1. In this meta-analysis, smoking cessation was associated with reduced symptoms of anxiety and depression.
2. Smoking cessation was also associated with lower stress, increased positive affect, and improved psychological quality of life as compared to individuals who continued smoking.
Evidence Rating Level: 2 (Good)
For some, smoking cigarettes is a form of stress reduction. Previous studies have found that for these individuals, the concern is that with smoking cessation, their stress levels will increase and thereby negatively affect their mental health. Furthermore, this effect can be exacerbated by nicotine withdrawal symptoms, which include agitation and changes to mood.
The purpose of the present meta-analysis was to summarize the literature on mental health outcomes and wellbeing following smoking cessation. A search of literature published up to January 2020 was conducted. Studies were included if they were randomized control trials or longitudinal cohort studies that recruited adults who smoked tobacco and were assessed for smoking cessation at follow-up. Studies that did not analyze mental health outcomes by smoking status or ineligible outcomes were excluded. Primary outcomes were change in depression symptoms, anxiety symptoms, or mixed depression and anxiety symptoms from baseline to follow-up.
A total of 102 studies with over 169,500 participants were included. With respect to primary outcomes, participants who underwent smoking cessation were less likely to have symptoms of anxiety, depression, and mixed anxiety and depression, Furthermore, participants who were successful in smoking cessation reported reduced stressed, increased positive affect, and improved psychological quality of life without reduction in social of life. The authors noted that there was high risk of bias in some of the included studies as well as heterogeneity in the measurement tools used to assess symptoms of anxiety and depression. Nonetheless, the results of the present study suggest that smoking cessation may not negatively impact mental health or stress levels and may improve quality of life.
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