Featured Review: Stopping smoking is linked to improved mental health

Topiary heads come out of water and turn green as they touch the air

Evidence published in the Cochrane Library today will reassure people who want to stop smoking that quitting for at least 6 weeks may improve their mental wellbeing, by reducing anxiety, depression, and stress. People’s social relationships are unlikely to suffer if they stop smoking. 

Smoking is the world's leading cause of preventable illness and death. One in every two people who smoke will die of a smoking-related disease unless they quit. Some people believe that smoking helps reduce stress and other mental health symptoms, and that quitting smoking might make their mental health problems worse. People who smoke may also worry that stopping smoking will have a negative impact on their social lives and friendships.

The review found that people who stopped smoking for at least 6 weeks experienced less depression, anxiety, and stress than people who continued to smoke. People who quit also experienced more positive feelings and better psychological wellbeing.  Giving up smoking did not have an impact on the quality of people’s social relationships and it is possible that stopping smoking may be associated with a small improvement in social wellbeing.

The review summarises evidence from 102 observational studies involving over 169,500 people. The review authors combined the results from 63 of these studies that measured changes in mental health symptoms in people who stopped smoking with changes occurring in people who continued to smoke. They also combined results from 10 studies that measured how many people developed a mental health disorder during the study. The studies involved a wide range of people, including people with mental health conditions and people with long-term physical illnesses. The length of time the studies followed people varied, with the shortest being 6 weeks, but some studies followed people for up to 6 years. The certainty of the evidence ranged from very low to moderate.

The lead author of this Cochrane Review, Dr Gemma Taylor from the Addiction & Mental Health Group at the University of Bath, said, “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. 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.”

Dr Gemma Taylor continued, “Many people who smoke are concerned that quitting could disrupt their social networks, and lead to feelings of loneliness. People can be reassured that stopping smoking does not seem to have a negative impact on social quality of life. People may also be concerned that quitting is stressful. The evidence shows that stress is reduced in people who stop smoking and that there are likely longer-term benefits for peoples’ mental health.”

A team of researchers from the Universities of Bath, Birmingham, Oxford, and New York University  worked together to produce this review.

Tuesday, March 9, 2021