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Nicotine Addiction and Mental Health

The Society of Behavioral Medicine has a new report on the links between nicotine addiction and mental health disorders. The connection is much stronger than it might appear at first glance:

  • People with depression and anxiety disorders are twice as likely to smoke cigarettes or e-cigarettes than the average population.
  • People who vape regularly are more likely to suffer mental health disorders, at a rate 2.4 times the average population.
  • Both vaping and e-cigarettes tend to increase feelings of anxiety or depression, according to reports from thousands of high school students.
  • A 2019 survey of college students found vaping is associated with higher levels of Attention-Deficit/Hyperactivity Disorder (ADHD).

It’s interesting to note that many people say they use tobacco products to relieve stress and anxiety, but the only anxiety it relieves is the anxiety caused by nicotine withdrawal. In other words, nicotine use has the appearance of stress relief only because it relieves the stress of not smoking. It actually causes the problem that smokers think it helps with.

A systematic review of the scientific literature on e-cigarettes and mental health found the results of addiction to e-cigarettes were parallel to combustible cigarettes: an increase in mental health problems. “Youth e-cigarette use is associated with greater mental health problems (compared with nonuse) across several domains, particularly among adolescents.” The domains considered included:

  • depression
  • anxiety
  • suicidality
  • eating disorders
  • post-traumatic stress disorder
  • attention-deficit/hyperactivity disorder
  • conduct disorder
  • impulsivity
  • stress

According to this review, adolescents and young adults with mental health disorders use nicotine at higher rates than average. Combustible cigarette use has been shown to increase rates of ADHD, conduct disorder, anxiety, depression, and substance use disorders. We see a cycle of stress leading to substance abuse which leads to greater stress and greater substance abuse, until the cycle is broken and a better way of coping is substituted for substance abuse.

The flip side of this connection between nicotine addiction and mental health disorders is that when people stop using nicotine products, their mental health improves:

Quitting smoking is linked with lower levels of anxiety, depression, and stress, as well as improved positive mood and quality of life compared with continuing to smoke.

While there is not as much data to go by, evidence indicates that quitting vaping and quitting e-cigarettes have a similar positive impact on mental health. In one study, 90% of those who successfully quit vaping said they felt “less stressed, anxious, or depressed.” A review of the literature on smoking cessation and mental health involving 102 studies and nearly 170,000 participants found a likely “small to moderate improvement” in mental health after quitting smoking.

Quitting nicotine products can be tough. The habit becomes entrenched and abstinence leads to anxiety and distress. But once the break is made, people feel better about themselves and their future. If they quit smoking, they’ve added on average 10 years to that future of lower stress, lower anxiety, less irritability, and less depression.

Written by Steve O’Keefe. First published July 31, 2024.

Sources:

“Nicotine Addiction and Mental Health: Breaking the Cycle,” Society of Behavioral Medicine, July 2024.

“Colliding Crises: Youth Mental Health and Nicotine Use,” Truth Initiative, September 19, 2021.

“Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults,” Nicotine & Tobacco Research, March 2021.

“Smoking cessation for improving mental health,” Cochrane Database of Systematic Reviews, March 2021.

Image Copyright: Pix4free, used under Creative Commons license.

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