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The Nexus between mental health and smoking

A common perception prevalent in the smoking ambience is that it helps relieving work and life related stress. Irrespective of the scientific credibility of this perception, it is integral to elucidate the nexus between smoking and its effects on mental health of the smokers.


How does smoking provide relief from stress?

Tobacco contains nicotine, an addictive chemical substance which gets absorbed in the blood of the smoker in smoked form. The consumption of Nicotine prompts the production of Dopamine in the body, a neurotransmitter linked to the sense of pleasurable experiences. Smokers establish consistent habitual patterns to maintain a steady dopamine release. When nicotine levels dip, cravings emerge, inducing a perceived 'stress' until satisfied by a cigarette. The relief experienced upon satisfying this craving is commonly termed 'relaxing.' Over time, smokers develop a tolerance, requiring higher nicotine levels for a sense of 'normalcy.' This dangerous addiction helps relieving stress which in turn is stimulated by the non-consumption of it. The cycle of 'relief' which is habitually developed in this process provides a temporary and false sense of relief.


The relation between smoking and mental health

There is evidence suggesting a link between smoking and the onset of a mental health condition. A population-level study revealed an increased risk of developing a mental health condition among individuals who smoked but had no prior history of such conditions. Conversely, mental health issues like anxiety and depression may contribute to smoking initiation, although evidence is inconsistent. Daily tobacco use was associated with a higher risk of psychosis and an earlier onset of psychotic illness, but causation couldn't be established. Various factors, including genetic vulnerability and a potential self-medication attempt for symptoms, may contribute to the high smoking rates in individuals with mental health conditions.


Smokers who have a mental health condition experience a heightened connection between smoking and a sense of relaxation. It's widely held that individuals with mental health issues turn to tobacco as a form of self-medication. However, the relief from nicotine withdrawal is short-lived, and persistent smoking can worsen existing problems. Those with a mental health condition often exhibit stronger addiction to smoking, with an increased number of cigarettes correlating with a higher likelihood of developing mental health issues. The severity of the mental health condition is directly linked to a higher likelihood of being a smoker. This invariable correlation between smoking and mental health creates a vicious cycle of temporary relief and long-term medical as well as lifestyle compromise.


Life-threatening consequences of smoking

Smoking is linked to an elevated risk of major depression, with adults experiencing depression having twice the smoking rates of those without depression. Individuals with depression often have low dopamine levels and may use cigarettes temporarily to boost dopamine and experience pleasurable feelings. However, smoking can negatively impact the brain's natural dopamine production mechanism, leading to a long-term decrease in supply and an increased tendency to smoke. While most people begin smoking before showing signs of depression, evidence suggests that, beyond depression triggering smoking initiation, smoking might be a causal factor in depression. While a definitive link between smoking and bipolar disorder is not firmly established, the prevalence of smoking among individuals with bipolar disorder is notably higher than in the general population. A study on bipolar disorder patients revealed that smokers tended to experience an earlier onset of the disorder, more severe symptoms, a higher likelihood of suicide attempts, and co-existing conditions such as anxiety or substance use disorder. Another study identified an association with suicide ideation in this context.


Smoking is not only a menace to an individual's health, but also is a major toxic pollutant that affects aquatic ecosystems and food chains. It is imperative that we take responsibility as a society to instigate upon our choices of comfort and leisure.

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