Quitting smoking results in improved mental health, according to a new study by researchers in the UK and published in the BMJ.
The physical benefits of stopping smoking are well known. Giving up smoking can reduce chance of cancers and cardiovascular and respiratory diseases, among other things. But the potential benefits to mental health on a smoke-free lifestyle have been less clear cut.
It is reported that even health professionals can be reluctant to advise people with mental health problems to stop smoking, in case quitting makes their mental health worse.
As the researchers explain in their study:
"Both quantitative and qualitative analyses indicate that regular smokers report smoking cigarettes to alleviate emotional problems and feelings of depression and anxiety, to stabilize mood, and for relaxation as well as relieving stress."
"This pattern of behavior occurs in smokers with and without diagnosed mental disorders. Unsurprisingly, views about smoking predict whether or not people attempt to quit and whether or not they are successful."
As smokers experience irritability, anxiety and depression when they have not smoked for a while, the study suggests that people may misinterpret symptoms of nicotine withdrawal for perceived psychological benefits of smoking.
The researchers wanted see to what extent giving up smoking can affect people's mental health and whether the effect quitting had was positive or adverse. They analyzed the results of 26 studies assessing people's mental health before and at least 6 weeks after smoking cessation.
The people in the study - who had an average age of 44 and smoked around 20 cigarettes a day - were drawn both from the general population and from patients who were being treated for clinical (psychiatric or physical) conditions.
Quitting smoking improves all facets of mental health
Measuring mental health status by anxiety, depression, positivity, stress and psychological quality of life, the researchers found that quitting smoking was associated with improvements in all of these factors.
This applied to the participants both in the general population and clinical patients - including people with mental health disorders.
Three broad explanations have been suggested, the researchers note, for associations between smoking and poor mental health:
- Smoking and poor mental health might have common causes
- People with poor mental health smoke as a coping mechanism for low mood and anxiety
- Smoking causes mental health problems or makes these problems worse.
Whatever the cause, the researchers believe that the relationship between smoking and mental health requires further attention. If smokers believe that their psychological wellbeing will be adversely affected by giving up, then they will be less likely to do so, which has implications for their physical wellbeing.
For instance, the study observes that the life expectancy of people with mental health disorders is 8 years less than the general population - the authors think smoking could be a reason for this.
"This could overcome barriers that clinicians have toward intervening with smokers with mental health problems," the researchers say, of their study. "Furthermore, challenging the widely held assumption that smoking has mental health benefits could motivate smokers to stop."