Our colleague, psychologist Dr. Rachel Smolowitz at Sheppard Pratt, wrote a great blog about how quitting tobacco use can improve mental health symptoms. Thank you, Dr. Smolowitz, for letting us share your blog with the EX Community!
Michael V. Burke, Ed.D
Program Director and NDC Counselor/ CTTS
For a long time, we’ve told people to calm down by smoking a cigarette. Mental health professionals even used to give cigarettes as positive reinforcement for good behavior. Everyone now knows that smoking is very bad for a person’s physical health (causes cancers, heart disease, and lung disease, among many other problems). What a lot of people don’t know is that quitting is great for mental health also!
A confusing part of this picture is this: most people report that smoking helps them calm down. Some people even say that smoking is the only thing that they enjoy. If smoking makes people feel calm, why would it be good to stop?
A lot of research indicates that quitting smoking is very helpful for:
- Having less depression
- Having less anxiety
- Having better overall wellbeing
- Fewer relapses on drugs and alcohol
- Sometimes, being able to take lower doses of psychiatric medications
To try to understand the research, let’s consider it in a few different ways:
Let’s say I’ve just had an argument and I’m looking for something to help me feel better. My options are to go for a walk or smoke a cigarette.
Which is easier? Cigarettes.
Which is faster? Cigarettes.
Which is better for my health? The walk.
Which works better? Most would say the walk.
Most people choose the easier and faster over the healthier and more effective – over and over again. This means that people tend to do worse at healthy coping when they smoke, which can make their symptoms worse and make them more likely to relapse.
Another part of this picture is nicotine, the addictive part of tobacco.
When a person’s body runs out of nicotine, they have an urge to smoke. This can make them feel anxious and irritable.
When a person smokes a cigarette, they get nicotine very quickly, and this relieves the anxious and irritable feelings.
This feels like it’s helping, even though it’s only relieving a problem created by the nicotine. When a person is used to not smoking, they no longer have those ups and downs in anxiety that relate to nicotine, and this can help their moods a lot!
In a smoking cessation group, a patient made the analogy that it’s like wearing shoes two sizes too small for the relief of taking them off.
So after reading this, maybe you’re ready to quit smoking. Now what?
The best way of quitting is a combination of counseling and medication (nicotine replacement, like the patch or gum, or a medication like Chantix or Wellbutrin). The Maryland Quitline provides both at 1-800-QUIT-NOW. [NOTE: A state quitline can be accessed anywhere in the US using this same phone number; please check with your state quitline re: availability of quitting medication as they differ by state]. They can also help you figure out if other resources might be helpful. Alternatively, talk to a doctor or therapist. This is a hard process, so use the tools that are available!
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