Abstract
Introduction: Mental and substance use disorders are the leading health problems in the world in terms of years lived with disability. Numerous studies have found the association between smoking, substance use, and mental health.
However, there are variations in the strength of these associations depending on the substance type, the pattern of their use, and the sociodemographic characteristics. Despite the fact that these factors have been well established as those having an association elsewhere, according to our knowledge, no study has yet been dedicated to this topic neither in Serbia nor in the Western Balkan region using data from a nationally representative sample.
In Serbia, the prevalence of smoking among the adult population aged 15 years and above (34.7%) is higher than the European Union (EU) average (26%) as well as the total alcohol consumption per capita (12.6 l in Serbia compared to worldwide average of 6.2 l). Last year, prevalence of cannabis use (0.4%) among the population aged 15 years and above, as the most used illicit substance in Serbia, is less common than in the EU, where the last year of cannabis use prevalence was 7%.
Last year, the prevalence of any other illicit drug except cannabis in Serbia was below 0.1% and therefore other illicit drugs were not included in this analysis. A high prevalence of the licit substance use (tobacco, alcohol, and sedatives) and the fact that 56.6% of Serbian adults were exposed to stress indicate the need for better understanding of the association between smoking, substance use, and psychological distress as a base for planning and implementation of tailored activities.