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Smoking and Mental Health
By the Quitter's Circle Staff
October 15, 2018

Smoking and Mental Health

The following post was developed through a paid partnership with Quitter’s Circle, NAMI, and MHA.

In just the last half century, the percentage of smokers in the United States has dropped tremendously – from 42.4 percent in 1965 to 15.5 percent in 2016. However, cigarette smoking is not declining as quickly for some population groups. Smoking is still common among adults living with mental illness — in the United States, more than 30 percent of adults with mental illness are smokers. In addition to smoking more, people with mental illness are only half as likely to quit as other smokers.

Why do so many people with mental illnesses smoke?


Many researchers believe that the relationship between smoking and mental health is cyclical. In the United States, stressful conditions may make someone more likely to start smoking or be diagnosed with a mental illness. Tobacco is often used to cope with stress because it is thought to temporarily relieve unpleasant feelings of anxiety. But even though smoking can temporarily alleviate stress, the cycle of addiction combined with mental illness can often create its own stress. In fact, the stress of the addiction to nicotine can even worsen some of the symptoms of mental health.


One’s financial status is a big factor that can put people with mental illnesses at high risk for smoking. Those with mental health issues are not only more likely to smoke, but are also more likely to be low-income, with 47.9 percent of those with mental illness living below the poverty level. Consequently, people living with mental illness are more susceptible to smoking and have more difficulty quitting because they often lack the financial resources, support, information, and access to smoking cessation treatments. For example, in 2015, only nine states covered all seven smoking cessation treatments under Medicaid.

Perceived Mental Health Benefits

Historically, the tobacco industry has put a lot of effort into connecting tobacco with mental health benefits. This included giving away free cigarettes to psychiatric facilities, positioning smoking as a form of stress relief and relaxation in advertising, and funding research that positions nicotine as self-medication. The industry did this to make smoking seem as though it had specific therapeutic benefits for people with mental illness. For example, one book by a former tobacco industry researcher suggested the effects of nicotine on individuals with schizophrenia may be therapeutic instead of addictive. This targeted a vulnerable population and caused many to have misconceptions about how smoking might relieve their symptoms.

Although nicotine can affect dopamine receptors in the brain that ease certain symptoms of depression and anxiety, enhance concentration and the ability to process information, those effects are temporary. Often, nicotine is only treating the symptoms of withdrawal and not the underlying condition. In fact, quitting smoking can be good for your mental health. Stopping smoking is linked to lower levels of anxiety, depression and stress.

The Road to Becoming Smokefree

While it may be more difficult for people with mental illness to quit smoking, it doesn’t mean they’re giving up. Many smokers with mental illness want to quit. People with mental illness who smoke and are interested in quitting should speak to a healthcare provider about ways to start their journey to a smokefree life.


Read on for more information regarding smoking and mental health:

Overcoming Barriers to Smoking When You Have a Mental Illness

Helping the Mental Health Community Quit Smoking ­ Interview with Dr. Jill Williams

Smoking and Mental Illness: Know the Facts

3 Ways Mental Health Organizations are Encouraging Smokefree Lifestyles

Helping a Loved One with a Mental Illness Quit Smoking



See additional quit smoking resources from our partner American Lung Association.