Smoking With Generalized Anxiety Disorder: Can Nicotine Cause Anxiety?

Portrait of a young man smoking a cigarette
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Generalized anxiety disorder (GAD) is characterized by constant worrying and anxiety. It is a chronic and persistent illness that can have a debilitating impact on your life, including your career, education, and personal life.

For many people with GAD, finding anxiety relief is a constant battle. Some with GAD self-medicate in order to soothe their nerves and get through their regular routine. This can include using harmful substances like alcohol, drugs, or nicotine.

Can nicotine cause anxiety? Smoking can be a harmful way to manage your anxiety, harming your overall health and putting you at risk of developing lung cancer. 

Despite widespread knowledge about the negative health effects of smoking and other forms of tobacco and nicotine use, such as lung cancer and chronic pulmonary obstructive disorder, approximately 12.5% of the U.S. population smokes.

Smoking rates for people with anxiety disorders, including generalized anxiety disorder, are higher than those for the general population. Some of the risk factors associated with anxiety and tobacco use include a stressful childhood, difficulty tolerating negative emotions, and impulsiveness.

The Link Between Nicotine and Anxiety

The link between nicotine and anxiety is one that continues to be explored. While several animal studies show that nicotine can alleviate anxiety and depression-like behaviors, other research shows that smoking can lead to anxiety disorders and depression.

While nicotine can create a sense of relaxation, it's only temporary and does not address the underlying cause of anxiety.

Feelings of anxiety eventually return, and without doing something about them, they can start to worsen over time. This can create a cycle where people smoke to alleviate anxiety and then feel the need to smoke more to deal with anxiety when it returns.

How Does Nicotine Affect the Body?

  • Increases the risk of cardiovascular, respiratory, and gastrointestinal disorders
  • Decreases the immune response
  • Increases oxidative stress
  • Increases cancer risk

Anxiety Relief from Nicotine Is Temporary

Many people turn to cigarettes when they are anxious, and the physiological effects of nicotine can create a calming sensation. But nicotine only produces temporary relief from anxiety while also compromising overall physical health. Ongoing anxiety-provoking situations will soon return the person to the same level of anxiety as they had prior to smoking a cigarette.

Smoking is a damaging and expensive habit. Particularly for those with GAD, smoking can actually worsen anxiety. While smoking might help soothe you in the moment, it can increase worries about money and health, which can cause severe and constant anxiety. Over time, the high costs can exacerbate symptoms of anxiety.


Nicotine can create temporary feelings of relaxation, but the many problems associated with smoking—including the high financial and health costs—can play a role in worsening anxiety over the long term.

What to Do Instead of Smoking

If you're using nicotine to self-medicate your anxiety, there are many treatment options available for GAD that are not as physically damaging and have long-lasting effects. First, seek out the advice of a medical professional. If you don't know where to start, your primary care physician can refer you to a therapist specializing in anxiety disorders.

In therapy, you will go over your anxiety symptoms and triggers and work to identify solutions to these issues. From cognitive-behavioral therapy (CBT) to dialectical therapy, many methods are available to help you.

In some cases, your doctor may recommend an anti-anxiety medication to help manage your worry and stress daily. Medication is only a short-term solution for some people, but others may be on medication for months or even years. You and your doctor will make this decision based on your unique situation.

You may need to resolve your anxiety before you attempt to quit smoking. Therapy can help you identify healthier coping skills that you can use to gain relief. Then, you can work on quitting.

It's important to discuss smoking with your doctor, however. Suppose your doctor suggests helping you quit while you still have high anxiety. In that case, you might want to request a referral to a therapist who can assist you in managing the spike in anxiety you might experience when you stop smoking.

Nicotine replacement therapy (NRT) is one option that might help you stop smoking and gradually reduce your nicotine use. Research suggests that using a quit smoking aid such as the nicotine patch can increase your chances of quitting successfully by around 50 to 60%.

A Word From Verywell

Nicotine and other substances, such as alcohol, may seem like an easy way to self-medicate for anxiety. But each can have health consequences. Getting help for your anxiety is the best way to get relief.

Frequently Asked Questions

  • Does nicotine cause anxiety?

    Yes. While many people think that smoking can ease anxiety, it's just the opposite. Research shows that nicotine can cause symptoms of anxiety or, at the very least, make them worse.

  • What organ does nicotine target that results in changes to mood and anxiety?

    The brain. Nicotine targets various neurotransmitters in the brain that play a role in mood and anxiety.

  • How long do the effects of nicotine last?

    Your body breaks down nicotine into many chemicals, including cotinine, which stays in the body longer than nicotine itself. Nicotine has a half-life of about two hours. The half-life is the amount of time it takes for half of a dose to be eliminated from the body.

  • Can quitting nicotine cause anxiety?

    Nicotine withdrawal can lead to a range of symptoms and feelings, including anxiety. It is normal for people to start experiencing feelings of agitation, tension, and anxiety within 24 hours of quitting smoking.

12 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.
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