The war in Ukraine has had a significant impact on the mental health of young people, particularly medical university students, who represent a vulnerable group due to high academic workload and professional stress. The aim of the study was to assess the level of nicotine dependence and the psycho-emotional state — including depression, anxiety, and stress — among medical students during wartime. A total of 91 students from three faculties of Dnipro State Medical University were examined using the Fagerström Test for Nicotine Dependence (FTND) and the Depression, Anxiety, and Stress Scales (DASS-21). It was found that female students demonstrated higher levels of anxiety and stress (p < 0.05), while depression scores did not differ by gender. Statistically significant differences were observed between faculties for depression and anxiety indicators: the highest medians were recorded among students of the medical faculty, and the lowest among dental students. Most respondents had normal levels of depression and stress; however, about two-thirds reported elevated anxiety. Nicotine dependence was found in one-third of the students, predominantly of mild degree (66.7 %), with no significant gender differences. No correlations were found between nicotine dependence and the levels of depression, anxiety, or stress. The obtained results indicate that the high level of anxiety among medical students is not caused by nicotine dependence but rather reflects the influence of the war and academic stress. These findings can be used to develop psychoeducational and preventive programs aimed at supporting mental health and reducing tobacco use among university students.