Mental Health News What the Rise in Smoking Says About Modern Day Coping Mechanisms By Adam England Updated on May 08, 2022 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Karen Cilli Fact checked by Karen Cilli Karen Cilli is a fact-checker for Verywell Mind. She has an extensive background in research, with 33 years of experience as a reference librarian and educator. Learn about our editorial process Print Theresa Chiechi / Verywell Key Takeaways Annual cigarette sales have increased for the first time in 20 years, according to the Federal Trade Commission.Young adults in particular can be more vulnerable to stress and may use cigarettes as a coping mechanism.As mental health care remains inaccessible for a lot of people, people are turning to cigarettes as a substitute. Cigarette sales have increased for the first time in two decades, as more people have taken up smoking during the pandemic, often using it as a coping mechanism or a substitute for mental health care. It’s no secret that smoking rates have been on the decline for years. Whereas just over one-fifth (20.9%) of US adults smoked in 2005, just 12.5% smoked in 2020. Of course, this is a far cry from the mid-1960s, when around half of men and one-third of women smoked. However, there are still many people taking up the habit. According to the Federal Trade Commission, annual cigarette sales have increased for the first time in 20 years. Young People Are Smoking Again There’s a lot of evidence that Gen Z are drinking less alcohol than the generations before them, and cannabis use is becoming increasingly associated with wellness (and has been legalized for recreational use in 18 states). Cigarettes provide an alternative: people know that smoking is bad for them, but they do it anyway. Lauren Debiac, MA The past few years have been especially stressful for many people, with the pandemic, lockdowns and racial injustices. Many people have been affected by these issues ... Younger people, especially, are more vulnerable to stress and mental health issues. — Lauren Debiac, MA The proportions of smokers aged 25-44 and 45-64 are highest, while the rates of smokers aged between 18 and 24 are lower. We know, however, that younger adults are among those taking up smoking over the last couple of years—but why? It’s not that there’s a lack of information out there, either. In 1966, the US became the first country to require warnings on cigarette packets, and it’s difficult to miss the various anti-smoking ads and campaigns we’ve seen over the years. However, despite the public being made aware of the risks for decades now, smoking remains the number one cause of preventable disease, disability, and death in the US, accounting for almost half a million deaths yearly. Is Smoking Still 'Cool'? Part of the appeal of smoking lies in its aesthetic. Smoking is glamorized. A quick search of “smoking” on Tumblr throws up images of Taylor Momsen, Angelina Jolie, and actors from the Golden Age of Hollywood, while there are iconic images of cultural icons from Audrey Hepburn and Marilyn Monroe to Jimi Hendrix and Kurt Cobain smoking. Additionally, contemporary celebrities, social media users, and tobacco brands themselves are posting ‘smoking selfies.’ Research published in 2018 showed that of Instagram posts featuring some of the most popular smoking-related hashtags and at least one person in the image, the ‘selfie while smoking’ was the most common, something that can serve to both normalize and glamorize smoking. Research carried out in Norway identified a number of types of young smoker. One such type was the 'cool smoker', for whom smoking was a performative act to look 'cool' and more adult-like. It's not difficult to see how this could be the case in the contemporary US too, particularly for young adults who might be struggling to find their place as an adult in society. At the same time, it’s become something of a symbol of nihilism. The idea that nothing really matters, so why not smoke cigarettes despite the health risks? In 2020, median household income saw a statistically significant decline for the first time since 2011, while there were 37.2 million people living in poverty in the US in the same year. Combine this with poor mental health throughout the country, and it's easy to see why people might decide to take up smoking. Smoking and Mental Health There are many smokers who are using cigarettes as a coping mechanism or as a substitute for other ways to manage anxiety and other mental health conditions. “The past few years have been especially stressful for many people, with the pandemic, lockdowns, and racial injustices, says Lauren Debiac, MA, addictions therapist at The Ohana Addiction Treatment Center in Hawaii. “Many people have been affected by these issues." “Younger people, especially, are more vulnerable to stress and mental health issues," she says, "So, it’s not surprising that younger people are turning to cigarettes to help them cope.” As Debiac explains, nicotine is both the main addictive chemical in cigarettes and is also a stimulant. This means that it can increase serotonin and prompt feelings of happiness and relaxation. It speaks volumes about the inaccessibility of mental health care for a lot of people. There’s still a mental health treatment gap, despite the best efforts of many to close it, with BIPOC and LGBTQ+ communities among those facing more barriers to accessing mental health care. The mental health of young people both in the US and globally is on the decline too, which may go some way to explaining why some members of Gen Z are picking up a smoking habit. This treatment gap is backed up by the demographics of current smokers. As per data from 2020, around 16% of lesbian, gay, or bisexual adults smoked compared to around 12% of straight adults. Meanwhile, more Indigenous and Black adults smoked than white adults. According to mental health nonprofit Mental Health America, the percentage of adults with a mental illness who report an unmet need for treatment has increased every year in the past decade, with almost one-quarter of adults (24.7%) with a mental illness reporting an unmet need for treatment in 2019—this was pre-pandemic, so the current figure would likely be higher. Meanwhile, over 60% of young people with major depression don’t receive any mental health treatment. If people can’t access the mental health care they need, it stands to reason that they might consider alternative options, including cigarettes. Not only that, but for some people there's a wariness around anti-anxiety medications like Klonopin (clonazepam) and Xanax (alprazolam), due to the potential for misuse of these drugs. Likewise, some people don't want to take antidepressants, whether due to a stigma or because of the potential side effects. Cigarettes provide an alternative option. “Another factor is that many young people don’t quite understand the dangers involved in cigarette smoking,” Debiac explains. “There have been fewer messages aimed at young adults in recent years that speak to the dangers of cigarette smoking.” While it's common knowledge that smoking isn't good for our health, particularly for younger people it can feel like something that won't affect them until far in the future—while being used as something that they feel helps them in the here and now. What This Means For You While smoking has generally been on the decline, it accounts for almost half a million deaths in the US each year and it's always best to stop or not start to begin with—the benefits to quitting can often be felt within days. The last couple of years have been challenging for many of us, and if you are struggling with your mental health you can contact your healthcare provider or search online for help. 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Current cigarette smoking among adults in the United States. Brawley OW, Glynn TJ, Khuri FR, Wender RC, Seffrin JR. The first surgeon general’s report on smoking and health: The 50th anniversary. CA Cancer J Clin. 2014;64(1):5-8. doi:10.3322/caac.21210 Federal Trade Commission. FTC report finds annual cigarette sales increased for the first time in 20 years. McCabe SE, Arterberry BJ, Dickinson K, et al. Assessment of changes in alcohol and marijuana abstinence, co-use, and use disorders among US young adults from 2002 to 2018. JAMA Pediatr. 2021;175(1):64-72. doi:10.1001/jamapediatrics.2020.3352 Hiilamo H, Crosbie E, Glantz SA. The evolution of health warning labels on cigarette packs: The role of precedents, and tobacco industry strategies to block diffusion. Tob Control. 2014;23(1):e2. doi:10.1136/tobaccocontrol-2012-050541 Cortese DK, Szczypka G, Emery S, Wang S, Hair E, Vallone D. Smoking selfies: Using Instagram to explore young women’s smoking behaviors. Soc Media Soc. 2018;4(3). doi:10.1177/2056305118790762 Scheffels J. Stigma, or sort of cool: Young adults’ accounts of smoking and identity. Eur J Cult Studies. 2009;12(4):469-486. doi:10.1177/1367549409342513 United States Census Bureau. Income and poverty in the United States: 2020. Mental Health America. The state of mental health in America. 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