Nicotine is an addictive stimulant drug present in tobacco and most vaping products. It’s also an anxiolytic, meaning it reduces anxiety. Nicotine withdrawal can cause nicotine cravings and increased anxiety levels.

This article outlines the link between nicotine and anxiety and considers whether nicotine can react with anxiety medications. It also considers whether or not quitting smoking or using nicotine-free vapes can affect your anxiety levels.

There are also some helpful resources for those looking to quit smoking or vaping.

Anxiety is a psychological and physical state that involves feelings of concern or worry, along with muscle tension and avoidance behaviors. Although anxiety is a normal reaction to stress, severe anxiety that interferes with daily functioning may indicate an anxiety disorder.

A 2020 review found that people with high levels of anxiety are more likely to use e-cigarettes.

Data from the Centers for Disease Control and Prevention (CDC) also shows an association between anxiety and tobacco use. In 2020, 45% of individuals with severe anxiety reported using tobacco, compared with 30% of people with mild anxiety and 18% of people with little to no anxiety.

As the review notes, the relationship between anxiety and nicotine involves a negative feedback loop. Nicotine is an anxiolytic drug, meaning it reduces anxiety levels. As such, people with higher anxiety levels may be more likely to use it to regulate their mood.

Over time, they may become dependent on nicotine to deal with everyday stress. Without nicotine, they may experience withdrawal and increased anxiety, which are hallmarks of severe nicotine addiction.

Most people who ingest nicotine do so in the form of smoking tobacco. In the majority of cases, it’s the tobacco smoke rather than the nicotine that interacts with certain medications.

Some anxiety medications that tobacco smoke can interact with include:

Some manufacturers market nicotine-free e-cigarettes and vapes as a means to help manage anxiety. However, there’s no evidence that nicotine-free vaping helps with anxiety.

In fact, a 2021 animal study found that nicotine-free vapor inhalation caused anxiety-like behaviors in mice. However, this study has yet to be replicated in humans, so it’s not clear if humans would experience the same effects.

As the CDC notes, more research is needed to understand the connection between vaping and mental health. Nonetheless, nicotine-free e-cigarettes and vapes contain a host of other chemicals that are harmful to health, so using them to treat anxiety isn’t recommended.

Quitting nicotine can lead to nicotine withdrawal. This is a combination of physical and psychological symptoms that someone may experience when cutting back on or quitting an addictive substance.

Anxiety is a common psychological symptom of nicotine withdrawal. It’s often most severe in the days or weeks after quitting. But after a few months without nicotine, most people find that their anxiety levels are lower than when they were smoking.

Some tips to help alleviate anxiety while quitting smoking include:

  • Being physically active: Physical activity can boost your mood. If you’re not used to regular exercise, start with a gentle walk and gradually increase your activity levels over time.
  • Keeping mentally busy: Keeping your mind occupied can help distract you from nicotine cravings and anxiety. Options to consider include doing chores, going for a walk, or engaging in a fun hobby.
  • Connecting with others: Try to maintain contact with people who support your efforts to quit smoking. Doing so can help boost your mood and motivation.
  • Rewarding yourself: Set aside some time for events, interests, or enjoyable activities. Even simple pleasures like reading a good book or listening to music can help balance your mood.
  • Talking with a doctor or mental health professional: If anxiety or other symptoms of nicotine withdrawal become unmanageable, consider talking with a doctor or therapist for additional help.

Helpful resources

Some resources that can help you quit smoking include:

  • the CDC smoking quitline: 1-800-QUIT-NOW
  • the National Cancer Institute smoking quitline: 1-877-44U-QUIT
  • the American Lung Association smoking cessation program: “Freedom From Smoking
  • the American Cancer Society email-based smoking cessation program: “Empowered to Quit
  • the National Institutes of Health (NIH) personalized Quit Plan
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Nicotine is a highly addictive drug present in tobacco products. It also produces an immediate anxiolytic effect. However, because this effect is temporary, you may feel the need to use nicotine regularly to help cope with everyday stress. This can lead to nicotine addiction.

Quitting smoking can lead to nicotine withdrawal, and this in itself can trigger or worsen anxiety in the short term during recovery. But quitting smoking is known to reduce anxiety levels in the long term.

If you’re having nicotine withdrawal symptoms like anxiety, consider contacting a doctor for additional help. Or you could try phoning a smoking cessation helpline or using one of the online resources listed above.

Some other things that may help you manage nicotine cravings and reduce anxiety levels during this time include keeping busy, connecting with others, and rewarding yourself with enjoyable activities.