Most people will experience anxiety during their lives; however, millions of Americans live with an anxiety disorder daily. [1] This includes Generalized Anxiety Disorder (GAD), social anxiety, and specific phobias. [1] Some people may use nicotine to achieve short-term relief from their anxiety, but research has shown that nicotine can cause anxiety and make symptoms more severe. [2]
- Nicotine can both cause anxiety and worsen anxiety symptoms in the long term.
- Nicotine can provide short-term stress relief, trapping people in a nicotine-anxiety cycle.
- Quitting nicotine and developing healthier ways to manage stress and anxiety can help to improve long-term outcomes.
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Does nicotine cause anxiety?
Nicotine, which is the main psychoactive component of cigarettes and vapes, can cause anxiety. There is a clear link between anxiety disorders and nicotine dependence, with anxiety disorders about twice as common in those with nicotine dependence as in those without. [3]
Nicotine affects the nicotinic acetylcholine receptors (nAChRs) in areas of the brain involved in emotion processing, most notably the hippocampus. [2] Over time, this can negatively affect the individual's behaviors in relation to anxiety and fear, which can lead to the development and continuation of anxiety disorders. [2]
This effect on the brain also leaves those with nicotine dependence at an increased risk of developing panic attacks or post-traumatic stress disorder (PTSD). [3] It can also negatively impact other mental health conditions, including depression and attention-deficit/hyperactivity disorder (ADHD), highlighting the widespread impact nicotine dependence can have. [3]
Short-term anxiety relief vs. Worsening anxiety long-term
As nicotine is highly addictive, it’s easy for individuals to become dependent and start using it frequently, particularly if it gives short-term improvement in anxiety symptoms. [3] In this way, individuals are trapped in a constant nicotine-anxiety cycle, using nicotine for short-term relief of stress, but this only acts to further exacerbate the underlying anxiety. [3]
Chronic nicotine use is often continued as anxiety symptoms generally worsen during nicotine withdrawal, making it very challenging to stop using nicotine. [3] Individuals struggling with this cycle should be encouraged to find alternative ways to manage their anxiety and seek professional help.
How long does nicotine-induced anxiety last?
Nicotine-induced anxiety will last for as long as nicotine is being regularly used. Once abstinent from nicotine, the anxiety will often worsen during the first few days of withdrawal, but then gradually reduce over the course of 3-4 weeks. [4]
Does vaping increase anxiety more than smoking?
Consumption of nicotine from both smoking cigarettes and vaping can increase anxiety in the same way. However, some vapes can contain a high concentration of nicotine, and appealing flavours can make it easier to consume a larger amount of nicotine compared to smoking. Over time, this can have the knock-on effect of increasing anxiety further due to the consistently higher amount of nicotine consumed.
Who is most at risk?
Higher strength and more frequent nicotine consumption will increase the risk of developing unwanted anxiety and other negative mental health impacts. Young people are particularly at risk as their developing brains make them more susceptible to addiction, with the vast majority of adult smokers starting before the age of 18. [5] Adolescent nicotine exposure can cause rewiring of the brain’s reward system, affecting their ongoing mental well-being, and can also impact their memory and learning. [6]
Does quitting nicotine help with anxiety?
Yes, quitting nicotine can significantly improve anxiety symptoms over time. While anxiety may temporarily worsen during the initial withdrawal period, individuals who successfully quit nicotine can experience substantial reductions in anxiety levels compared to when they were actively using. [4]
The brain's nicotinic acetylcholine receptors begin to normalize once nicotine use stops, allowing for healthier emotion regulation and reduced anxiety responses. Quitting nicotine removes a significant contributing factor to anxiety symptoms, with living nicotine-free providing long-term mental health benefits.
Recovery timeline: How anxiety changes over time
As anxiety is closely linked with nicotine use, higher consumption of nicotine can worsen anxiety. Once someone stops using nicotine, anxiety is often worse during the first few days of withdrawal, with strong cravings to continue using nicotine. [4] Individuals may also experience increased irritability and restlessness during this period. [4]
After the initial few days of withdrawal, anxiety and other associated withdrawal symptoms tend to slowly improve over a total of 3-4 weeks, which signifies the end of the acute withdrawal period. [4] If nicotine abstinence is sustained and healthy lifestyle changes are made, the brain’s mechanisms for emotional regulation continue to normalize over the next few months. This allows individuals to feel calmer and less anxious compared to when they were using nicotine.
Healthier ways to manage anxiety without nicotine
When becoming abstinent from nicotine, long-term success requires the development of healthier alternative strategies for managing anxiety. Some examples of these are below:
- Healthy diet. Eating a nutritious, balanced diet with limited caffeine and alcohol can help improve anxiety.
- Physical activity. Regular exercise is a natural way to reduce anxiety. [7] Additionally, approximately 2-2.5 hours of moderate-intensity exercise per week can help reduce the risk of developing chronic diseases. [7]
- Good sleep. Having a regular sleep cycle of around 7-9 hours per night will help someone feel more rested, with poor sleep known to exacerbate anxiety. [8]
- Meditation, breathing exercises, and mindfulness. These techniques can help people feel calm, providing immediate relief from anxiety.
- Social support. Regularly engaging with friends and family can help bring emotional relief, particularly during nicotine withdrawal.
- Professional help. Cognitive Behavioral Therapy (CBT) can provide practical help for managing anxiety. Working regularly on these techniques with a professional can help with long-term anxiety management.
If you, or someone you know, is struggling with nicotine addiction or mental well-being, please reach out to a medical or mental health professional for support.
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