Smoking cessation for improving mental health
Gemma Mj Taylor1, Nicola Lindson2, Amanda Farley3
1Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.
The Cochrane Database of Systematic Reviews
|March 9, 2021
Summary
Quitting smoking improves mental health, contrary to popular belief. This review found that smoking cessation is linked to reduced symptoms of anxiety, depression, and stress, benefiting overall psychological well-being.
Area of Science:
- Psychiatry and Behavioral Science
- Public Health
- Addiction Medicine
Background:
- Common perception: smoking aids stress management and self-medication for mental health conditions.
- Biological plausibility: chronic smoking may worsen mental health via neuroadaptations and nicotine withdrawal.
- Hypothesis: smoking cessation may improve, not worsen, mental health.
Purpose of the Study:
- To examine the association between tobacco smoking cessation and changes in mental health.
- To synthesize evidence on the impact of quitting smoking on depression, anxiety, and stress symptoms.
Main Methods:
- Systematic review and meta-analysis of controlled before-after studies and longitudinal cohort studies.
- Searched multiple databases (Cochrane, MEDLINE, Embase, PsycINFO) and trial registries (April 2012–January 2020).
- Assessed primary outcomes (depression, anxiety, mixed symptoms) and secondary outcomes (stress, quality of life, affect, social impact).
Main Results:
- 102 studies (169,500+ participants) included; 63 provided mental health data.
- Smoking cessation associated with improved anxiety (SMD -0.28), depression (SMD -0.30), and mixed symptoms (SMD -0.31).
- Improvements observed in stress, positive affect, and psychological quality of life; no significant change in social quality of life.
Conclusions:
- Evidence suggests mental health does not worsen after quitting smoking.
- Smoking cessation is associated with small to moderate improvements in mental health across various populations.
- Further research with advanced methods is needed to strengthen evidence regarding confounding factors.
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