Research: Smoking Cessation May Improve Mental Health And Alcohol Use Disorder

Do you smoke (cigarettes)?

It is a simple question, but one that many people struggle to answer. Being honest about a cigarette habit becomes more and more difficult with the stigma that is attached to it by our family, friends, co-workers, and perfect strangers. There was a time when close to 50% of the U.S. adult population smoked cigarettes. Then in January 1964 the Surgeon General issued an official report concluding that smoking causes lung cancer. Most adults at that time probably knew intuitively that smoking was a health hazard…but many, despite an interesting chronology discouraging smoking, continued to smoke and some still continue to smoke to this day. Today, according to the Centers for Disease Control and Prevention (CDC) roughly 18.1% of all adults (18 years of older), in the United States smoke cigarettes.

An interesting phenomenon regarding smoking is that it is used in films and television series; it almost takes on a character of its own.

  • If you were a fan of “Sex and the City,” then you probably recall how Carrie struggled to quit smoking to please her various suitors and yet when she would pick up a cigarette feeling like a failure she seemed to find comfort in her Marlboro lights.
  • Currently HBO’s “True Detective” has made smoking and drinking part of Rust Cohle’s being…and his partner Martin Hart not only smokes and drinks, but also chews tobacco. By the time each episode ends you feel like you are in a smoked filled bus station of days gone by.
  • Just this past weekend we saw the film The Monuments Men set in World War II…smoking and drinking were a small and sometimes humorous part of a number of scenes. For sure every retired veteran in that audience understood the part cigarette smoking has traditionally played in times of war.


So why all this talk about smoking?

This week the results of two studies were published on-line. Each study had to do with smoking tobacco and each had significant findings. The first study we will just briefly touch on has to do with people who smoke, but do not consider themselves smokers. This study was conducted by Dr. Wael K. Al-Delaimy, Eric C.Leas, Rong W. Zablocki and Steven D. Edland from the Department of Family and Preventive Medicine, University of California San Diego. You can read more about the study in the journal Tobacco Control: Smokers who report smoking but do not consider themselves smokers: a phenomenon in need of further attention.  The researchers conclude that in 2011 12.3% of all smokers living in California were non-identifying smokers (NIS).

Regarding this study…the bottom line may be if you are not admitting that you are a smoker, then there is a pretty good chance you will find taking the first step to quit very difficult. This is very much like using and abusing alcohol and drugs.

Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders

The second study we would like to discuss was published online February 12, 2014, in the Psychological Medicine journal: Smoking cessation is associated with lower rates of mood, anxiety and alcohol use disorders. (See a PDF of the original article here.) The lead research was Patricia A Cavazos-Rehg of the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. She was joined by researchers from Michigan State University, the University of Minnesota and other from Washington University in St. Louis.

Research parameters…


  • 4800 daily smokers were analyzed by the researchers
  • These smokers were from the National Epidemiologic Study on Alcohol and Related Conditions survey
  • The survey was given twice.


Research results…


  • During the first survey around 40% of the daily smokers reported having mood or anxiety issues.
  • About 50% of the daily smokers also had alcohol problems
  • About 25% had drug issues
  • The survey was repeated three years later: At that time, 42% who were still smoking had mood disorders, while those who had quit smoking only 29% still reported mood disorders.
  • Additionally, after three years alcohol and drug use rates were also lower for the former smokers:  Of those who quit smoking only 18% were still had problems with alcohol vs. 28% of those who didn’t stop smoking; drug problems continued for 5% of the quitters vs. 16% of those who continued to smoke.

The researchers are quick to point out that while their research suggests a strong link between smoking cessation and improving one’s mental health, to this point they were not able to prove a cause and effect relationship.

The first steps in recovery

While the first study we discussed really is fascinating as to how human nature works, the second study is encouraging and very good news for those who are seeking recovery from any and all substance abuse.

It is not unusual for someone who self medicates with alcohol or drugs to also suffer from co-occurring disorders like bipolar or anxiety disorder or mood disorders. Additionally, he or she may also smoke cigarettes. The entire dynamic can seem overwhelming to not only the addict, but to family members. It begs the question, which addiction or behavioral health issue to tackle first?

According to the February 11, 2014, press release issued by Washington University in St. Louis:

“Clinicians tend to treat the depression, alcohol dependence or drug problem first and allow patients to ‘self-medicate’ with cigarettes if necessary,” said lead investigator Patricia A. Cavazos-Rehg, PhD. “The assumption is that psychiatric problems are more challenging to treat and that quitting smoking may interfere with treatment.”


If you are trying to help your loved one with an addiction problem, who may also be suffering from a co-occurring disorder, you might find that getting their attention will be served by working with an interventionist. An intervention is defined as having a neutral person who is an expert in addiction and recovery intervene upon the addict and their family to bring the addiction and its harmful impacts to the surface so that recovery and healing can begin.

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