The Association of Smog Exposure with Psychological Distress in University Students of Pakistan

Abstract

Objective: To determine the association between smog exposure and psychological distress among university students in selected cities of Pakistan.

Methodology: This analytical cross-sectional study was conducted from December 2024 to May 2025, on 366 individuals from different universities of Islamabad, Lahore and Multan. Data was collected by purposive sampling technique using a comprehensive questionnaire based on literature review. Data analysis was done on SPSS Version 27.

Results: In this study conducted on 366 university students, results showed a positive association between smog exposure and psychological distress (p = 0.004 for both the genders; linear trend p = 0.001). Students in high-smog areas like Lahore and Multan reported no distress (14.8% and 16.5% respectively) lesser than Islamabad (36.6%). Lahore (22.1%) along with Multan (23.1%) showed notably higher severe distress. Air Quality Index (AQI) data, collected from January through February in 2025 did support all these findings with Lahore itself reaching such extreme pollution levels with AQI 214 as Islamabad remained at a relatively moderate level with AQI 142–213.

Conclusions: This study concludes that smog exposure is significantly associated with psychological well-being of university students, particularly in highly polluted cities. These findings underscore the importance of air quality management and mental health support services in urban educational settings.

Keywords: Air pollution, Anxiety, Mental well-being, Psychological health, Psychological distress, Smog