Let’s be clear — addiction is not good for mental health. So much so that Tobacco Use Disorder (the name given to nicotine dependence) is a recognised psychiatric disorder.
Of course the Be Free campaign is not about medical terms, but the conversations, attitudes and perceptions in the places where young adults spend their time — and these are a quite different story. Here we often find a view that smoking helps people to calm down and feel better. But while we recognise that this is what people will generally report as the experience of having a cigarette, there is a huge difference between that immediate impression and the overall effect that smoking has on a young adult.
There are many different things going on when someone has a cigarette “to calm down”. There is a distraction/displacement of attention or the pleasure of a nicotine “hit”, there is often the impact of physically moving away from an issue, environment or incident or the benefit of gaining a break, and there is the comfort of carrying out a simple, routine activity. There will also be the relief of nicotine withdrawal symptoms, which include cravings, irritability, anxiety, restlessness and difficulty concentrating.
When talking of the impact of smoking on mental well-being we need to clearly distinguish between this immediate feeling of relief, and the overall impact on the individual.
The simple fact is that you can’t get the pleasure of relief from withdrawal symptoms without first having to experience the unpleasant withdrawal symptoms — taking off shoes that are too tight is a pleasure, but it requires having to wear shoes that are too tight.
We also need to factor in the other effects of smoking, such as feeling less well generally, or of being unable to settle or focus on what needs doing. We have to balance the identification that some people get from being smokers, with the awareness that they are addicted, an identity that few young people will enjoy (we are aware that young people may not consider themselves to be either smokers or addicts until they try to quit).
This is a complex balancing act, which is difficult to predict and while there are correlations between smoking and poor mental health in adolescents, we cannot simply assume that one leads to the other. Crucially, we don’t need to — because we can, and do, ask people who smoke what conclusions they themselves come to. And people who smoke, on the whole, say that smoking does not make them happier, but that stopping smoking does.
We know that most people who smoke say that they want to stop, and an even higher proportion of people who smoke say that they regret ever having started. This suggests that, weighing up the pros and cons, most people who smoke conclude that the negatives outweigh the positives.
Of course it could be true that smoking makes people happy, but that they don’t want the financial costs and health risks. But we also know that people who smoke report being less mentally well than those who do not.
This correlation alone can’t tell us if smoking is a help or a hindrance but, in other research, people who stop smoking report that they are happier after they do so.
And other studies indicate that stopping smoking is associated with improved outcomes in depression, anxiety, stress and psychological quality of life, that smoking is ineffective at reducing depressive symptoms and that the perceived positive benefits are actually linked to the alleviation of cravings and withdrawal symptoms.
The conclusion that smoking is not an effective or beneficial coping mechanism is clear. Yet this still leaves the fact that many young adults are looking for a coping mechanism to deal with stress, anxiety, boredom or social isolation. The best way to undermine that lingering appeal of smoking is to ensure that other, more effective and helpful, coping mechanisms are available.