Can Smoking Cause Anxiety?

Community Member

I grew up with a smoker. My mother, who suffers from both schizophrenia and anxiety, was a three pack a day smoker when I was growing up. I loathed her smoking so much that I did everything a little kid could do to stop her from the act. I remember stomping on her cigarettes and even throwing them out the window all to no avail. My mother would try to quit but it never seemed to work out. One method which finally did work was she went to a hypnotist. His name was "Master G" or something similar. I went too so I got to see how this was done. The hypnotist actually had one of those little balls on a chain that he swung back and forth. I was dubious that it could actually work. But when we got home, my mother miraculously stopped smoking. That is, until one of the cigarette companies sent her a free pack to try in the mail about a year later. My mother could not resist and her addiction started all over again.

Not being a smoker myself, I could never understand the addiction or the craving for nicotine. When I asked my mother about why she smoked, she always said it calmed her nerves and she was too anxious to not smoke. But was this and is this really true? I know this is what she did believe.

We know now that there is a definite link between mental health disorders and smoking. If you look on the American Academy of Family Physicians website you will see a listing of articles about how individuals having a mental disorder are more likely to smoke, sometimes as a way to "self medicate." Here are some of the facts as cited on this website by The Tobacco Cessation Leadership Network:

  • Rates of smoking are 2-4 times higher among people with psychiatric disorders and substance use disorders.

  • 60% of current smokers report a past or current history of a mental health diagnosis sometime in their lifetime

  • Among current smokers, the most common current (within the last 30 days) mental health diagnoses are: Major Depressive Disorder, Substance Abuse, Alcohol Abuse, and Anxiety disorders.

So we know that persons with mental health issues including anxiety disorders are more likely to be smokers. But getting back to the reason my mother gave for smoking, does smoking relieve anxiety or does it create it? If you look at the scientific literature the answer becomes clear. Smoking appears to increase one's risk for anxiety related disorders especially panic attacks.

Here are some the results and conclusions about smoking causing anxiety related symptoms from psychiatric studies:

  • A 2002 article in The American Journal of Psychiatry concludes that: "Previous epidemiologic studies have found a higher risk of panic disorder in early adulthood among those who smoke cigarettes during adolescence, offering support for the hypothesis that cigarette smoking may increase the risk of the development of panic and other anxiety disorders."

  • A 1999 study cited in the Archives of General Psychiatry reported that daily smoking increased the risk for the first episode of panic attack in the user.

  • The authors of a 2001 article, "Nicotine Addiction and Other Psychiatric Disorders" in concluded that smoking rates were elevated by 56% in patients with panic disorder as compared to controls. Also heavy smoking in adolescence (greater than one pack a day) in adolescence was associated with a higher risk of panic disorder, generalized anxiety disorder, and agoraphobia."

It appears that smoking in adolescence is of particular concern for having more of a risk for developing panic attacks. This is the age when many people do start smoking. It is reported by many ex-smokers that the cessation of smoking has led them to feel more calm and less anxious.

What are your thoughts? Are you a smoker who suffers from anxiety and/or panic attacks? Do you think there is any relationship between your smoking and anxiety related symptoms? Do we have any ex-smokers here? How did you quit? And do you find that your anxiety symptoms are greater or lesser now that you have stopped smoking? You know we love to hear from you so please do join in the discussion.

For more information about smoking and its effects upon your health and also how to quit smoking please read these Health Central articles:


Breslau, N., & Klein, D.F., (1999) Smoking and Panic Attacks: An Epidemiologic Investigation. Archives of General Psychiatry, 56:1141-1147.

George, T.P., & Vessicchio, J.C., (2001) Nicotine Addiction and Other Psychiatric Disorders. Psychiatric Times, 18: 2

Goodwin, R., & Hamilton, S.P., (2002) Cigarette Smoking and Panic: The Role of Neuroticism. The American Journal of Psychiatry, 159:1208-1213