Most people are aware of the physical benefits of quitting smoking, including reducing the risk of developing cancer and improving heart health, but did you know that cigarettes can have a negative impact on your mental health too?
According to recent research, smoking can be so detrimental to emotional wellbeing that giving up can improve mental health, even for those with no history of psychiatric conditions.
Improvements in depression and anxiety
Researchers from the University of Oxford revealed smokers reported improved depression and anxiety scores after giving up cigarettes.
The results, which were published in JAMA Network Open, showed weeks nine to 24 of smoking abstinence saw the biggest improvements.
The study looked at the data of both adults with and without psychiatric disorders who smoked. Just over half (55.4 per cent) had a history of a mental illness, though the outcome of the research shows mental health improvements in both groups.
Paul Aveyard, co-author and professor of Behavioural Medicine at the Nuffield Department of Primary Care Health Sciences, said: “While smoking gives a short-term benefit, smoking itself is the cause of the problems. Without smoking, mental health improves on average.”
He added: “[The study] shows that when people stop smoking their mental health improves, whereas those who do not stop smoking have no improvement.”
Proportion of smokers with mental health history remains same
While the number of people who have quit smoking has grown over the last few years, the same is not true for those with mental health conditions.
According to official government figures, 13.3 per cent of adults smoked cigarettes in 2021, which is the lowest proportion since records began in 2011.
England had the lowest number out of the UK at 13 per cent, which is a big drop from 20 per cent just ten years before.
However, the number of people with a mental health condition who smoke has remained at around 40 per cent since 1993, with no signs of declining.
This is likely down to the fact that many of those who struggle with depression or anxiety regard smoking as a stress reliever.
They might see smoking as calming, a coping strategy, and a way to make themselves feel better. For this reason, adults with depression are more than twice as likely to smoke than those without it.
This is because cigarettes contain nicotine, which stimulates the release of dopamine in the brain. This is a feel-good chemical, which is often low in those with depression.
Therefore, people experience improved moods, better concentration, lower levels of anger, frustration and stress, and are more able to relax when they light up. It is easy to see why smokers, particularly those with mental health problems, crave these feelings.
However, the Mental Health Foundation states that regular smoking tells the brain to stop producing dopamine itself. This causes natural levels of dopamine to drop, which means smokers need even more cigarettes to experience the same feelings.
The organisation notes: “This cycle is how most smokers become nicotine dependent.”
Does quitting smoking cause mental health decline?
Oxford University even claims that some healthcare professionals discourage patients from quitting smoking for fear doing so could worsen the state of their mental wellbeing, as they will experience a big drop in dopamine levels, making them feel depressed and stressed.
Mr Aveyard added that this is why those with depression or anxiety struggle to quit, as they “feel they need cigarettes to cope with stress”.
However, he noted: “What people perceive are the benefits of smoking are the symptoms of withdrawal from cigarettes.”
The study showed mental health improvements were experienced in both data groups, demonstrating that it will not cause mental health decline as many smokers might believe.
Min Gao, co-author and researcher in Nuffield Department of Primary Care Health Sciences, added: “Quitting smoking will not worsen and may improve mental health outcomes.”
Finding ways to quit without causing mental health damage
As quitting smoking can be so difficult, particularly for those with mental health challenges, it is important to be fully prepared before throwing your last pack in the bin.
- E-cigarettes
Firstly, as people with depression or anxiety might have low levels of dopamine, they might not want to give up on their nicotine habit cold turkey.
Therefore, they could benefit from swapping tobacco cigarettes to vape liquids instead. These enable them to get a nicotine fix, which would raise their dopamine levels and help them manage stress and emotions, without the harmful effects of tobacco.
Angela Wu, lead author of the study and researcher in the Nuffield Department of Primary Care Health Sciences at the University of Oxford, added: “There are many alternatives and options to help you quit, such as counselling, nicotine replacement therapy (for example, patches, gum and sprays) and even trying out electronic cigarettes.”
She noted that vape products do not contain tobacco, which is the “most harmful element of smoking cigarettes”, but still provide smokers with that nicotine high.
- Manage stress in other ways
Before ditching cigarettes, it is a good idea to find alternative ways to manage stress. For instance, you could take up a new hobby, such as gardening or painting, which you might find peaceful or mindful.
Some people enjoy exercise, which also boosts mood, while eating a better diet, doing meditation or acupuncture are effective for many people too.
Stress-relieving strategies work differently for everyone, so find something you enjoy and benefits you first, so you know it will work when you quit smoking.
- Avoid triggers
If you turn to cigarettes when you are feeling worked up, try to avoid stressful situations as much as you can while you quit. For instance, don’t do it in the lead up to a big event, if you have a job interview planned, if you are attending social events and know you’ll get nervous, or if you are going to have to face a difficult confrontation soon.
Although it is impossible to predict when challenging situations will arise, actively avoiding situations you know you find difficult will make it easier to steer clear of cigarettes.
