The link between Smoking and Depression

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Full ashtray

Smoking cigarettes.
Photo courtesy of

Smoking may be the cause not the result of depression.

People who smoke are far more likely to become depressed than nonsmokers. About 40% of smokers suffer from a mood disorder, largely depression, while the rate in the whole population is typically in the range of 2% to 10% in any one year.

The connections between tobacco smoking and mental health issues may be even more severe than was previously thought. The connections are not limited to depression or related mood disorders.

One recent study took another look at the National Epidemiologic Study on Alcohol and Related Conditions, a large nationwide survey of mental health and addiction issues.  (P. A. Cavazos-Rehg, N. Breslau, D. Hatsukami, M. J. Krauss, E. L. Spitznagel, R. A. Grucza, P. Salyer, S. M. Hartz, L. J. Bierut. Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders. Psychological Medicine, 2014; 1 DOI: 10.1017/S0033291713003206)

This study surveyed 35,000 people; about 4,800 of those were daily smokers. The study participants were resurveyed 3 years later. Smokers in this study appear to have significantly higher rates of mental health issues.

Half of all smokers reported having “Alcohol problems” While 24% reported some form of drug use problem.

Over the course of the three-year period between studies, some people quit smoking. Among those who quit smoking the rates of mental health and substance abuse problems declined, while those who continued to smoke continued to have higher rates of mental health and substance use disorders.

This challenges the conventional wisdom that in treating serious mental health or substance abuse issues the issue of tobacco smoking can be left for a later time.

Chemical use of many kinds is known to impact mental health. Excessive alcohol use results in depression. Many practitioners have been reluctant to treat someone for depression while they are still drinking alcohol.

Recently professionals in the mental health and substance abuse field have moved to thinking that substance use issues and mental health issues so thoroughly interact that both problems need to be treated simultaneously.

The evidence continues to mount that there is a connection between tobacco use and both mental health issues and substance use disorders. It is becoming clear that ending tobacco use might have a significant impact on mental health.

Recently I have been hearing of studies in which the seriously mentally ill were taught smoking cessation and the results of their recovery from both issues were essentially the same as the general population.

If you are a smoker, quitting may well improve your mood and your mental health. If you are struggling with a mental health or substance use disorder there is no reason to put off quitting smoking and there are a growing number of reasons to think that quitting will make your other problems easier to manage.

Have you seen a connection between your smoking and other life problems?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at

3 thoughts on “The link between Smoking and Depression

  1. I quit smoking almost 2 years ago. I’m curious if there is any research/answers to jump starting metabolism after quitting. 2 years later and mine is still at a standstill! 😦


    • Thanks for the comment. I have heard lots of ideas from clients but have not read any research on this topic. It appears to me that different things work for different people. I will watch to see if there is any definitive research on this topic.


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