“All of us at anxietycentre.com have experienced debilitating anxiety. But we’ve also overcome it and returned to normal and lasting health. Because we know the hardship anxiety unwellness can cause, we are committed to helping others, with over 30 years of service.” - Jim Folk, President, anxietycentre.com

How To Quit Smoking When You Have Anxiety Disorder

Jim Folk author
Written by: Jim Folk.
Medically reviewed by: Marilyn Folk, BScN.
Last updated: August 10, 2019


how to quit smoking when you have anxiety disorder

Do you have anxiety disorder and want to quit smoking? Do you have anxiety disorder symptoms and finding it difficult to quit smoking?

There are many reasons why anxiety disorder can make quitting smoking more difficult. Quitting smoking can also increase anxiety making it even more difficult for anxiety disorder sufferers to quit smoking. Fortunately, we can overcome these problems and discontinue successfully.

We first start with the problems associated with quitting smoking when you have anxiety disorder.

The problem of quitting smoking when you have anxiety disorder

Nicotine increases dopamine in the brain,[1] the neurotransmitter often referred to as the “feel good” chemical.[2] This is one of the reasons smokers believe smoking reduces stress. It’s not that smoking reduces stress, but that the smoker “feels” better due to the boost in dopamine.

Nicotine is also a stimulant similar to caffeine.[3] Caffeine brings about its stimulating effect by causing the body to release cortisol,[4] the body’s most powerful stress hormone stimulant. Cortisol gives the body a “boost” in energy, making us feel “good” and “alive.” The combination of dopamine and cortisol can make a person feel pretty good.

The problem, however, is that the body can build a tolerance to nicotine, which then requires more and more to feel “good.”[3] Then, when the body doesn’t get it, we can feel poorly, which is only relieved by more nicotine. Hence, the physical addiction. Another reason some smokers believe smoking relaxes them is due to nicotine dampening down the symptoms of addiction.[5]

But cortisol stresses the body,[6] which means smoking also stresses the body. Anxiety, because it triggers the release of stress hormones, also stresses the body.[7] Consequently, you have two factors triggering cortisol, both of which stress the body. A body that becomes chronically stressed can exhibit symptoms.[8]

For instance, anxiety symptoms are symptoms of stress. We call them anxiety symptoms because overly anxious behavior is the main source of the stress that causes the body to become chronically stressed and symptomatic.

Rather than smoking relaxing the body, it fuels stress. And stress can fuel anxiety ­since stress increases the activity in the areas of the brain responsible for fear detection and reaction.[9] Consequently, a negative cycle can set up where anxiety stresses the body, smoking stresses the body, elevated stress exacerbates anxiety, an increase in anxiety increases stress, smoking adds to that stress, and so on.

It gets worse. Quitting smoking also stresses the body as the body adjusts away from the chemical addiction, not to mention the stress of changing a habit, which is why quitting can be difficult. Once the body is already chronically stressed (hyperstimulated) and symptomatic, quitting smoking can aggravate hyperstimulation. An increase in hyperstimulation can cause an increase in symptoms.

Together, these factors can create multiple problems, such as:

  • Anxiety causes stress.
  • Smoking causes stress.
  • Chronic stress produces symptoms.
  • Quitting smoking requires breaking the chemical addiction, which causes stress.
  • Quitting smoking requires breaking mental habits, which also can cause stress.
  • An increase in stress can cause symptoms.
  • If you worry about your symptoms, that worry will also increase anxiety and stress.

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So, what can you do if you want to quit smoking when you have anxiety disorder?

First, quitting is a good idea. It will reduce your body’s overall level of stress, which can help reduce hyperstimulation and its symptoms. Reducing stress can also reduce anxiety since stress can increase anxiety.

Second, you want to set up the best environment to quit. You can use the following tips to help you with that:

Talk with your doctor about the best medical options.

There are many medical options available to help quit smoking. Discuss them with your doctor to find the best options for you. Also discuss joining a quit-smoking program. Quit-smoking programs improve the chances of being successful.[10]

Consider nicotine replacement therapy.

Some people have had good success with nicotine replacement therapy. Studies have also shown them to improve the chances of success.

Ask for the help of your loved ones.

Supportive loved ones can play an important role in your success. Their ongoing encouragement can be just what you need when you feel tempted to resume smoking.

Reduce your stress as much as possible.

Reducing stress reduces hyperstimulation. As stress diminishes, the easier it is to support yourself after you quit as your body adjusts away from the physical addiction to nicotine.

Finding healthy ways of reducing stress can more than make up for the little bit of relaxation you got from smoking. Developing healthy stress management practices can also sustain you throughout your life and without the negative side effects of nicotine addiction.

Increase your rest as much as possible.

Increasing rest reduces stress. Again, a reduction in stress can make the quitting process much easier.

Avoid stimulants

Stimulants stress the body, which can aggravate the stress of quitting smoking. Therefore, avoid caffeine, dark chocolate, energy drinks, etc.

Avoid situations, circumstances, and environments that were associated with smoking.

Habits often become associated with familiar situations, circumstances, and environments. For instance, if you smoked when you drank coffee or alcohol, drinking coffee or alcohol can trigger a desire to smoke. You can prevent these types of habitual triggers by avoiding and changing situations, circumstances, and environments that are associated with smoking.

For example, instead of going for coffee, go for a walk.  Anything you can do to change up your habits will help in the quitting process.

Once you have successfully quit and you feel confident in your success, you can return to those familiar situations, circumstances, and environments.

Get rid of any temptation by throwing out your ashtrays, lighters, and remaining cigarettes.

Making your cigarettes and associated paraphernalia unavailable can be a helpful deterrent to resume smoking. As the saying goes, “out of sight out of mind.”

Set aside any important decisions while you work through the quitting process.

Making important decisions can be stressful. Adding stress can make the breaking free process more difficult. If you can, set aside and postpone important decisions until you have successfully quit and feel confident in your success.

Engage in as many pleasurable activities as you can.

Pleasurable activities can serve as a good distraction. They also reduce stress.

Plan for a few weeks of discomfort as your body adjusts away from the physical addiction.

Breaking free from a physical addiction takes time for the body to adjust and stabilize. Plan for it so that your expectations are realistic. It also can help knowing that the unsettledness is temporary and will end when the body has had sufficient time to adjust.

Do your best to contain your moods.

Your upsetness and irritability will be temporary. Containing yourself in the meantime will make the transition easier on you, your body, and your loved ones. Keeping yourself contained will also prevent strong emotions from increasing stress.

Get physical.

Physical activity increases dopamine. Physical activity can also serve as a distraction and exercise your lungs. Regular physical activity can also reduce stress and withdrawal symptoms. All of these can benefit you as you break free from nicotine.

Don’t diet when you are quitting.

Quitting one habit is enough. Once you have successfully quit smoking, then you can decide what other changes you’d like to make. But, do try to eat healthy. Eating nutritious whole and natural foods also reduces stress and gives the body important nutrients required to replenish those depleted by stress.

Get therapy.

Professional help and support can be especially helpful. Not only can a professional therapist provide ongoing guidance and reassurance while you are breaking free of the addictive effects of nicotine but he/she can also help you address your anxiety issues. All of which can make breaking free much easier.

If you don’t succeed, try again.

You can try as many times as it takes to succeed. View quitting smoking as a process and not as a one-time, make-it-or-break-it event. It takes the average person multiple attempts before experiencing success, so don’t give up. 

Give yourself a break.

Quitting smoking isn’t easy. It can be especially difficult with anxiety disorder. Offer yourself plenty of grace. There will be ups and downs. Accept them, regroup, and keep going. You can get there with perseverance and determination, which are similar skills required to overcome anxiety disorder.

You can use quitting smoking as a training ground to learn and anchor those important skills.

Reward yourself when you succeed.

Celebrate your victory and enjoy the fruits of it. There’s nothing wrong with being satisfied with your effort and success. Even treat yourself, if you want. That treat can be anything you want as long as you can realistically afford it.

I’m not going to suggest quitting is easy. It’s not and for many reasons. But quitting will help in your desire to overcome anxiety disorder and its symptoms. Quitting smoking is a goal well-worth pursuing and working at, similar to that of overcoming anxiety disorder.

You’ll thank yourself when you begin to experience improved health and quality of life!

What happens if my anxiety increases after quitting smoking?

Typically, anxiety decreases after smoking.[11] But if you notice an increase, it could be coming from a couple of sources:

1. Stress

As we mentioned, quitting smoking is stressful. If you’ve just quit and feel more anxious, that feeling could be coming from the increase in stress as stress can cause an increase in feeling anxious.[12]

If you work at containing your anxious feelings and reducing your body’s stress, you should see this feeling diminish as your body recovers from the stress of quitting. A reduction in stress will cause a reduction in the feelings of anxiety.

2. Anxious behavior

Changing habits can also be stressful and anxiety provoking, especially if a person is worried about the change and what lies ahead. Adopting healthy anxiety coping strategies can help reduce this type of anxious behavior.

Working with an experienced anxiety disorder therapist is the most effective way of overcoming problematic anxiety. The therapist can help you identify and address the underlying factors that cause issues with problematic anxiety. Once you’ve successfully addressed those issues, they no longer cause problems with anxiety.

In the meantime, here are a few tips to help if you notice an increase in anxiety after quitting:

  • Remind yourself that this increase in anxiety is temporary and will subside as your body adjusts away from the nicotine and stress of quitting. Many people find they feel much better within a few weeks of quitting.
  • Avoid stimulants. Stimulants stress the body, which can increase the feelings of anxiety. Avoiding stimulants can help the body adjust away from nicotine naturally.
  • Avoid high sugar and junk foods. Sweets and junk foods stress the body.
  • Increase regular deep relaxation. Regular deep relaxation is a proven method for reducing stress.
  • Increase regular light to moderate exercise. Exercise increases dopamine and reduces stress. Both helpful after quitting.
  • Reduce stress wherever you can. This will help the body adjust and speed up the adjustment period.
  • Spend time in nature. Also proven to reduce anxiety and stress.
  • Engage in pleasurable activities. Increasing pleasure reduces anxiety and stress.

What happens if quitting smoking causes panic attacks?

Panic attacks are nothing more than high degree episodes of anxiety that are accompanied by high degree stress responses. You can learn more about panic attacks and how to stop them in our “Anxiety Attack Symptoms” section.

For more information about quitting smoking, visit the National Cancer Institute’s “How To Handle Withdrawal Symptoms and Triggers When You Decide To Quit Smoking” article.

We wish you every success in quitting smoking!


The combination of good self-help information and working with an experienced anxiety disorder therapist is the most effective way to address anxiety disorder and its many symptoms. Until the core causes of anxiety are addressed - the underlying factors that motivate apprehensive behavior - a struggle with anxiety disorder can return again and again. Identifying and successfully addressing anxiety's underlying factors is the best way to overcome problematic anxiety.


Additional Resources:


Return to Anxiety Frequently Asked Questions section.


REFERENCES:

1. Herman, Aryeh, et al. "PHARMACOGENETICS OF NICOTINE ADDICTION: ROLE OF DOPAMINE." Pharmacogenomics, 15 Feb. 2014.

2. Dfarhud, Dariush, et al. "Happiness & Health: The Biological Factors- Systematic Review Article." Iranian Journal of Public Health, Nov. 2014.

3. Felman, Adam. “Nicotine: Facts, Effects, and Addiction.” Medical News Today, MediLexicon International, 11 Jan. 2018.

4.  Lovallo W.R., et al. "Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels." Psychosom. Med. 2005;67(5):734–739. doi: 10.1097/01.psy.0000181270.20036.06.

5. Benowitz, Neal L. "Nicotine Addiction." New England Journal Of Medicine, 17, June 2010.

6. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

7. Harvard Health Publishing. “Understanding the Stress Response.” Harvard Health, May 2018.

8. Mariotti, Agnese. “The Effects of Chronic Stress on Health: New Insights into the Molecular Mechanisms of Brain–Body Communication.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Nov. 2015.

9. Salim, Samina, "Oxidative Stress and the Central Nervous System." The Journal Of Pharmacology and Experimental Therapeutics, January 2017.

10. McMaster. “Ready to Quit Smoking? Group Therapy Boosts Your Chances of Success.” Ready to Quit Smoking? Group Therapy Boosts Your Chances of Success, McMaster Optimal Aging Portal, 8 Jan. 2018.

11. Taylor, Gemma, et al. "Change in mental health after smoking cessation: systematic review and meta-analysis." The British Medical Journal, 2014.

12. Berczi, Istvan. “Walter Cannon's ‘Fight or Flight Response’ - ‘Acute Stress Response.’” Walter Cannon's "Fight or Flight Response"  - "Acute Stress Response", 2017.


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