This section explains how smoking affects mood, why it may feel pleasurable in the short-term through the alleviation of nicotine withdrawal symptoms and dopamine release, and its association with lower psychological wellbeing.
Tobacco smoking is considered pleasurable by many people who smoke.1 The perceived enjoyment and relaxation from smoking are the most commonly reported reasons for not intending to quit among Australians who currently smoke2. The extent of this pleasure appears related to the quantity of nicotine consumed.3 Nicotine consumption is associated with dopamine release within brain regions associated with experiences of reward and pleasure (see Section 6.4 Pharmacological effects). However, the stimulating effects of nicotine quickly decline (see Section 6.2 Pharmacokinetics), and the pleasurable effects of smoking can largely be attributed to alleviation of nicotine withdrawal symptoms.4 As nicotine levels decline, people who smoke may experience irritability, anxiety and low mood, which are temporarily relieved by smoking, reinforcing the perception that smoking improves mood. These effects may contribute to smoking being used as a form of ‘self-medication’ to relieve feelings of anxiety, stress, boredom, and symptoms of mental health conditions (see 9A.3.3 on explanations for higher smoking prevalence among people with substance and mental disorders).5
Despite the perceived benefits of smoking on mood and mental health,5 people who smoke tend to report lower overall levels of psychological well-being than non-smokers and ex-smokers.6 Quitting smoking is associated with improvements in mood, psychological quality of life and mental health compared to continued smoking.5,7 See Section 9A.3 for a detailed overview of smoking and mental health and Section 18.6.10 for a discussion of e-cigarette use and mental health.
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References
1. de Wit H and Zacny J. Abuse potential of nicotine replacement therapies. CNS Drugs, 1995; 4:456–68. Available from: https://link.springer.com/article/10.2165/00023210-199504060-00008
2. Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2022–2023 – 2. Tobacco smoking. Canberra: AIHW, 2024. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey/data.
3. Pomerleau CS and Pomerleau OF. Euphoriant effects of nicotine in smokers. Psychopharmacology (Berl), 1992; 108(4):460–5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/1410160
4. Advocat C, Comaty J, and Julien R, Julien’s primer of drug action. 13th edNew York: Worth Publishers; 2014. Available from: http://www.ncbi.nlm.nih.gov/nlmcatalog/101666863.
5. Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, et al. Change in mental health after smoking cessation: systematic review and meta-analysis. British Medical Journal, 2014; 348:g1151. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24524926
6. West R. Beneficial effects of nicotine: fact or fiction? Addiction, 1993; 88(5):589–90. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8043039
7. Taylor GM, Lindson N, Farley A, Leinberger-Jabari A, Sawyer K, et al. Smoking cessation for improving mental health. Cochrane Database of Systematic Reviews, 2021; 3(3):CD013522. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33687070