Do Cigarettes Really Help With Anxiety and Depression?

Photo by Christian Erfurt on Unsplash

I’ve suffered from depression and anxiety since I was a teenager, and for years I’ve used them as an excuse to justify my smoking habit.

When I have a cigarette, it has an immediate “relaxing” effect on me. Although nicotine is a physical stimulant, it feels like it’s calming me down and reducing my stress.

I stopped smoking cigarettes a little over a month ago, after over a decade of on-and-off smoking (mostly on). I was a pack-a-day smoker and the transition to being nicotine-free has been rough.

In my first few weeks without cigarettes, I noticed my depression and anxiety getting significantly worse. I find myself getting anxious more easily, often without any identifiable cause. I’ve also been crying a lot, over the tiniest things, which is very unusual for me.

I’ve had to keep reminding myself that this is a symptom of the withdrawal and that it won’t last forever. It’s been incredibly hard to resist going back to smoking when I know that just a couple of cigarettes would make the symptoms subside.

As I’ve worked on staying smoke-free, I’ve been wondering about whether cigarettes even really do reduce anxiety and depression. I realized that I’ve always taken for granted that cigarettes help me manage these issues, without actually looking into the evidence.

I know from my own experience that cigarettes have a short-term effect on reducing my anxiety and depression, but what about in the long-term? Could they actually be making these issues even worse?

It turns out, the answer is complicated.

The Correlation

What researchers know for sure is that there is a correlation between smoking, anxiety, and depression. There have been quite a few studies of this over the years, and this 2006 review by Holly Morrell and Lee Cohen helps link them together.

Smokers are significantly more likely to suffer from anxiety and depression than non-smokers. Heavy smokers are more likely to have anxiety and depression than casual smokers.

It’s good to know it’s not just me.

The Causation?

Even though studies have established a strong correlation between smoking, anxiety, and depression, Morrell and Cohen’s review found that causation hadn’t been conclusively revealed yet.

Whenever multiple factors correlate with each other, there are a few possible explanations. One factor could be causing the other (for example, smoking causing anxiety). Or, the causation could be reversed (anxiety causing smoking). There could also be a third factor which causes both (depression causing anxiety and smoking). Finally, it could simply be a coincidence.

Correlation between smoking, anxiety, and depression has been found in so many studies that we can safely rule out coincidence, but it’s still not known for sure which is causing which.

To put it plainly — Did I smoke because I was anxious and depressed, or was I anxious and depressed because I smoked?

It could even be the case that the causality runs in both directions.

There have been a few studies that found causality. The one I’ve found cited most often studied teenagers in particular, and was run in the 90s. I certainly hope that there continues to be more research in this area though, because I know it’s a problem that affects many of us.

In the meantime, regardless of which was the causality runs, I’m going to continue to try my hardest to quit smoking. Whether smoking increases or decreases anxiety and depression, the negative health effects just aren’t worth it. After only about a month, I can already feel myself starting to breathe easier and sleep better, and I know things will only improve from here.

I’m a lawyer and teacher from North Carolina. I write about sobriety, mental health, running, and more. Buy me a “coffee” at

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