Quitting Smoking More Effective than Antidepressants


Quitting smoking is in some ways more strongly associated with improvements in people’s mental health than is the use of antidepressant medications, according to research in BMJ Open.

The UK-based researchers reviewed 26 studies that assessed people’s mental health with standardized questionnaires before and after quitting smoking, including up to nine years after smoking cessation.

“Anxiety, depression, mixed anxiety and depression, and stress significantly decreased between baseline and follow-up in quitters compared with continuing smokers,” the researchers wrote. “Both psychological quality of life and positive affect significantly increased between baseline and follow-up in quitters compared with continuing smokers.” They also found that these differences were consistent in both the general population and in people who’d been diagnosed with physical or psychiatric disorders.

“Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke,” they concluded. “The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders.”

Taylor, Gemma, Ann McNeill, Alan Girling, Amanda Farley, Nicola Lindson-Hawley, and Paul Aveyard. “Change in Mental Health after Smoking Cessation: Systematic Review and Meta-Analysis.” BMJ 348 (February 13, 2014): g1151. doi:10.1136/bmj.g1151. (Full text)


  1. Well, the problem with that correlation is that it’s equally possible that people quit smoking when they stop experiencing stress and anxiety. Most people I know who smoke do it primarly in two types of situations:

    – social setting (party, lunch with co-workers etc.)

    – stressful situation (before exam, when experiencing relationship difficulties, to calm down after a fight with one’s boss etc.)

    Nicotine is a “psych drug” too.

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    • Nicotine is a stimulant and a depressant. We unconsciously regulate it’s effect to get what we need to balance out at any given moment. If you have a crappy job and have to smile in the face of disparaging comments and behavior, the depressant effect can help to mask anger, for instance. There’s a reason why most people who still smoke are working class, and if psychiatry came up with a drug which is both a stimulant and depressant that only has an effect for seven minutes, can be used as necessary, has been very well studied so that it’s effects are known, and doesn’t cause health problems or addiction, I’d take it now and then to buffer the effects of having to deal with other people’s crap gracefully in order to avoid negative consequences.

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    • B: I don’t envy smokers here in the states. The sharp increase in restrictions regarding the use of tobacco creates a nuisance situation for smokers, who at least on the back of their brain, are plotting how to get their next smoke. Quitting smoking is surely a destressing experience, if you are able to achieve it. As for the use of tobacco itself, Thomas Szasz, no fan of medicalizing “alcoholism,” recounted that in his day psychiatrists smoked like fiends at the conventions he attended, and they were none to happy with his off-handed suggestion to medicalize their habit as nicotinism.

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  2. Just don’t try to quit smoking by taking the “safe smoking cessations meds,” like Wellbutrin and Chantix, because they’re not “safe … meds.” And doctors do misdiagnose the adverse effects of these drugs as the major mental illnesses.

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