Mental Health and Smoking
Many people with mental health conditions smoke. Some of the most common mental health conditions are emotional distress, depression, anxiety, and bipolar disorder.
If you experience any of these conditions, you are not alone if you smoke or if you have a hard time quitting. The good news is that you can quit with the right support, resources, and medications.
Research shows that quitting does not make symptoms of emotional distress worse. It can actually make you feel better! Below, read more about support and resources available on BecomeAnEX. You will also learn about different medications that are safe and effective.
Quitting Smoking with a Mental, Behavioral, or Emotional Health Diagnosis Top
Each year, one out of five Americans experiences depression, anxiety, or other mental, behavioral, or emotional disorders.
If you have experienced one of these conditions, there’s good news! Quit smoking treatments can work for you, and they won’t make your symptoms any worse.
If you smoke and you often experience stress or anxiety, or if you have been diagnosed with another mental health condition, you’re not alone. In fact, smoking is much more common among people with a mental health condition.[2, 3] There are many reasons for this. One is that health care providers who treat mental health issues do not talk about or treat smoking as often as other health care providers.
In addition, there are several myths about smoking and mental health that can prevent doctors and others from trying to help their patients quit. Here are three of them, with research that shows they are not true.
- Myth: Smokers with mental health conditions don’t want to stop smoking.
TRUTH: Smokers with mental health conditions want to quit as much as any other group of smokers. Most have tried to quit in the past, and more than half are thinking about quitting within six months.
- Myth: Smokers with mental health conditions can’t quit smoking.
TRUTH: Many people with mental health conditions also have other life challenges that make it harder to quit. These may include: fewer resources available, more friends who smoke, and stronger dependence on cigarettes. However, if you have a mental health condition and you smoke, you can quit. You just need the right support, treatment, and medication.
- Myth: Quitting smoking can make mental health conditions symptoms worse.
TRUTH: If you experience depression, anxiety, or stress, quitting smoking can make you feel better! Even if you have schizophrenia, studies show that quitting smoking does not make your symptoms any worse.
As you are quitting, you might feel irritable or restless, have trouble sleeping or concentrating, or feel anxious, depressed, or hungry. Don’t worry! In most cases, these are symptoms of nicotine withdrawal, and not your mental health condition getting worse.[9, 10] These feelings usually go away in a few days. Once you get past the withdrawal symptoms, quitting smoking can make you feel as good as using anti-depressants.
Quit Smoking Treatments Work for People with Mental Health Conditions. Top
If you have depression, anxiety, bipolar disorder, or other conditions, quit smoking treatments work for you just as they do for people without a similar diagnosis. However, you may need some extra help to be successful.
For example, it might help you to get treatment more often or for a longer period of time. BecomeAnEX is a great resource for anyone who wants to quit. It can be used as often or as long as you want. And the community members are always ready to support you in your quit.
You might also need higher doses of quit smoking medications or more than one kind of medication at a time. Quitting smoking can change the way some medications work, especially those used to treat severe mental health conditions.[13, 14] For many people, quitting smoking means they need less of their other medications. You should discuss any changes in medication with your health care provider. If you have serious mental illness , you should tell your doctor when you are stopping smoking so you can talk about any medication changes.
Nicotine Replacement Therapy (NRT)
NRT helps people quit smoking, both those with and without mental health conditions. Today there are five types of NRT available in the United States:
- Nicotine Patch
- Nicotine Inhaler
- Nicotine Nasal Spray
- Nicotine Gum
- Nicotine Lozenge
Using NRT with counseling or coaching has been shown to work better than using NRT by itself.
Smokers can use two non-nicotine medications to help them quit: bupropion (Zyban), and varenicline (Chantix). Both of these have a labeled warning that ‘some patients have experienced changes in behavior, hostility, agitation, depressed mood, and suicidal thoughts or actions while taking the medication’, and that if these should occur, the smoker should stop taking the medication and discuss these symptoms with a health care provider.
However, the warning about these medications does not say that you should be excluded from taking these medications to stop smoking if you have a mental health condition. In fact, a review of 17 different studies found that these medications help people with serious mental illness to quit smoking.
The review also found that taking non-nicotine medications did not make emotional distress worse. As with any medication change, you should talk with your doctor about whether using Zyban or Chantix is right for you.
Coaching or Counseling
Coaching or counseling for quitting smoking is recommended for all smokers. Both can be done face-to-face either in an individual or group setting, or by telephone. A recent review study found that some Internet programs, such as BecomeAnEX, are as effective as these other kinds of quit smoking treatments.
While not enough is known about the specific treatments that are most effective for people with mental health conditions, we do know that you can expect better results with more intensive treatment if you have a mental health condition. Because of this, in most cases some kind of coaching or counseling will be more helpful for you than using medications by yourself or quitting "cold turkey."[3, 6, 12] To see what other people like you have used to quit, check out the BecomeAnEX community. It is available 24/7, and can provide you with as much support as you need to help you quit.
For Smokers Living with Mental Illness:
NAMI Connection Recovery Support Group is a free, peer-led support group for adults living with mental illness. You will gain insight from hearing the challenges and successes of others, and the groups are led by NAMI-trained facilitators who've been there. Tell your support system about your plan to quit so they can hold you to your word and help you when you're struggling.
- National Institute of Mental Health. Any Mental Illness (AMI) Among U.S. Adults. 2016 [cited 2016 July 26]; Available from: http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml.
- Walker, E.R., R.E. McGee, and B.G. Druss, Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry, 2015. 72(4): p. 334-41.
- Khanna, P., et al., Smoking cessation advice for people with serious mental illness. Cochrane Database Syst Rev, 2016.
- Peterson, A.L., A.S. Hryshko-Mullen, and Y. Cortez, Assessment and diagnosis of nicotine dependence in mental health settings. Am J Addict, 2003. 12(3): p. 192-7.
- Siru, R., G.K. Hulse, and R.J. Tait, Assessing motivation to quit smoking in people with mental illness: a review. Addiction, 2009. 104(5): p. 719-33.
- El-Guebaly, N., et al., Smoking cessation approaches for persons with mental illness or addictive disorders. Psychiatr Serv, 2002. 53(9): p. 1166-70.
- Taylor, G., et al., Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ, 2014. 348: p. g1151.
- Ragg, M., et al., The impact of smoking cessation on schizophrenia and major depression. Australas Psychiatry, 2013. 21(3): p. 238-45.
- Hughes, J.R., Measurement of the effects of abstinence from tobacco: a qualitative review. Psychol Addict Behav, 2007. 21(2): p. 127-37.
- Hughes, J.R., Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob Res, 2007. 9(3): p. 315-27.
- Banham, L. and S. Gilbody, Smoking cessation in severe mental illness: what works? Addiction, 2010. 105(7): p. 1176-89.
- Fiore, M., Treating tobacco use and dependence: 2008 update: Clinical practice guideline. 2008: DIANE Publishing.
- Li, H. and Q. Shi, Drugs and Diseases Interacting with Cigarette Smoking in US Prescription Drug Labelling. Clin Pharmacokinet, 2015. 54(5): p. 493-501.
- Schaffer, S.D., S. Yoon, and I. Zadezensky, A review of smoking cessation: potentially risky effects on prescribed medications. J Clin Nurs, 2009. 18(11): p. 1533-40.
- U.S. Food and Drug Administration. FDA Drug Safety Communication: Safety review update of Chantix (varenicline) and risk of neuropsychiatric adverse events. 2011 [cited 2016 July 26]; Available from: http://www.fda.gov/Drugs/DrugSafety/ucm276737.htm.
- Graham, A.L., et al., Systematic review and meta-analysis of Internet interventions for smoking cessation among adults. Subst Abuse Rehabil, 2016. 7: p. 55-69.