Does Nicotine Cause Anxiety?

Nicotine and Anxiety

The common myth is that nicotine decreases anxiety and that when feeling anxious having nicotine will ease the anxious feeling. The truth is that continued use of nicotine only eases the withdrawal symptom of nicotine.  This relief felt from nicotine is only temporary. (1) It is not addressing the underlying issue of the anxiety, which is why the anxiety inevitably returns. Since the temporary feeling of relief occurs using nicotine, the use increases which increases the anxiety over time. So, does nicotine cause anxiety?

What is Nicotine? 

Before we can explore the relationship between nicotine and anxiety, it’s important to understand what nicotine is. Nicotine is a substance found in tobacco leaves and certain plants that acts on the brain as a stimulant. It has an effect on the body similar to caffeine, although its effects are much shorter-lived. When someone smokes or vapes cigarettes or uses other nicotine products, these products deliver high concentrations of nicotine into the bloodstream quickly. This causes many short-term effects like increased heart rate and blood pressure, which can lead to feelings of nervousness and jitteriness in some people. 

Long-Term Effects of Nicotine & Anxiety 


Long-term exposure to nicotine has been linked to an increased risk of developing panic disorders and GAD. Studies have also shown that people who smoke have higher levels of cortisol (a hormone released during times of stress) than nonsmokers do — suggesting that chronic exposure to nicotine may affect hormones related to stress levels and create a more anxious state overall. Additionally, research suggests that smoking may worsen existing mental health conditions like depression or bipolar disorder by causing changes in neurotransmitter levels associated with these conditions.   

Nicotine Effects on the Body 

Ongoing use of nicotine, as many of us know, can increase health concerns, in turn increasing mental health issues with depression, stress, and anxiety. The effects nicotine has on the body are increased risk of cardiovascular issues and respiratory and gastrointestinal disorders. Nicotine decreases the immune response and increases oxidative stress and is widely known to increase the risk of cancer. (2)

Nicotine Cravings and Withdraw

Nicotine withdrawal is one of the main reasons people find it so difficult to quit smoking cigarettes. The symptoms of nicotine withdrawal can be extremely unpleasant, and they can make it very tempting to start smoking again. However, there are ways to deal with nicotine withdrawal so that you can successfully quit smoking for good.

Withdrawals can be uncomfortable but it’s important to remember that withdrawal is not dangerous and the worst symptoms or cravings last only a couple of days to a couple of weeks. The most common withdrawal symptoms are cravings, feeling down or sad and sometimes depressed, feeling irritable or on edge, having trouble concentrating, being restless, slower heart rate, feeling hungry, and even experiencing weight gain. (1) 

Using coping strategies during these times can relieve a lot of withdrawal symptoms experienced. It is also important to have awareness of triggers. Triggers are reminders in your daily life that trigger your desire. They can be social triggers, such as being in a social gathering where you use to use or where others use; emotional triggers, such as feeling stressed and anxious, bored, lonely, sad, frustrated, or upset after an argument, or even happy or excited; Pattern use or activity triggers are things like using after you eat, being in a car, with drinking coffee or an alcoholic beverage. 

Knowing your triggers can help you create plans for when they pop up. To resist you may need to limit your contact with other nicotine users and avoid certain activities in the early stages of quitting. (3)

Nicotine withdrawal is the set of physical and psychological symptoms that occur when a person who smokes cigarettes suddenly stops using nicotine. These symptoms can range from mild to severe but they are only temporary. There are a few things you can do to ease the symptoms of nicotine withdrawal including staying busy, exercising, and reaching out for support from family and friends or joining a support group for people who are trying to quit smoking. Quitting smoking is difficult but it’s important to remember that you are not alone and that there are resources available to help you succeed.

Coping Without Nicotine

Stress can be a good thing in life when it’s at a level that helps us achieve our goals and is controllable. Too much stress creates more problems. If you are looking at quitting nicotine, first look at lowering your stress levels. Often nicotine use increases in times of high stress, if stress is more manageable, it will help with the withdrawals and cravings. Here are some stress-reducing practices to try: (1)

  • Grounding exercises – such as breathing exercises and visualizations.
  • Self-care – Taking a warm bath, getting a massage, stretching out the tension in different areas of your body.
  • Physical health needs – Regular exercise and healthy balanced meals.
  • Mindfulness – Focus on the here and now and try not to get caught up in worrying about what is going to happen next.
  • Support system – regularly talk with the people who care about you. Stress doesn’t have to be handled alone.
  • Practice acceptance – remind yourself there are good days and there are bad days. 
  • Decaffeinate – Caffeine can increase anxiety making you feel tense and jittery. Switching to decaf, herbal tea, or hot water with lemon can help.

What To Do

Discuss your nicotine use with your doctor but be transparent about your anxiety. Your doctor may encourage you to quit at a time when your anxiety and stress are high. Get assistance through therapy and or treatment for your anxiety for a better chance at quitting nicotine. Therapies such as cognitive behavioral therapy (CBT) and dialectical therapy are a couple of modalities that can be very helpful. In some instances, your doctor may want to suggest a psychotropic medication to aid in reducing anxiety and even nicotine replacement therapy (NRT). Research has shown that using such NRTs as nicotine patches increases the chance of quitting by 50-60%. (2)