It’s your first month in your first year at university. Away from home in an unfamiliar city, juggling between classes and residence, the library and the pubs, it’s not at all what you expected. You miss home, can’t connect with fellow students, and are unhappy with more than a few of your classes. So you seek comfort in a faithful friend: cigarettes. Your cigarette consumption has gone through the roof and you do not like it. But, you reason, “smoking makes me feel better.”
Smokers often say that one of the benefits of their habit is that it works to counteract negative moods and relieve stress. Among smokers, one of the most common justifications for cigarette use is self-medication. Contrary to this belief, a recently published article in the journal Addictive Behaviors showed that smoking actually increases depressive symptoms in teens.
The findings are part of a long-term Nicotine Dependence in Teens cohort study based at the University of Montreal Hospital Research Centre. The NDIT study began in 1999 under the direction of Dr. Jennifer O’Loughlin, a professor at the University of Montreal’s Department of Social and Preventive Medicine, and scientist at the University of Montreal Hospital Research Centre.
“We were interested in the idea of self-medication as one of the reasons why we think people start and continue to smoke, and why we see a relationship between smoking and depression,” says lead author Dr. Michael Chaiton, a professor in Tobacco and Public Health at U of T and a scientist at the Ontario Tobacco Research Unit. “Many people report that smoking has a positive effect on their mood, however our findings suggest that smoking worsens both mood and, perhaps, one’s ability to deal with stressful situations.”
The study involved about 662 high school students, who were divided into three different groups: never smokers, smokers who did not use cigarettes to self-medicate, improve mood or physical state, and smokers who used cigarettes to self-medicate. The depressive symptoms of each group of participants were measured using the Depressed Mood Inventory, a scale that asked questions such as how often subjects felt unhappy, sad or depressed, or too tired to do things. The participants’ reported moods were analyzed before and after smoking. Before beginning to smoke, subjects who used cigarettes to self-medicate and those who did not, reported no differences in depressive symptom scores.
However, as Michael Chaiton explains, “After subjects began smoking, you saw a large difference in the depressive symptoms of teenagers who reported that cigarettes improved their mood, and those who did not use cigarettes to self-medicate. Those adolescents who reported emotional benefits from smoking were more likely to experience more serious depressive symptoms over time.”
Although cigarettes might have short-term benefits for smokers, in the long term, they are more likely to cause depressive symptoms. “When people say they feel better after a smoke, it’s a real experience,” says Chaiton. “Smoking after craving a cigarette relieves your symptoms of withdrawal. However, what often occurs is that during stressful situations, that feeling of relief gets translated into ‘smoking is also helping me.’ This is the case in the short term. Over the long term, smoking exacerbates negative mood.”
In a related study, researchers found that people who quit smoking start to feel better about six weeks after quitting. Their mood improves after the withdrawal period.
Michael Chaiton, along with other researchers of the NDIT study are continuing to measure depressive symptoms in the high school participants who are now in their twenties, and are examining how the effects of smoking on depression change over time. What is certain is that there is a strong relationship between smoking and depression. As Chaiton suggests, “When you are smoking, you have a worse mood than when you are not… One of the best ways to deal with negative moods and stress is to quit smoking.”
