stress in College Students
Caroline Milch
Salem State University
Author Note:
Caroline Milch, Department of Psychology, Salem State University
Correspondence concerning this article should be addressed to Caroline Milch, Department of
Psychology, Salem State University, Salem, Ma 01970

2. Stress in College Students
Abstract
This experiment aimed to find out how nicotine effects stress levels. In a controlled study
of 17 participants, each participant was asked to fill out a nicotine dependence test to indicate
who was addicted to nicotine. There were 9 smokers and 8 nonsmokers. Each participant was
required to do public speaking for five minutes and mental math for five minutes. The purpose of
this study was to induce stress on each participant. To measure stress, each participant’s heart
rate was taken and a subjective test was given at the end. The researcher hypothesized that those
who smoke will report more stress than nonsmokers. The results were not significant enough to
support the hypothesis, however there were some indication that smokers were more stressed out
than nonsmokers.

3. Stress in College Students
Introduction
Stress is a big part of everyone’s life in America and many adults use nicotine to cope
with stress. People who are addicted to nicotine find that under any amount of stress, smoking a
cigarette is a great stress reliever. However, it may be a very temporary stress reliever. After a
certain period of time that someone has been abstinent from nicotine, the individual is once again
stressed out, not only from everyday life but also from the withdrawal effects.
A recent meta-analysis by Heishman, Kleykamp and Singleton (2010) reviewed the
outcomes of 41 studies conducted between 1994 and 2008 on the effects of nicotine on
performance. The studies each included the researchers giving nicotine to the adult smokers and
non-smokers and then tested the participants in nine different areas of performance. These areas
included motor abilities, attention, and memory. Each study showed a significant increase in
performance. As noted by Heishman, Kleykamp and Singleton (2010), a key limitation of the
literature is that nicotine only shows performance enhancement when it is not confounded with
withdrawal relief.
Recent studies have shown that nicotine withdrawal dramatically decreases human
performance and over time, increases stress in one’s life. Parrot, Garnham, Wesnes, and Pincock
(1996) investigated the effects of nicotine abstinence on task performance and mood state over a
period of 24 hours. The researchers were testing a group of 20 smokers. Each participant was
required to smoke a cigarette at least 15 minutes before the test session in order for them to have
a non-deprived baseline. The study included two test sessions, one of normal smoking and then
another with smoking cessation. The non-smoking test required the participants to stay abstinent
from smoking for 24 hours. Their performance was checked after 2, 6 and then 24 hour periods.
The researchers also checked their subjective feelings every two hours. The participants showed

4. Stress in College Students
a decrease in task performance, heart rate, feelings of depression, anxiety, anger, restlessness and
the urge to smoke. This was all compared to the test during the normal smoking period. Besides
heart rate, abstinence symptoms were reduced in severity by the end of the 24 hour period. These
results suggest that burden of the withdrawal effects can cause more accumulative stress in one’s
life.
The next study was aimed to find a relationship between addictive behaviors and
addictive overlap to stress, acceptance of others and purpose of life. Okasaka, Morita, Nakatani,
and Fujisawa (2008) conducted a survey on 691 college students among eight universities. The
study consisted of three different surveys that assessed food addiction, nicotine addiction and
alcohol addiction; the Eating Attitude Test- 20, The Kurihama Alcoholism Screening Test and
The Fagerstrom Test for Nicotine Dependence. Next, the students were given two other tests that
assessed stress and acceptance from others and then purpose of life. The results were compared
between students with addictive behaviors, addictive tendencies and without addictive behaviors.
In regards to food and nicotine addiction, the researchers found vastly different results between
three groups that were observed for stress, acceptance from others and Purpose in life scores.
However, there were not any notable differences found in regards to alcohol addiction. They also
found that 28.8% of students displayed only one addictive behavior, 8.5% of students displayed
two addictive behaviors and only 0.4% of students displayed all three addictive behaviors. The
scores displayed notable differences in stress and acceptance from others among students with
one addictive behavior, two or three addictive behaviors, and no addictive behaviors at all.
However, there appeared to be no differences in the Purpose in Life score in regards to
overlapping addictions. The researchers concluded that there is a relationship between mental
health, addictive behaviors and overlapping addiction among university students.

5. Stress in College Students
A study that was conducted by Parrot and Murphy (2012) aimed to explain the way
nicotine has stress-inducing side effects on cigarette smokers. Proposed studies have shown that
taking up smoking leads to higher stress and depression in one’s life. Also, “cross sectional
studies show that adult smokers report more irritability, stress and depression then non-smokers.”
(Parrot et. al) The withdrawal effects of nicotine addiction are explained using the “deprivation
reverse model”. People who are addicted to nicotine often experience subtle abstinence
symptoms when they aren’t smoking cigarettes and day by day these can increase everyday
stress. Adolescents who pick up smoking become more stressed and when they quit, it eventually
reduces the stress in their life. Parrot and Murphy made an explanatory leaflet to show to 82
cigarette smokers in a cohort study. The participants read the leaflet which enhanced their
knowledge of the adverse effects of smoking. Their understanding of the information was
maintained a week later. Hence, these informational leaflets can be useful in schools and with
adults who are already smoking. This may prevent people from starting to smoke or give them
incentive to quit.
Wardle, Munafo and Witt (2010) aimed to find out the effects of social stress during
subtle nicotine abstinence. According to the researchers, when someone relapses to smoking, it
is often participated by stress. However, not a lot is known about how nicotine withdrawal can
affect the average response to everyday stress. Also, there is not a lot known if nicotine
replacements actually reduce the way the withdrawal effects change stress responses. The
researchers use the Trier Social Stress Test, to study subjective feelings, heart rate, blood
pressure and salivary cortisol. In the study, there were 49 regular smokers that were randomly
assigned to one of three groups: smoking normal(SM), 12 hours of abstention with a placebo
patch (PL), and then 12 hours of abstention with nicotine patch (NIC). After participating in a

6. Stress in College Students
single session using the TSST, the results were expected; there were increases in subjective
negative effect, heart rate, mean arterial blood pressure and cortisol. All of the groups did not
differ in subjective or cardiovascular responses but the placebo patch group had larger increase
in cortisol due to stress. The researchers concluded that the increase of cortisol is an indication
that the human body goes through a great amount of stress while trying to stop smoking
cigarettes. On the other hand, cortisol is what allows the body to deal with stress in an
appropriate way that does not include completely breaking down. Nicotine addiction can
actually make the stress system irregular which can overall make the cortisol levels in the body
lower. When the cortisol levels are lower,smoking relapse is expected because the body no
longer deals with stress like someone who was never addicted to cigarettes. The fact that the
group with the nicotine patch also deals with higher cortisol levels like those who were smoking
cigarettes may be an indication that the patch causes undesired side effects.
Balk, Lynskey and Agrawal (2009) performed a study that tried to find a relationship
between nicotine dependence and stressful life events. Previous studies have found a positive
correlation between the amount of stressful life events and nicotine dependence. The way they
went about executing this study was using data from the 2001-2002 National Epidemiological
Survey on Alcohol and Related Condition that 18,013 smokers took. While looking at the results
of the survey, they were examining if the amount of stressful life events (SLEs) in the past 12
months was related to meeting the criteria for nicotine dependence (ND) in the same 12 months.
Many stressful life events were related to nicotine dependence in the past 12 months. Those who
had more than one stressful life event had significantly higher nicotine dependence than those
with only one or none at all. Although this data cannot make causal conclusions, the researchers

7. Stress in College Students
found a positive correlation between the two. Those who have a lot of stress in their lives
possibly could find it harder to quit smoking and that’s why there is a positive relationship.
All of the studies reviewed above investigate the stress inducing effects of nicotine on
one’s life. It is relatively clear that nicotine causes a lot of unwanted stress in one’s life. They all
touch upon the subject of stress and nicotine but do not directly investigate the question whether
being addicted to nicotine makes life more stressful. The purpose of this study is to compare the
stress levels of smokers and non-smokers using a quasi-experimental design. In a laboratory
setting, I will have both groups do the same sets of activities that have different levels of stress.
Each participant will have a heart rate/ cardiovascular monitor to test their stress levels. Also,
there will be a survey to test their subjective feelings in order to make better conclusive results.
The hypothesis is the participants who smoke will report more stress than those who do not
smoke.
Method
Participants
The participants consisted of 17 students, (9 smokers, 8 nonsmokers) 10 females, 7 males.
Each student was 18 years or older.
Measures
Before the test started each participant was given the Fagerstrom Nicotine Dependence Test
(Fagerstrom et.al.) to measure the amount of nicotine dependence. This study contains nominal
variables; smokers and nonsmokers. The students were separated into groups by what they
scored on the questionnaire. All students who scored a zero on the questionnaire were classified
as “nonsmokers” anyone who scored a 2 or above were classified as “smokers” During the study,
participants were tested with parts of the Trier Social Stress Test (Kirschbaum et. al.) The

8. Stress in College Students
researcher measured each participant’s heart rate before the test, during the test and after the test.
The researcher did this by finding their pulse on their wrist, measured the pulse for fifteen
seconds and then multiplied that number by four. Once the participants completed the test
section, the researcher administered a four-question subjective questionnaire.
Procedure
Students were recruited by word of mouth. Each student who agreed to participate in the study
was required to fill out the Fagerstrom Nicotine Dependence test. Among those participants who
were in psychology classes were able to receive extra credit via the online sona system. To
measure student’s stress levels, they participated in parts of the Trier Social Stress Test. The
students were asked to prepare a speech as if they were being interviewed for their dream job.
The researcher acted as the manager for this hypothetical job they were being interviewed for.
Each participant was required to speak for a total of five minutes and if they stopped any time
before the five minutes were up, they were required to keep going. After the five minutes were
completed, their initial heart rate was recorded. The next part of the test included the students
performing mental math in front of the researcher. The students were asked to count backwards
from 1,022 in intervals of 13. They had five minutes to do so. If participants were to mess up the
calculations, they were required to start over and go back to 1,002. After this test, the student’s
ending heart rate was recorded. Finally a four question subjective test was given to the
participants that asked how stressed they were during each section of the study.
Results
An independent samples t test showed no significant difference between smokers and
nonsmokers in their stress levels and heart rate. Smokers showed higher stress levels (M=9.67,
SD=3.67) compared to nonsmokers (M= 8.36, SD=4.75). However smokers showed lower heart

9. Stress in College Students
rates (M=75.71, SD=7.97) compared to nonsmokers (M=83.96, SD=13.35). The results for total
stress were t(15)=.631 and for average heart rate t(15)=-1.57. Neither of these scores were
significant enough to support the hypothesis.
Discussion
The purpose of this study was to compare the stress levels of a smoker to a nonsmoker.
The hypothesis was that smokers would report higher stress levels and have a higher heart rate
than nonsmokers. There was not a significant difference between smokers and nonsmokers in
terms of their heart rate and stress levels. The results turned out this way due to a lack of a
controlled laboratory setting and professionalism; along with the lack of highly addicted cigarette
smokers. In the interest of time, participants who were moderately addicted to cigarettes were
allowed to participate in the study instead of only highly addicted participants. This lessened the
likely hood of nicotine causing a heightened reaction to stress. Compared to other studies, the
results were relatively similar because smokers reported more stress than nonsmokers. However,
the results of this study were not as conclusive due to the many limitations of this study.
The strengths of this study were the unexpected learning experience for the participants.
In the portion where each student had to think of a speech to say in front of a prospective
employer, it was a challenge to see how well they were prepared for the interview process for
their dream job. Many students reported being amazed at how difficult it was to think of things to
say about themselves that would convince a prospective employer to hire them. Also many of the
smokers who participated in this study gained some insight on unknown negative effects of
nicotine.
This study had many drawbacks that skewed the results. The sample size was not large
enough to produce significant results. The demographics were quite limited because the

10. Stress in College Students
researcher collected a convenience sample and many participants were familiar with the
researcher. The goal was to stress participants out, but due to the fact that the participants knew
the researcher, the stressful nature of public speaking was diminished. Also, the original Trier
Social Stress test included two other people in the room with the researcher. Those two extra
judges were not included in this study. If there were the two extra judges, the stress of public
speaking would have been higher. Also, the way participants reacted to stress was almost entirely
dependent on the type of person the participant would. For example, one participant who was a
smoker did great on the public speaking portion because he appeared to be a confident person
who worked well under pressure. A female participant in the nonsmokers group did not work as
well under pressure which in turn produced higher stress scores. Overall, a larger sample size
and a better resemblance of the Trier Social Stress test would have produced more significant
results to support the hypothesis.

11. Stress in College Students
References
Balk, E., Linksy, M., & Agrawal , A. (2009). The association between dsm-iv nicotine
dependence and stressful life events in the national epidemiologic survey on alcohol and related
conditions. American Journal of Drug and Alcohol Abuse, 35, 85-90.
Heatherton T.F., Kozlowski L.T., Frecker R.C., Fagerström K.-O.The Fagerström Test for
Nicotine Dependence: A revision of the Fagerström tolerance Questionnaire. Br. J. Addict.
1991;86: 1119–1127
Heishman, S. J., Kleykamp, B. A., & Singleton, E. G. (2010). Meta-analysis of the acute effects
of nicotine and smoking on human performance.Psychopharmacology, 210, 453-469.
Kirschbaum C., Pirke K-M, Hellhammer D. H (1993a) The ‘Trier Social Stress Test’—a tool for
investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology
28:76–81
Okasaka, Y., Morita, N., Nakatani , Y., & Fujisawa , K. (2008). Correlation between addictive
behaviors and mental health in university students. Psychiatry & Clinical Neurosciences, 62, 84-
92.
Parrot, A. C., Garnham, N. J., Wesnes, K., & Pincock, C. (1996). Cigarette smoking and
abstinence: Comparative effects upon cognitive task performance and mood state over 24 hours.
Human Psychopharmacology: Clinical and Experimental, 11, 391-400.
Parrot, A. C., & Murphy, R. S. (2012). Explaining the stress-inducing effects of nicotine to
cigarette smokers. Human Psychopharmacology: Clinical and Experimental, 27, 150-155.
Wardle, M., Munafo, M., & Witt, H. (2011). Effect of social stress during acute nicotine
abstinence. Psychopharmacology, 218, 39-48.