Objective: Smoking is a major mental health concern due to its addictive nature and its status as the leading preventable cause of premature death worldwide. This study aimed to examine the levels of alexithymia, anger, anxiety, and depression in smokers compared to nonsmokers. Materials and Methods: This case-control study involved 176 smokers from a Smoking Cessation Clinic and 175 age- and gender-matched nonsmokers. Participants completed assessments using the Toronto Alexithymia Scale (TAS-20), State-Trait Anger Expression Inventory (STAXI), and Hospital Anxiety and Depression Scale (HADS). Nicotine dependence in smokers was measured using the Fagerström Nicotine Dependency Test. Statistical analysis was performed using SPSS 22.0. Findings: Significant differences were observed between smokers and nonsmokers in TAS, TAS-1, TAS-2, HADS-A, and HADS-D scores. Smokers exhibited higher levels of alexithymia, anger expression, and anxiety, while nonsmokers demonstrated better anger control. Additionally, addiction levels in smokers were associated with variations in TAS, TAS-1, TAS-2, TAS-3, STAXI scores (SA, AC, AI, AO), and HADS-A, highlighting a complex interplay between addiction, psychological factors, and smoking habits. Result: This study establishes a link between smoking status, addiction levels, and elevated alexithymia, anger, anxiety, and depression. The findings underscore the psychological impact of smoking, contributing valuable insights for mental health interventions in individuals with smoking habits.