Ever since this pandemic started, many health experts all over the world have more reasons to think back to the link between smoking and anxiety: They came up with questions like, does smoking cause anxiety? Or does anxiety cause people to smoke?
Just like every other aspects of addiction and mental health, they don’t have a specific conclusions.
Brian Hitsman, an associate professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago said he thinks he and his colleagues have generated more questions on the subject of smoking and anxiety than they have answered.
The professor said anxiety and smoking are the most popular mental health issues in the United State of America which affects 15 to 19 per cent of the adult population and surrounding everything from phobias and panic attacks to intense fear of social situations and worries.
The latest data released in November from the Centres for Disease Control and Prevention showed 45 per cent of people with severe anxiety use tobacco. Even for those with mild anxiety, 30 per cent use tobacco. Yet for those who report little to no anxiety, only 18 per cent use tobacco.
Another research in Current Psychiatry Report also shows higher rates of anxiety disorders among smokers than the general population.
Lorra Garey, the study's lead author, said alcohol and substance abuse could be clouding the true connection. Another complicating factor is the two-way relationship between smoking and anxiety.
“It's this perpetual loop feeding into itself. You have anxiety contributing to smoking … and then you have people becoming addicted to nicotine and experiencing acute withdrawal with symptoms that mimic anxiety,” said Garey, a research assistant professor at the University of Houston.
“These things are so interrelated it's hard to tease apart,” she said. “Ultimately, we need more rigorous research to really track the different factors over time to fully understand them.”
Another problem, Hitsman said, is smokers often mistakenly think having a cigarette will tamp down their anxiety.
“It's in their head that smoking is an effective way to manage their emotional distress, but it's probably only making them feel better because it's helping manage their nicotine withdrawal,” he said. “Smoking actually increases your heart rate and causes changes in the body that are opposite of relaxation.”
In fact, smoking wreaks havoc on the entire cardiovascular system, releasing chemicals that damage and clog arteries, which can lead to a heart attack or stroke.
Whether tobacco use and anxiety rates have been affected by the COVID-19 pandemic is difficult to pinpoint. But Garey suspects they're rising.
“So many factors that contribute to anxiety—financial burden, child care issues—are making it worse. And there's also a concern about a greater severity of smoking, and people who've quit restarting,” she said.
Quitting smoking can be incredibly difficult for anyone, largely because of the presence of nicotine, a highly addictive drug the U.S. surgeon general once likened to heroin and cocaine. During the pandemic, people struggling with nicotine addiction might find it harder than usual to set up doctor's appointments or counseling sessions.
Explaining wide varieties of methods that can help smokers, Garey said exercising daily, prescription methods and replacing nicotine products with gum and patches can help the battles that come with nicotine withdrawal.
She added that smokers who have anxiety benefit more from taking exercise, doing yoga and practicing belly breathing exercise.
“Smoking is such an automatic, time-consuming thing, so it can be so helpful to take a break, focus on the moment, and replace smoking with something healthy that you really enjoy, she advised”
