The Smoking-Mental Illness Connection: 10 Facts You Should Know

by Dr Antonio Howell, MD

in quit smoking

Dr. Howell

Smoking and mental illness – is there any connection between these two? For years, scientists have carried out extensive research on smoking and mental health. In this article, we will explore how smoking could lead to mental disorder and why people with such illness are more likely to engage in the deadly habit of cigarette smoking.



Below are some facts that highlight the smoking-mental illness connection.


  1. Smoking rates are 2-4 times higher among people with psychiatric illness and those who suffer from substance abuse, according to a 2005 study published in the American Journal on Addictions.
  2. In the same study, 60 percent of smokers report having a past or current diagnosis of a mental disorder.
  3. The most common mental health diagnoses among smokers are alcohol abuse, anxiety disorder, phobia (including social phobia), major depressive disorder and substance abuse – reported a population-based prevalence study which appeared in the Journal of the American Medical Association in 2000.
  4. People with mental disorder have a higher risk of premature death than the general population, in part, because of high rates of cigarette smoking. This finding appeared in the journal Preventing Chronic Disease.
  5. Heavy smokers tend to report experiencing a substantially poorer well-being, functional disability, and greater symptom burden when seeking mental health treatments than those who don’t smoke.
  6. Smokers who suffer from mental health problems are more likely to receive treatments for nicotine dependence in a mental health setting, than from a primary care provider.
  7. Smoking during pregnancy is linked to a higher risk of bipolar disorder (BD) in children later in life. The new study, which was published in the American Journal of Psychiatry, suggests that pregnant women who smoke have a two-fold increased risk of having babies who are going to develop BD in early adulthood.
  8. There are various factors that make mental health patients more vulnerable to cigarette smoking. Some patients engage in tobacco use to mask the symptoms of their condition or the side effects of their medications. Another thing, cigarettes tend to be very attractive for mental health patients because nicotine stimulates that production of hormones involved in feelings of pleasure and enjoyment. Furthermore, they are more likely to be exposed to stressful situations and homelessness, and have a lower socioeconomic status – factors that could trigger smoking.
  9. In a 2007 study published in the Schizophrenia Bulletin, researchers at Stanford University found that tobacco manufacturers make schizophrenic patients a target of advertisements, making it believe that cigarettes are an effective self-medication for the said mental condition. These companies have also made it possible to exempt psychiatric hospitals from smoking bans.
  10. Smokers with mental illness should be given comprehensive treatments to ensure that they are able to successfully quit without worsening their condition. There has been reports in the literature showing that the risk of depression in patients with history of major depression increases through the first months of nicotine withdrawal. Alongside medical treatments, behavioral interventions are also beneficial in helping smokers with mental illness quit the habit that’s making their condition worse.


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