Change in mental health after smoking cessation: systematic review and meta-analysis (2014-03/25)

Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke.
The effect size seems as large for those with psychiatric disorders as those without. The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders.

 

 

Researchers believe that the data are valid and propose three possible explanations for the association. The first is that smoking cessation causes the improvement in mental health, the second is that improving mental health causes cessation, and the third is that a common factor explains both improved mental health and cessation.
Observational data can never prove causality, but almost all we know about the harms of smoking and the benefits of cessation derive from observational studies as randomised trials to examine this have insurmountable ethical and practical difficulties.

Whether or not smoking cessation directly causes the observed improvement in mental health, there are direct clinical implications. Smokers can be reassured that stopping smoking is associated with mental health benefits. This could also overcome barriers that clinicians have toward intervening with smokers with mental health problems. Furthermore, challenging the widely held assumption that smoking has mental health benefits could motivate smokers to stop.

Many smokers want to stop but continue smoking as they believe smoking has mental health benefits, in addition, health professionals are reluctant to deal with smoking in people with mental disorders in case stopping smoking worsens mental health.

Smoking cessation is associated with an improvement in mental health in comparison with continuing to smoke.

The effect estimates are equal or larger to those of antidepressant treatment for mood disorders.

26 studies that assessed mental health with questionnaires designed to measure anxiety, depression, mixed anxiety and depression, psychological quality of life, positive affect, and stress were included.
Follow-up mental health scores were measured between seven weeks and nine years after baseline. Anxiety, depression, mixed anxiety and depression, and stress significantly decreased between baseline and follow-up in quitters compared with continuing smokers.

There was no evidence that the effect size differed between the general population and populations with physical or psychiatric disorders.

For more imformation
Change in mental health after smoking cessation: systematic review and meta-analysis

MDN