Does smoking increase anxiety and depression? If I quit, will I feel better?

By R. Ryan S Patel DO, FAPA, OSU-CCS Psychiatristrainbow cigarette (3)

Most students know about harmful effects of smoking cigarettes including the risk of cancer, stroke, heart disease, breathing problems (1). Students may also know that stopping smoking reduces these health risks (2-3).

Most people may not know that smoking contributes to anxiety and depression and that you can feel good and increase happiness by quitting smoking.


This study (4) analyzed mental health inforation across 26 studies and looked at positive and negative changes in mental health before and after quitting smoking cigarettes.

What did the study show?
When compared to smokers, 7 weeks to 9 years after quitting smoking, those who quit smoking reported a DECREASE in:
• Anxiety
• Depression
• Mixed anxiety and depression
• Stress
When compared to smokers, 7 weeks to 9 years after quitting smoking, those who quit smoking reported an INCREASE in:
• Psychological quality of life 0.22 Positive affect significantly 0.40
• This improvement occurred whether or not participants had anxiety or depression before quitting smoking.

But I thought people smoke to be less anxious and depressed?
• When they have not smoked for a while, smokers experience irritability, anxiety, and depression (6, 7)
• These feelings are relieved by smoking (5) thus creating the perception that smoking has psychological benefits, while in fact it is smoking that caused these psychological disturbances in the first place.

How can I quit smoking?

You may want to talk to your doctor/prescriber about medications and nicotine replacement as additional options that can help you quit.

Is smoking worth anxiety, depression and feeling bad? Is it zapping your energy level? How good will you feel after you stop smoking for good?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
1. US Department of Health and Human Services. The health consequences of smoking: a
report of the Surgeon General. US Department of Health and Human Services, 2004.

2. US Department of Health and Human Services. The health benefits of smoking cessation.
US Department of Health and Human Services, 1990.

3. Pirie K, Peto R, Reeves G, Green J, Beral V. The 21st century hazards of smoking and
benefits of stopping: a prospective study of one million women in the UK. Lancet

4. Taylor G, et al. Change in mental health after smoking cessation: systematic review and meta-analysis. OPEN ACCESS. BMJ 2014;348:g1151 doi: 10.1136/bmj.g1151 (Published 13 February 2014)
5. Parrott AC. Does cigarette smoking cause stress? Am Psychol 1999;54:817-20.

6. Hughes JR. Effects of abstinence from tobacco: valid symptoms and time course. Nicotine
Tob Res 2007;9:315-27.

7. Guthrie SK, Ni L, Zubieta JK, Teter CJ, Domino EF. Changes in craving for a cigarette
and arterial nicotine plasma concentrations in abstinent smokers. Prog
NeuroPsychopharmacol Biol Psychiatry 2004;28:617-23.