Does Nicotine Cause Anxiety?

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Rachel Sacks

Updated 12/26/2022

Anxiety is something we all experience. From stress over money problems to worry about the future, there can be many different things that cause our levels of anxiety to increase. If you’re feeling more anxious lately, you may want to get to the bottom of what’s causing your anxiety.

With so many different causes, you may wonder if nicotine causes anxiety. An estimated 30.8 million U.S. adults were regular smokers (smoked every day or most days) in 2020. Meanwhile, over 40 million adults have anxiety disorders.

We may reach for a cigarette when we want to calm our nerves, but is there a connection between nicotine and anxiety?

This article will cover everything you need to know about the relationship between smoking and anxiety.

Before we answer the question of whether nicotine causes anxiety, or if vaping nicotine causes anxiety, we’ll go over the basics of anxiety.

When you feel stressed or anxious about something — whether it’s work, an upcoming event or something else — your body is protecting you by becoming more aware of any potential dangers and going into “fight-or-flight” mode.

If stress and anxiety are constant and start interfering with your daily life, career or relationships, you could be dealing with a mental health issue like an anxiety disorder.

Anxiety disorders are a group of mental health conditions that affect your behavior, thoughts and emotions. There are several types of anxiety disorders, including the five major types:

Symptoms of anxiety disorders can vary by the exact type. For example, a symptom of panic disorder is the occurrence of panic attacks — sudden waves of anxiety or fear with no clear danger or trigger present.

However, there are some common anxiety symptoms, which include:

  • Feelings of panic and excessive worry

  • Thoughts you can’t control and obsess over

  • Heart palpitations

  • Chest pain

  • Shortness of breath

  • Inability to stay calm

  • Excessive sweating

  • Difficulty sleeping

While experts don’t know exactly what causes anxiety disorders, certain factors like chemical imbalances or genetic and environmental factors could play a role.

There are many possible causes of anxiety. Could smoking be one? Does vaping nicotine cause anxiety?

If you deal with an anxiety disorder like generalized anxiety disorder, trying to find relief is a constant struggle. Some people may self-medicate and turn to smoking or vaping to soothe their nerves.

Over 12 percent of the U.S. population smokes, and a connection has been found between nicotine and mental health conditions such as major depression and anxiety disorders. A 2008 review of studies reported that those with psychiatric disorders were almost twice as likely to smoke nicotine compared to people without mental health conditions.

According to 2019 data from the Centers for Disease Control and Prevention (CDC), about 45 percent of people who use tobacco products also had severe anxiety, while 30 percent reported mild anxiety.

Regular smokers were also found to be more likely to develop PTSD after a traumatic or dangerous event.

A higher risk for panic attacks, as well as early onset of panic disorder, is also connected to regular smoking. Teens who smoke daily have been found more likely to develop panic disorder and have panic attacks in early adulthood.

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While there’s certainly a connection between nicotine and anxiety, does nicotine cause anxiety directly? The answer is less clear.

Many studies suggest that nicotine can affect our levels of anxiety, how we respond to stress and our feelings of depression. But the effects of nicotine on anxiety can either reduce anxiety levels or increase stress and anxiety, depending on some factors.

Smoking and anxiety can form a vicious cycle. Many people who have anxiety may smoke to relax but then might experience nicotine withdrawal symptoms that are similar to those of anxiety symptoms when they try to quit smoking — or have anxiety itself when quitting.

While it may be tempting to smoke when you’re feeling anxious, there are healthier ways to deal with anxiety.

Therapy and medication are two common options for treating anxiety disorders.

Psychotherapy — or talk therapy — generally involves identifying unhealthy thoughts and behavior patterns and learning ways to cultivate healthier thought patterns or to use mindfulness to reduce anxiety.

Medication can help relieve symptoms of anxiety, with antidepressants, anti-anxiety medicines and beta-blockers being common choices. The antidepressant bupropion (Wellbutrin) has also been found to help people quit smoking.

Our complete guide to medications for anxiety goes into more detail about what medications are used for anxiety and how they work. Or you can start a consultation with a mental health professional to find a treatment plan that works for you — whether it’s therapy, medication or both.

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Does nicotine cause anxiety? There’s certainly a connection between the two. Those with mental health conditions — like anxiety disorders — are one of the top groups of people who are regular smokers.

Other research has found that smoking can lead to anxiety and major depression for some. But other people may find relief from anxiety symptoms through smoking or vaping.

But while one of the effects of nicotine may be temporary relief of symptoms of anxiety disorders, this can lead to developing a nicotine dependence — which then increases the desire to smoke due to withdrawal symptoms, which are similar to feelings of anxiety.

16 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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  5. NIMH » Panic Disorder: When Fear Overwhelms. (n.d.). NIMH. Retrieved from
  6. National Institute of Mental Health (NIH). Anxiety Disorders. (2022). Retrieved from
  7. Anxiety Disorders: Types, Causes, Symptoms & Treatments. (2020, December 17). Cleveland Clinic. Retrieved from
  8. Kutlu, M. G., Parikh, V., & Gould, T. J. (2015). Nicotine Addiction and Psychiatric Disorders. International review of neurobiology, 124, 171–208. Retrieved from
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  12. Picciotto, M. R., Brunzell, D. H., & Caldarone, B. J. (2002). Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport, 13(9), 1097–1106. Retrieved from
  13. Tips for Coping with Nicotine Withdrawal and Triggers. (2022, January 3). National Cancer Institute. Retrieved from
  14. Hughes, J. R., Stead, L. F., Hartmann-Boyce, J., Cahill, K., & Lancaster, T. (2014). Antidepressants for smoking cessation. The Cochrane database of systematic reviews, 2014(1), CD000031. Retrieved from
  15. Top 10 Populations Disproportionately Affected by Cigarette Smoking and Tobacco Use. (n.d.). American Lung Association. Retrieved from
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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