BACKGROUND: This study aimed to assess the impact of smoking status, as measured by pack-years (PY), on components of metabolic syndrome while considering the influence of anxiety. DESIGN: This cross-sectional study was conducted at a smoking cessation clinic in Turkey, enrolling individuals who visited the clinic in 2022. The Fagerstrom Test for Nicotine Dependence and the State-Trait Anxiety Inventory were utilized as assessment tools, while metabolic syndrome parameters (body mass index, hypertension, hyperglycemia, dyslipidemia) were evaluated. Smoking status was classified based on pack-years. RESULTS: The study revealed a dose-dependent relationship between smoking status and essential metabolic factors such as systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin A1c (HbA1c), and low-density lipoprotein (LDL). Notably, triglyceride (TG) levels exhibited a significant increase, particularly at 25 pack years. While anxiety levels did not exhibit a significant correlation with smoking status, they demonstrated an upward trend with increasing SBP and DBP values. Anxiety levels did not exhibit a significant correlation with smoking status. CONCLUSIONS: A significant association was identified between nicotine addiction, as indicated by PY, and both metabolic syndrome parameters and anxiety levels. Early smoking cessation is strongly recommended for current smokers, and former smokers are advised to abstain from smoking to mitigate its adverse effects on metabolic syndrome components. These findings underscore the interconnectedness of cigarette smoking's effects on both physical and mental health, emphasizing the necessity of comprehensive approaches encompassing both metabolic disorder management and mental health support within cessation programs.