Does smoking help or cause anxiety?

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Many people see cigarette smoking as a way to calm their nerves and deal with their anxiety. In reality smoking cigarettes can actually cause anxiety or make it worse. It’s true that nicotine is connected to your mood in how it affects your brain. While many smokers believe smoking calms their nerves, what it’s actually doing is relieving the nicotine withdrawal symptoms. This makes the relief only temporary, so without addressing the root causes of their anxiety, the cycle of anxiety will continue.

Anxiety Disorder

There are five types of anxiety disorders

Anxiety is typically defined as feeling frightened, nervous, or panicked. Many people feel anxiety from time to time in difficult situations but typically feel better when the situation ends. If it continues, anxiety can be a problem. You might feel sad or depressed and have trouble sleeping or concentrating. Your heart might race or you could feel faint or have stomach problems.

There are five major types of anxiety disorders:

  • Generalized Anxiety Disorder (GAD)- characterized by chronic anxiety, exaggerated tension and worry, even when there is nothing to provoke it.
  • Panic Disorder- characterized by repeated and unexpected episodes of intense fear, accompanied with physical symptoms such as heart palpitations, chest pains, dizziness, shortness of breath, or abdominal stress.
  • Obsessive Compulsive Disorder (OCD)- characterized by recurrent unwanted thoughts (obsessions) or repetitive behaviors (compulsions). Behaviors include counting, hand-washing, checking, or cleaning with the hope of making the obsessive thoughts go away. However they only provided temporary relief, while not performing them increases anxiety.
  • Social Phobia (Social Anxiety Disorder)- characterized by overwhelming anxiety and excessive self-consciousness, in typical social situations. It may be limited to certain situations or be so broad they experience it every time they interact with people.
  • Post-Traumatic Stress Disorder (PTSD)- an anxiety disorder caused by exposure a terrifying event in which physical harm was threatened or endured. Events that may trigger it include natural or human caused disasters, violent assaults, accidents, or military combat.

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Teen smoking a cigarette
Each day 3,000 teens begin smoking cigarettes which may cause anxiety

Impact on Teens and New Smokers

Study suggests smoking can impact mental health

A study at Columbia University suggests smoking may have more consequences beyond the physical health impacts.  Research is showing smoking can impact mental health by increasing risk of some anxiety disorders.

The study found teens were fifteen times as likely to develop panic disorders, or repeated episodes of panic, in early adulthood than non-smokers when they smoked a pack a day. Adults who smoked heavily as teens were five times as likely to develop generalized anxiety disorder, or feelings of apprehension or worry resulting in physical symptoms. They were also seven times more likely to develop agoraphobia, or fear of open spaces.

While there have been previous studies linking smoking with psychiatric disorders, it hadn’t been determined if smoking caused anxiety or anxiety caused people to smoke.

These new findings provide unequivocal support for the theory that smoking contributes to increased risk of anxiety disorder. There was no evidence that anxiety disorder increased the initiation of smoking.

Other studies have found that that nicotine actually increases feelings of anxiety. In fact, anxious teens may find smoking actually makes them feel more anxious. While regular smokers report smoking makes the feel calm, it’s been determined this is purely the relief from nicotine withdrawal symptoms. It was found that when regular smokers quit for more than two weeks, their levels of anxiety decreased from when they were smoking.

Man Smoking cigarette on bench
Cigarettes can actually cause anxiety, instead of reducing it

Study Foundations

Based on the Children in the Community Study

Researchers based the data on the Children in the Community Study, an ongoing research project involving 1,000 randomly sampled families living in upstate New York. Participants included nearly 700 smoking and nonsmoking teenagers interviewed between 1985 and 1986, at an average age of 16. They were then interviewed again between 1991 and 1993, at an average age of 22.

In addition to tracking developmental trajectories over 20 years from adolescence into adulthood, the CIC Study has used prospective data to investigate early risks for borderline personality disorders ( BPD) and symptoms (including both environmental factors and early characteristics), implications of comorbidity with BPD, and associated negative prognostic risk of adolescent psychiatric disorders into adulthood.

Of the heavy cigarette smokers in their teens, 10% of the participants reported being agoraphobic during the second interview approximately six years later, compared to 2% of those who were not heavy smokers as teenagers. Similarly, 20% of the heavy-smoking teens later reported generalized anxiety disorders, compared to 4% of those who did not smoke heavily. Finally, Panic disorders were seen in almost 8% of young adults who smoked heavily as teens, compared to less than 1% of those who did not.

There was no association between teen smoking and the later development of obsessive-compulsive disorder or social anxiety disorder. Prior studies have suggested that impaired breathing may be associated with agoraphobia, generalized anxiety disorder, and panic disorder, but not with social anxiety disorder or obsessive-compulsive disorder. This explains the correlation to the general anxiety and agoraphobia with smoking, versus the OCD and social anxiety.

It’s believed that future studies may shed light on the role that impaired breathing and the anxiety-producing effects of nicotine play on the three anxiety disorders found to be higher in this group of young adults. In the meantime, both the researchers stress that education efforts need to include both the physical and mental health consequences of smoking.

"Study after study shows that teens believe that they will have no trouble quitting smoking and that it doesn't hurt them to smoke during their teen years," researchers say. "But this study tells a different story. Even if you smoke for only a few years, you can suffer substantial and serious ill consequences. That is an important message to get across."

While smoking may feel like it’s relieving anxiety for smokers, in reality it’s likely only relieving the nicotine withdrawal, and depending how young they begin smoking it can have a significant impact on their future mental health. Smoking is not as easily quit as many young smokers believe, so the best plan is to never light up. If it’s too late for that, quitting smoking as soon as you are able can help to reduce the impact it will have on your health as a whole.


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