To investigate the relationship between symptoms of anxiety and current cigarette smoking, the authors conducted a cross-sectional survey of internal medicine outpatients. The participants completed a questionnaire that contained the Sheehan Patient-Rated Anxiety Scale, as well as several demographic, substance use, and medical questions. Of the 471 persons asked to participate, 370 (78.5%) agreed. The current smokers scored statistically higher on the anxiety scale than the nonsmokers (P = 0.009). For a subset of depressive questions, the smokers scored higher than the nonsmokers (P = 0.005). When subjected to univariate and multivariate analyses, only the depressive symptoms (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.34-1.43) and amount of caffeine intake (OR = 1.84, 95% CI = 1.28-2.650) were significantly related to current smoking. The authors conclude that among patients attending a university's internal medicine clinic, current depressive symptoms and amount of caffeine intake were significantly related to current cigarette use. Symptoms of anxiety were not related to current cigarette smoking.