Tobacco Addiction and its Role in Depression

Smoking man

It is commonly suggested that smoking has antidepressant effects and is known to relieve stress. Yet, smokers are 70 percent more susceptible to anxiety and depression than compared to non-smokers.

A survey conducted by the British Heart Foundation found that a third
of U.K. smokers claimed they couldn’t quit smoking as they were convinced of the stress-reducing effects of smoking.

Dopamine releases in the mesolimbic system of our brain reinforce a sense of well-being. Nicotine further enhances the release of norepinephrine into the neuronal synapse inducing an antidepressant effect.   Tobacco is a drug.  Just as oxycontin will produce a change in brain chemistry, tobacco also increases the sense of well-being in the smoker.  Our bodies and minds are significantly influenced by what we ingest.

The perception of a cigarette relieving stress is a misinterpretation of what’s actually happening — what you’re really experiencing when you light up a cigarette is the early signs of withdrawal,” explained Mike Knapton, associate medical director for the British Heart Foundation. “Those symptoms of withdrawal are very similar to stress … The cigarette will relieve those symptoms, and you think that it’s making you feel better, but all it’s doing is abolishing the early signs of nicotine withdrawal. Then of course this cycle goes on cigarette after cigarette.

Nicotine- a silent killer

Smoking causes one of every five deaths in the U.S. every year. The mortality rate among smokers in the U.S. is about three times than that among nonsmokers. The major causes of this increased mortality rate are the associated diseases including cancer, respiratory illnesses and vascular diseases that are all potentially fatal.

Despite a decline in cigarette smoking between 2002 and 2006, one fourth of Americans continue to smoke regardless of the health hazards. Some smokers most often form a physical and psychological dependence on nicotine.

High Rates of Depression Among Young Smokers

A study, earlier this year, uncovered a significant increase in depression in the U.S. from 2005 to 2013 among smokers.

Woman smokingThe researchers at Columbia University’s Mailman School of Public Health assessed fluctuations in the prevalence of depression in a group consisting of former, current and non-smokers. Even though the depression rates were consistently the highest among smokers, the increase in the rate of depression was most noticeable among former and non-smokers.

The study was published in the journal Drug and Alcohol Dependence.

The research team, led by Renee Goodwin, PhD, in the Department of Epidemiology, analyzed data from the National Household Survey on Drug Use, a yearly cross-sectional study of approximately 497, 000 Americans, aged 12 and over.

Specific findings from the study illustrated:

Depression rose from 16 percent to 22 percent, among current smokers aged 12 to17.
Depression also rose from 6 percent to 8 percent among male smokers and 6 percent to 9 percent among smokers in the highest paid group.

Throughout this period, the rate of depression among current smokers was almost twice as high as among former and never smokers.

The very high rates of depression among the youngest smokers, those aged 12-17, is very concerning, as it may impair their ability not only to stop smoking, but also to navigate the important developmental tasks of adolescence that are important for a successful adult life” said Dr. Deborah Hasin, senior research member of the Mailman School of Public Health.

Over half of the smokers with depression report having their first cigarette of the day within five minutes of waking up. They also demonstrated a greater likelihood to smoke over a pack daily. These tendencies indicate heavy smoking.

Admission to addiction treatment centers almost always have co-occurring issues, such as depression.  The individual smoker who is already dealing with a biological predisposition toward depression may be at increased risk of other types of addictions.

Depression and Nicotine Dependence

Nicotine plays a complex role in depression due to an emotional uplift that smokers experience right after smoking a cigarette. Depression, however, is a risk factor for nicotine dependence. Smokers with a nicotine-dependency are twice as susceptible to experiencing a major depressive episode compared to non-smokers.

Studies show that people smoke due to a sensitivity to stress and crave the boosting effects of dopamine associated with relief. Taxing life incidents significantly enhance susceptibility to depression.

The chances of the onset of a major depressive episode increase within a span of 2 months into the stressful event, especially in individuals with an effected serotonin transporter genotype. Nicotine hinders serotonin release in some parts of the brain that may help diminish stress.

Various researchers have concluded that there is a cause and effect relationship between smoking and depression where smoking increases susceptibility to depression.

Even though the basis for this relationship remains largely unclear, nicotine’s inhibitory effect on neurotransmitter activity in the brain has emerged as the strongest link to an increased risk of depression.

Kenneth A. Perkins, PhD and colleagues assessed whether smoking can improve a negative mood. Through the use of nicotinized and denicotinized cigarettes, it was discovered that smokers do feel better after smoking but only after a day long abstinence.

However, the impact of cigarettes on a stressful mood was at most “modest.” In case of this study, sources of stress were categorized into a difficult computer task, preparing for a public speech, and watching depressing slides. The researchers concluded that solace from stress due to smoking depended more on the situation rather than the consumption of nicotine.

These results challenge the common assumption that smoking, and nicotine in particular, broadly alleviates negative affect,” the study concluded.


In case of co-occurring nicotine dependence and depression, treatment essentially begins with the assessment for both disorders that often exist simultaneously.

Smoking CigarettesScreening tools are highly recommended to identify all existing conditions followed by pharmacological and evidence based interventions that address both comorbidities.

Cognitive Behavioral Therapy is also an important strategy to help the smokers initiate a change in their negative thoughts and beliefs while addressing the true nature of their habitual behavior.

It is important to keep in mind that with depression in play, the nicotine withdrawals experienced during treatment a lot more intense. Intensive cessation treatment programs are known to render quicker yet effective results. The key is to remain focused at the end goal.


Sana Ahmed photoAbout the Author:

A journalist and social media savvy content writer with wide research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute focusing on mental health and addiction recovery, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.

Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. The art of using words to educate, stir emotions, create change and provoke action is at the core of her career, as she strives to develop content and deliver news that matters.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed By: Jacquelyn Ekern, MS, LPC on April 9, 2017
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About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.