Everyone knows smoking is very bad for physical health. But what about its impact on mental health? Many smokers believe that smoking helps relieve stress, anxiety and low mood, when in fact the opposite is true. Today, for the first time, the national No Smoking Day campaign will focus on the significant benefits of quitting for mental health and wellness. This is the beginning of a new conversation that feels particularly relevant as we set our sights in the direction of the national recovery of COVID-19.
New data analysis published by Public Health England shows the strong link between smoking and poor mental well-being. In surveys by the Office for National Statistics, smokers score worse than the population as a whole on every mental well-being indicator.
As COVID-19 took its toll, levels of mental well-being worsened and smokers were particularly hard hit. In 2019, more than a quarter of smokers in England reported having high anxiety (an estimated 1.6 million people) compared to 20% of non-smokers and 14% reported low happiness (900,000 people) , which is double the proportion of non-smokers. In 2020, these figures rose to 38% of smokers (2.4 million people) who report high anxiety and 21% (1.3 million people) who report low levels of happiness, compared to 34% and 12% of non-smokers, respectively. smokers. Reported levels of low life satisfaction and low self-esteem among smokers also increased significantly.
What smokers see as relieving feelings of anxiety, stress and low mood is actually the result of a vicious cycle – the tobacco withdrawal cycle. Smoke mixes with chemicals in the brain and when a smoker has not had a cigarette for a while, the lust for another one makes them feel irritable and anxious. These feelings can be temporarily relieved by the next cigarette, after which the cycle starts all over again.
The benefits of quitting smoking for mental health and wellness are outlined in a new Cochrane review published this week. It updates a 2014 meta-analysis that looks at what happens to people’s mental health when they quit once they have passed the withdrawal stage.
The authors found that compared to people who stopped smoking, people who stopped smoking had greater decreases in:
- anxiety (evidence from 3141 people in 15 studies);
- depression (7156 people; 34 studies); and
- mixed anxiety and depression (2829 people; 8 studies).
Compared to people who stopped smoking, people who stopped smoking showed greater improvements in:
- symptoms of stress (evidence from 4 studies in 1792 people);
- positive feelings (13 studies; 4880 people); and
- mental well-being (9 studies; 18,034 people).
The improvements were seen across all groups, including those diagnosed with a mental health condition. This is important as people with mental health conditions are more likely to smoke than the general public and smoking rates increase with the severity of the disease.
The evidence suggests that mental health benefits can be seen as soon as six weeks after quitting smoking and even maintained for a number of years thereafter. Reducing anxiety and depression in those who quit smoking is found to be at least as great as using antidepressants.
It’s time to share with people who smoke that quitting can not only make them healthier but also happier. With the theme “Quitting smoking does not have to be stressful”, No Smoking Day 2021 acknowledges the valid concerns that smokers have about the smoking cessation process itself, and points them to the evidence-based support that will help them get through. It uses case studies of former smokers who can talk about the mental health benefits of becoming smoke-free to help dispel the myths that persist for far too long.
The mental health impact of COVID-19 is becoming increasingly clear. Building back better includes many challenges, which will not the least be to restore the mental resilience of the population. To convey to people who smoke the message that smoking is not a crutch to help them deal with the stress and tension in their lives, but is a shackle that holds them back, is a good starting point.