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Smoking Cessation May Help Mental Health, Social Well-Being

March 18, 2021

Rather than compromise mental health, quitting smoking for at least 6 weeks can reduce anxiety, depression, and stress and improve mental well-being, according to an evidence review published in the Cochrane Database of Systematic Reviews. 

“There is a common perception that smoking generally helps people to manage stress, and may be a form of ‘self‐medication’ in people with mental health conditions,” researchers explained in the study background. “However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (eg, anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health.”

The review included 102 studies involving more than 169,500 people; 23 studies focused on people with mental health conditions. To be included in the reviews, studies had to last at least 6 weeks (although some followed participants for as long as 6 years) and measure changes in mental health of participants who stopping or continued smoking.

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According to the review, people who stopped smoking had greater reductions in depression, anxiety, and stress compared with people who had continued smoking. Those who ceased smoking also had more positive feelings and better mental well-being.

Smoking cessation did not hurt social well-being, researchers reported, but may have slightly enhanced it. Additionally, there were fewer new cases of anxiety as well as new cases of mixed anxiety and depression in people who stopped smoking compared with people who continued. 

Confidence in the evidence ranged from very low to moderate, researchers noted.

“We found stopping smoking was associated with small to moderate improvements in mood. The benefits of smoking cessation on mood seem to be similar in a range of people, and most crucially, there is no reason to fear that people with mental health conditions will experience a worsening of their health if they stop smoking,” said lead author Gemma Taylor, PhD, from the Addiction and Mental Health Group at the University of Bath in the United Kingdom. 

“Our confidence in the precise size of the benefit is limited due to the way the studies were designed, and future studies that can overcome those challenges will greatly strengthen the evidence about the impacts of smoking cessation on mental health.”

—Jolynn Tumolo


Taylor GM, Lindson N, Farley A, et al. Smoking cessation for improving mental health. Cochrane Database of Systematic Reviews. 2021;3:CD013522.

Cochrane Review finds stopping smoking is linked to improved mental health [press release]. Hoboken, New Jersey: Wiley; March 9, 2021.

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