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Information / Smoking & mental health
Smoking, stress & mental health
Smoking and mental health can become tightly linked. Cigarettes may feel like they are helping with stress or anxiety, but nicotine dependence can also create some of the feelings smoking then seems to relieve.
Last reviewed: 27th September 2026
QUICK ANSWER
Smoking can feel calming without improving mental health overall.
NHS guidance says people who stop smoking tend to have lower anxiety, depression and stress after the withdrawal stage, alongside better mood and quality of life.
Why does smoking feel like it helps with stress?
Nicotine reaches the brain quickly. That can create a short-lived feeling of relief or reward.
As nicotine levels fall again, withdrawal can bring irritability, anxiety, restlessness and cravings. Smoking another cigarette can temporarily relieve those feelings.
This can create a loop where withdrawal feels like everyday stress and the next cigarette feels like the solution.
The smoking-stress loop
Smoke
The urge settles for a while.
Nicotine falls
Tension, irritability or anxiety can build.
Smoke again
The withdrawal eases and the cigarette feels calming.
Smoking and mental health in Wales
The latest National Survey for Wales shows a clear difference in smoking prevalence between people with and without a reported mental health condition. This is one part of a wider pattern of smoking and health inequalities in Wales.
24%
of people with a mental health condition reported smoking
National Survey for Wales, April 2024 to March 2025.
8%
of people with none of the listed conditions reported smoking
National Survey for Wales, April 2024 to March 2025.
These are survey estimates. They show an association between mental health and smoking at population level; they do not explain why any individual person smokes.
What happens to mental health when someone stops?
The first days can feel rough. Nicotine withdrawal can temporarily cause anxiety, irritability, restlessness, poor concentration, sleep problems or low mood.
That does not mean quitting is damaging mental health. A Cochrane review of 102 studies involving more than 169,500 people found no evidence that stopping smoking worsened mental health in the longer term. Compared with continuing to smoke, quitting was associated with reductions in anxiety, depression and stress and with improvements in positive feelings and psychological wellbeing. The certainty of the evidence varied by outcome, so this should be understood as evidence of an association rather than a guarantee for any one person.
The quit plan should protect your mental health too
Use treatment for cravings rather than trying to push through withdrawal alone. Tell the adviser if cigarettes are tied to anxiety, low mood, trauma, routines or social situations.
The practical quit page goes into that in more detail.
If you take medication for your mental health
Smoking can affect how the body processes some antipsychotic medicines and antidepressants.
If you take these medicines, tell your GP, psychiatrist or pharmacist when you plan to stop smoking. Your dose may need monitoring or adjustment.
Do not change or stop prescribed medication yourself.
Keep both teams in the loop
Your mental-health team and stop-smoking adviser can work alongside each other. Tell both about the support and medicines you are using.
You do not have to choose between quitting and looking after your mental health
Get support for withdrawal and cravings and tell Help Me Quit about your mental health from the start. The plan can be built around both.
NEW RESEARCH • 2026
Mental health in our 2026 social-housing research
33% of social-housing respondents reported at least one mental-health condition they had received treatment for in the previous year. 26% reported depression and 11% said they were on an NHS mental-health waiting list.
These health findings are self-reported and were not verified against clinical or NHS records.