Many people with depression use nicotine, and vice versa. This is likely due to genetics, brain chemistry, and other factors.
For some, nicotine withdrawal may cause temporary depression. Unfortunately, this can make it harder to quit smoking or vaping.
People living with depression can quit using nicotine with the right support. This might include smoking cessation therapy, medication (if needed), and stress-management techniques.
You’re probably familiar with some of the ways that nicotine can harm your physical health [1]. Smoking is linked to heart disease, stroke, and other chronic diseases. But nicotine can also impact your mental health. Research shows a significant overlap [2] between nicotine dependency and mental health concerns.
While it’s not considered a stand-alone cause of depression, using nicotine may increase your risk [3]. Learning more about the connection between nicotine and depression can help you make healthier choices for your mental and physical health and know when to reach out for help.
Does nicotine cause depression?
Research shows that having major depression may double your risk of nicotine dependence [4].
Experts have identified a few factors [5] that may help explain this overlap:
Brain chemistry: People with depression often have lower levels of “feel-good” brain chemicals like dopamine. As a result, they might be more prone to use stimulants like nicotine to temporarily boost their mood. Unfortunately, long-term nicotine dependence may decrease the brain’s natural dopamine production. This may lead to worsening depression and increased nicotine use.
Genetics: There’s evidence that depression and nicotine use disorder have a genetic component [6]. So if you have a close relative, like a sibling or parent, who lives with depression and uses nicotine, you may be at greater risk of experiencing both.
Stress: Nicotine is a stimulant [7]. As such, many people use it to reduce stress. Stimulants activate the nervous system, providing a temporary increase in energy and alertness. They also bind to the brain’s pleasure centers, providing a brief jolt of euphoria. But these effects are temporary. Repeated nicotine use may blunt the brain’s ability to respond to stress [7] in healthy ways.
Sleep disturbance: Frequent nicotine use can make it harder to fall and stay asleep. Not getting enough rest is a known risk factor for depression [8].
Tobacco use (either by smoking or chewing) is the most common way to ingest nicotine. But it isn’t the only one. Vaping and electronic cigarette products can contain high levels of nicotine, and these products are also associated with an increased risk of depression [9], especially in young people.
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Can quitting nicotine cause depression?
Quitting nicotine doesn’t cause depression. But a person may go through withdrawal when they quit.
Tobacco cessation programs [10] can help make this process a little easier. But without support, withdrawal can create uncomfortable mental and physical symptoms, including temporary depression. Additionally, quitting nicotine can sometimes unmask underlying major depressive disorder [11] (MDD) in people who didn’t have symptoms before.
Why it feels like nicotine helps depression
Like with other mood-altering substances, there’s a misconception that nicotine can treat depression [7]. This is because, for a brief period, it can make a person feel better [12]. Nicotine can temporarily improve your focus, lift your mood, and provide tactile stimulation. But over time, you may need more nicotine to achieve the same effects. This is known as tolerance.
Unlike the relief you might experience from taking prescription antidepressants, nicotine’s positive effects are short-lived. Researchers are beginning to explore [13] the effects of nicotine patches on depression and other psychiatric concerns. But we need more studies to confirm the safety and efficacy of this approach.
Can depression make it harder to quit smoking?
Yes, having depression can make it harder — but not impossible — to quit smoking. This is because when you suddenly stop using nicotine, you may experience a decline in mood that can mimic depression [11], especially if you use large amounts of nicotine [11].
When a person experiences depression due to nicotine withdrawal, they may want to do anything they can to feel better, even if it’s not a healthy choice. The cycle of withdrawal, depression, and relapse can be difficult to interrupt without the right support.
Healthier ways to manage depression
For many people, smoking is more than just a physical habit. It’s something they use to cope with emotional discomfort. If you want to manage your depression without relying on nicotine, it’s important to focus on replacement coping strategies [12]. This usually means developing daily stress-management habits as well as coping strategies you can use in the moment when you feel stressed.
If you’ve tried quitting smoking on your own but haven’t been successful, you may want to consider smoking cessation therapy. This form of care can address mood concerns like depression, along with nicotine dependence, at the same time.
Additionally, certain antidepressants [13] may support smoking cessation. If you’re interested in taking medication, talk to your provider. They can help you weigh the pros and cons of this approach and determine if it’s right for you.
When someone feels like nicotine is the only thing holding their mood together, I remind them that the ‘relief’ they feel is often their brain calming down from withdrawal — not the nicotine fixing their mood. It can feel real in the moment, but it doesn’t mean nicotine is treating depression. Understanding that cycle helps people feel less dependent and more in control.
Brandy Chalmers, LPC
Clinical reviewer
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Nicotine and depression have a complex relationship. Having depression doesn't automatically mean you'll become a smoker. But it can increase your risk. This is likely due to a combination of genetics, brain chemistry, stress, and other factors. Nicotine withdrawal can also cause depressive symptoms, and this can make it harder to quit.
If you’re dealing with depression and nicotine dependence, know that help is available. Smoking cessation therapy and medication (if needed) can help you balance your mood and change your relationship with nicotine.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- How Smoking and Nicotine Damage Your Body https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/how-smoking-and-nicotine-damage-your-body
- Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study https://pmc.ncbi.nlm.nih.gov/articles/PMC8802724/#sec1-5
- Smoking & Depression https://smokefree.gov/challenges-when-quitting/mood/smoking-depression
- Smoking and depression--a review https://pubmed.ncbi.nlm.nih.gov/22558621/
- Smoking and Mental Health https://ash.org.uk/resources/view/smoking-and-mental-health
- The Role of Genetics in Nicotine Dependence: Mapping the Pathways from Genome to Syndrome https://pmc.ncbi.nlm.nih.gov/articles/PMC3114454/
- Puffing away sadness https://www.health.harvard.edu/blog/puffing-away-sadness-2020022418913
- Effects of Nicotine on the Central Nervous System and Sleep Quality in Relation to Other Stimulants: A Narrative Review https://pmc.ncbi.nlm.nih.gov/articles/PMC10733894/
- Health Effects of Vaping https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html
- Tools & Tips https://smokefree.gov/
- Depression and smoking cessation: Does the evidence support psychiatric practice? https://pmc.ncbi.nlm.nih.gov/articles/PMC2655079/
- Nicotine: It’s why smoking is so addictive https://www.hss.gov.nt.ca/en/services/health-effects-tobacco/nicotine-it%E2%80%99s-why-smoking-so-addictive
- Effects of open-label transdermal nicotine antidepressant augmentation on affective symptoms and executive function in late-life depression https://www.sciencedirect.com/science/article/pii/S0165032724010826
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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