Smoking and Depression: The Role of Nicotine Replacement Therapy and Treatment, According to Yale School of Public Health

If living in a pandemic for the last year and a half has taught us anything, it’s that our  mental health is fragile and needs to be prioritized.

Since we’ve all been on the pendulum of ever-changing lockdowns, stay-at-home orders, and phased reopenings, people have sought out mental health supports at ever-increasing rates.

But what if one of the things making your mental health worse was actually wrapped up in one of your daily habits: your cigarettes?

Does smoking impact your mental health?

Research has found a significant connection between smoking and mental illness: Americans with mental illness have a 70% greater likelihood of smoking than the general population, and individuals with mental illness tend to start smoking at an earlier age, smoke more heavily, and are more addicted to cigarettes than the general population.

While it’s unclear if smoking causes mental illness, it most likely doesn’t help your mental health challenges. Researchers have several hypotheses about the link between the increased rates of smoking among people with mental illnesses:

• Self-medication: this theory is that people turn to smoking to mitigate their symptoms of depression or anxiety - so that these symptoms are triggers that lead you to smoke.
• Brain chemistry: there is a theory that smoking might impact your brain chemistry and make you more susceptible to depression or anxiety.
• Misattribution of withdrawal symptoms: when you smoke, nicotine releases a chemical called dopamine into your bloodstream, which makes you feel pleasure. But when the nicotine wears off and you start to experience withdrawal, you might mistake the withdrawal symptoms for anxiety or depression, and then the next cigarette fixes it by providing another dopamine hit. So you could be mis-associating the good feelings you get from cigarettes with just fixing your withdrawal symptoms, instead of helping with your anxiety, stress, or depression.
• Other risk factors: there is also a possibility that people who have mental health challenges also have risk factors for tobacco use, including lower socioeconomic status, more stressful living situations, and less access to healthcare.

Will quitting smoking cure my depression?

The clearest thing we know is that cutting back on cigarettes won’t make you feel worse. We know that your physical health will begin to improve within hours of quitting smoking, and your mental health will likely follow.

Because we don’t know why the association between smoking and mental illness exists, quitting smoking alone might not be enough to solve your mental health challenges. If you’re looking to cut back on cigarettes it’s a great idea to obtain the support of your friends and family, as well as a licensed mental health provider.

But, studies have shown that quitting smoking can have many positive impacts on your mental health, including a reduction in anxiety and depression symptoms, improved mood, and improved overall health. One study even found that quitting smoking before 35 can give you back a whole decade of your life, and even quitting in late middle age can help you gain back five of six years.

““The daily cycle of waking up with cravings, satisfying the cravings through smoking, only to be back wanting another cigarette within hours has an understandable impact on how people feel,” said Dr. Gemma Taylor, a researcher at the University of Bath.

Often, people attempt to solve their smoking cessation and mental health issues separately. This can even be as simple as continuing to smoke while going on antidepressant or antianxiety medications, even though cigarettes can interfere with how these medications work and can mean you need a higher dose - while if you cut back on smoking, you could easily need a lower dose of your medication.

But new research from the Yale School of Public Health found that combining standard mental health care with smoking cessation could save hundreds of thousands of lives over the next few decades.

“We’ve known for a long time that people with depression smoke more than the general population, and that mental health care settings often don’t have cessation treatment as part of standard care,” said Jamie Tam, Ph.D., an assistant professor and the study’s lead author. “Our study asks: what is that missed opportunity? What do we have to gain when mental health care and smoking cessation treatment are fully integrated?”

It turns out, potentially a lot.

The study found that if a significant number of patients adopted both mental health and smoking cessation treatment, we could prevent a minimum of 32,000 deaths by 2100. If every person who needed both mental health and smoking cessation support could get it, we could prevent more than 200,000 deaths by 2100.

I want to cut back on cigarettes. How can I get started?

Research is clear that combining nicotine replacement therapies with mental health support is the most effective way to quit smoking.

A therapist or counselor can help you identify the root causes and factors that drove you to smoking in the first place, and can help you identify triggers, strategies and routines to help remove cigarettes from your life. For example, if you notice that you pick up a cigarette whenever you feel a little bit of stress, they might encourage you to take note of what is causing your stress, and help you figure out new stress relief strategies.

In addition, if you’re already using antidepressants or antianxiety medications, you should consult with your prescriber as you begin to cut back on smoking to determine if you need a higher or lower dose as you go through the smoking cessation process.

You can use a website like PsychologyToday.com or your health insurance provider portal to find a mental health provider who can help you.

Combining mental health services with smoking cessation tools like a nicotine gum, pouch, or lozenge can lead to a much higher chance of success with quitting smoking - and improving your overall health, happiness, productivity, and quality of life.

Even if you’re at a tough spot in life, cigarettes aren’t the answer. LUCY nicotine replacement may be the perfect solution.

Disclaimer: The information contained in this website is provided for general informational purposes only and is not intended as, nor should not be construed as a substitute for, professional medical or health advice on any subject matter. Please consult your physician regarding any medical treatment decisions.