Your question: Why do I get anxiety when I smoke cigarettes?

My reply:

Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy. 

Smoking is an extremely common habit. Statistics(1) show that an estimated 17% of the world’s population is smokers. Much is said about it being unhealthy for physical health, but not enough is said about the fact that smoking also impacts mental health.

Multiple studies have demonstrated an association between cigarette smoking and increased anxiety symptoms(1). This has both physiological and emotional reasons, and is related to cigarette smoke and nicotine, as well as the noxious effects they have on the body.

It is common that smoking generates anxiety and that at the same time, you turn to cigarettes to alleviate the symptoms of anxiety, since many people take cigarettes as a calming agent for everyday problems. The problem is that this vicious circle keeps you in the same situation.

Although it is complicated, it is time for you to take action and take control of your own life by gradually decreasing your cigarette consumption and dealing with the annoying symptoms of anxiety. Before we offer suggestions to help you on your way to improving your situation, it is necessary to understand the source of your smoking-related anxiety.

What is the relation between smoking and anxiety?

Nicotine, which is found in all cigarettes to a lesser or greater extent, is a chemical that makes them addictive. This substance affects the nervous system, triggering dopamine, a neurotransmitter related to emotions and satisfaction.

What happens when nicotine enters your body is that it puts your body in a state of stimulation and energy. This is why you may feel tachycardia and tremors in your body, as well as a momentary surge of energy. This can make you feel anxious because nicotine, being addictive, demands you to keep using it, and part of the anxiety you feel after smoking comes from the need to smoke again.

At the same time, people with greater anxiety are more likely to smoke because they consider that this “calms them down”. All these factors make anxiety and smoking have a close relationship and keep the person in an endless vicious circle. You smoke because you have anxiety and you have anxiety because you smoke.

How to reduce smoking and anxiety?

This is a two-way problem. You can’t quit smoking and expect the craving to go away, just as you can’t work on reducing cravings while continuing to smoke regularly. Therefore, you must treat both problems at your own pace, seeing a medical professional when you feel you can’t control it on your own.

Some strategies for coping with smoking and anxiety are:


It is necessary to be honest with yourself, so it is useful to record in a diary the reasons why you want to quit smoking, specifying what you think your life will be like if you quit smoking. This will allow you to stay motivated on your way to dealing with anxiety and gradually decrease your cigarette consumption.

Modifying the habit

You must learn to deal with anxiety and stress in different ways, without turning to cigarettes every time you experience a stressful situation. Replacing smoking with simple, everyday activities such as exercise, meditation or reading will decrease your overall anxiety, since you are not “treating” it with something that only makes you more anxious.

Reduce it gradually

There is no magic wand that will make you quit smoking overnight. Like any change, quitting smoking must be gradual. You can start by halving the number of cigarettes you smoke per day or per week, and from there, subtract one cigarette per day during each week. It is normal to have relapses, since it is necessary that you understand cigarette smoking as an addiction, but with enough willpower and psychosocial support, you will be able to achieve it.

Support groups

Support groups are extremely helpful in the process of quitting smoking. You can get them in person or online. They should be led by a professional such as a trained therapist. This will allow you to create new social bonds and also, to understand that you are not alone in your process of coping with the anxiety generated by smoking, discovering new strategies that can be useful to you.

In my experience…

Smoking is a habit that has become extremely normalized in society, to the point where people do not have a clear notion of how it affects their health. Smoking can make you feel anxious and anxiety can make you want to smoke. Although you may feel that this is uncontrollable, the truth is that you have the strength and ability to make healthy changes in your life, even if it costs you and you make mistakes many times.

Remember that you have the ability to improve your psychological state, even if during moments of anxiety or depression you feel hopeless. You can always make small changes that will pay off in the long run. The fact that you are contacting me to seek professional attention in psychological counseling is already a step, and I recognize and applaud you for that. You are already doing something and wanting to change always leads you in the right direction.

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