Quitting smoking reduces anxiety, especially among those who mainly smoke to “cope” with life, according to new research from Oxford and Cambridge Universities and Kings College London.

“The belief that smoking is stress relieving is pervasive, but almost certainly wrong. The reverse is true: smoking is probably anxiogenic (causes anxiety) and smokers deserve to know this and understand how their own experience may be misleading,” said the researchers.

For the study, researchers followed 491 smokers who were enrolled in U.K.’s National Health Service smoking cessation clinics throughout England.

They had all received nicotine patches and were attending weekly appointments. Overall, 106 (21.6 percent) of the participants had been diagnosed with mental health problems before they tried quitting smoking — mostly anxiety and mood disorders.

At the beginning of the study, participants were assessed for their anxiety levels. They were also asked their reason for smoking: mainly pleasure, mainly to cope, or about equal.

Sixty-eight (24 percent) of the participants were still smoke-free six months later. Ten of these had a current psychiatric disorder.

According to the results, those who were able to quit smoking showed lower levels of anxiety. The decrease in anxiety was especially notable among the ex-smokers who used smoking “to cope,” compared to those who smoked “for pleasure.”

Among participants who started smoking again, pleasure smokers reported no change in anxiety levels after relapsing. However, those who smoked “to cope,” as well as those with a diagnosed mental health disorder showed an increase in anxiety.

Participants who smoked to cope were far more likely to have a cigarette first thing in the morning. The researchers say this behavior aims to “stave off withdrawal symptoms, including anxiety.” If they managed to quit smoking, these repeated episodes of anxiety eventually lifted and they felt less anxious.

“In summary, stopping smoking probably reduces anxiety and the effect is probably larger in those who have a psychiatric disorder and who smoke to cope with stress. A failed quit attempt may well increase anxiety to a modest degree, but perhaps to a clinically relevant degree in people with a psychiatric disorder and those who report smoking to cope,” said the researchers.

“Clinicians should reassure patients that stopping smoking is beneficial for their mental health, but they may need to monitor for clinically relevant increases in anxiety among people who fail to attain abstinence.”

Source: British Journal of Psychiatry