Mental Health & Smoking and Vaping

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People with mental health conditions like depression, anxiety, and ADHD, smoke and vape at much higher rates than people without these conditions.

One major reason for this is that the tobacco industry has spent a lot of money promoting the idea that their products can help people manage stress and feel happy. Some harmful industry tactics have included giving away free cigarettes to psychiatric facilities and creating misleading marketing about smoking, vaping and mental health.

The truth is that nicotine addiction can increase anxiety symptoms and stress levels. And it is associated with worse mental health outcomes. Quitting smoking and vaping can improve your mental health.

The good news is you can quit, even if you have a mental health condition. There are some things to be aware of and strategies that can make quitting easier.

How can quitting smoking and vaping help me if I have a mental illness?

Quitting smoking and vaping can benefit your mental health in several important ways. These benefits include:

• Quitting can actually make you feel less anxious, depressed, or stressed
• Quitting can make it easier to stay quit from alcohol and other drugs
• Quitting improves your mood and sense of wellbeing

Research shows that quitting smoking is linked with lower levels of anxiety, depression and stress. Truth Initiative surveys found that 90% of young people who quit vaping felt less stressed, anxious, or depressed.

Quitting also improves outcomes for substance use and mental health conditions. People trying to quit using alcohol or other drugs are more successful if they quit smoking and vaping at the same time. And people getting treatment for depression or mood disorders benefit from quitting smoking. Those who quit smoking as part of their treatment experience fewer symptoms.

What are the mental health risks of smoking and vaping?

Nicotine addiction can increase anxiety symptoms and stress levels. This may be surprising, especially if you have smoked or vaped to deal with stress and anxiety in the past. There are biological reasons why this is the case.

Nicotine addiction can intensify symptoms of mental health conditions including:

• Stress
• Anxiety
• Depression
• Post traumatic stress disorder (PTSD)
• Panic disorder
• Bipolar disorder
• Schizophrenia

In addition, people who smoke sleep less and wake more often on average than people who don’t smoke. People who smoke also spend less time in deep sleep. Poor sleep is a significant factor in mental health that is directly related to smoking.

What is the connection between nicotine dependence, nicotine withdrawal, and mental health?

In the short term, smoking or vaping nicotine may feel good. Smoking and vaping help make the “feel good” chemical in the brain called dopamine. Dopamine can create feelings of pleasure and relaxation. And smoking or vaping might provide a short-term distraction from stressful situations.

The major negative mental health effects of smoking and vaping happen over the long term. Because of the way nicotine works in the body, those feel-good chemicals only last for a short time. Then nicotine withdrawal sets in.

Withdrawal symptoms include:

• Cravings
• Feeling irritated or upset
• Feeling jumpy and restless
• Having a hard time concentrating
• Changes in sleep and eating habits
• Feeling anxious or depressed

Over time, it can take more and more nicotine to create that same good feeling and deal with these symptoms of withdrawal. This is called nicotine dependence.

In the long term, the pleasurable experience of smoking or vaping turns into using nicotine just to get rid of withdrawal symptoms.

Because withdrawal often feels like anxiety or depression, it can feel like smoking and vaping improves symptoms. In reality, it only makes the withdrawal/exposure cycle continue.

The constant cycle of nicotine withdrawal (feel awful), nicotine use (feel better), and more withdrawal (feel awful again) can affect your mood, your sense of well-being, and your outlook.

What is the effect of smoking on psychiatric medications?

Many people with depression, psychosis, and other mental health conditions use psychiatric (mental health) medications as part of treatment. Tobacco can make some psychiatric medications less effective. Tobacco comes in cigarettes, cigars, or other products containing tobacco leaves.

When you smoke, your body processes and gets rid of some psychiatric medications faster. This means there is less medication in your body. People who smoke often need higher doses of mental health medications than people who don’t smoke.

When someone quits smoking, their body processes antipsychotic or antidepressant medications more slowly. As a result, blood levels of these medications rise and the old dose can become too strong.

If you’re interested in quitting, be sure to tell your doctor that you want to quit and want help. This is especially important if you are taking medication for depression or psychosis.

Nicotine replacement therapy does not change how the body processes psychiatric medications.

Next, learn 4 ways to make quitting easier if you have a mental illness