Cigarette smoking is a major, worldwide health hazard [1]. Ninety percent of teenagers who smoke 3-4 cigarettes a day become regular smokers for 35-40 years [2]. Disorders resulting from tobacco use were included for the first time by the American Psychiatric Association in its third edition of the Diagnostic and statistical manual of mental disorders (DSM-III) [3]. It is now considered the number-one cause of death among the DSM-III disorders [4]. Dependence on nicotine, the addictive substance in cigarettes, has been found to be associated with high rates of depression and anxiety [5] and to increase the lifetime risk for these disorders [6]. With declining sales elsewhere, the tobacco industry is increasingly promoting tobacco use in the developing countries, which consume almost 52% of tobacco products [7]. Imports of tobacco into Saudi Arabia have increased about ninefold in less than ten years [8], which would seem to indicate an increase in smoking. Previous studies have shown that smoking is prevalent among Saudi physicians and school and university students [9-1 5]. These studies have explored the knowledge, attitudes, and beliefs of smokers and nonsmokers, but none have thus far assessed the relation-