Does smoking increase or reduce anxiety? The real effects of smoking on stress

By Cristiano Antonino On Mar 7, 2023

Smoking and anxiety: How many smokers are convinced that lighting up a cigarette reduces anxiety and stress? And that quitting would make them feel more nervous? Probably most, considering the frequency with which they resort to this act if they feel nervous and stressed with the idea of relieving tension

What is the relationship between smoking and anxiety?

In reality, it is quite the opposite and it is quitting smoking that reduces anxiety and protects against the increased risk of developing panic attacks that covers smokers: smoking and thus introducing hundreds of toxic substances into the body increases anxiety levels in individuals who already suffer from it and/or feel stressed, interacting in particular with the increased sensitivity to respiratory disorders that characterises the anxious, while quitting smoking brings great benefits in reducing it.

This is what emerges from various research studies and in particular from a study recently published in the British Journal of Psychiatry that analysed the psychological state of almost 500 smokers who were starting a smoking cessation programme and therefore intended to cure their smoking, finding that those who had succeeded 6 months later showed a significant reduction in anxiety levels.

Since not all smokers are the same, the sample was divided into two groups: smokers for pleasure and smokers for stress reduction.

The most interesting finding was that the reduction in anxiety was greater in subjects who smoked to manage stress than in those who smoked primarily for pleasure.

In contrast, when examining smokers who had quit and were therefore unable to quit, the researchers found an increase in anxiety among those who smoked to manage stress, while the anxiety level of those who smoked purely for pleasure remained stable.

The decrease in anxiety in those who smoked to manage stress was due to the elimination of withdrawal symptoms, including anxiety, which led them to light their first cigarette upon waking.

Detoxification eliminated the withdrawal problem and thus resulted in decreased anxiety levels.

Does smoking cause anxiety?

It should also not be overlooked that studies conducted over the last 20 years have shown a greater risk for already anxious individuals to become smokers and that smokers run a greater risk of developing panic attacks: the replacement of oxygen transported by haemoglobin in the blood with carbon monoxide interferes with the respiratory function and worsens the body’s overall health, decreasing tissue oxygenation and generating a state of malaise in the subject that has a very negative effect on the psychological state of anxious people.

In fact, smoking entails a significant risk of developing respiratory disorders and pathologies that worsen anxiety, and in anxious subjects, who are particularly sensitive to discomforts related to breathing (‘air hunger’, fear of suffocation, feeling of breathing poorly and/or badly), all this leads to an increase in physical symptoms and the risk of developing panic attacks or worsening them, if already present.

It should be remembered that in studies on panic attacks conducted in the laboratory, panic is induced by acting precisely on breathing, increasing the rate of carbon dioxide in the air breathed by the subjects of the experiment.

Quitting smoking can therefore protect against anxiety and panic: not only does smoking have no utility in relieving anxiety and stress, it only leads to their worsening.