Posted on March 7, 2014 in Mental Health

Can Smoking Lead to Psychological Distress?

Psychological distress is a term mental health professionals use to describe the negative mental/emotional effects of day-to-day encounters with stressful events or situations. People affected by serious forms of this distress have heightened risks for eventually developing some form of diagnosable mental illness. According to the results of a study published in late 2013 in the journal Tobacco Control, people who smoke cigarettes have an increased likelihood of experiencing psychological distress. Conversely, habitual smokers who break their reliance on nicotine decrease their chances of experiencing worsening forms of psychological distress.

Psychological Distress Basics

Psychological distress is not a mental illness; instead, it functions as something called a “nonspecific indicator” for mental illness. This means that people affected by psychological distress have a greater likelihood of developing a diagnosable mental disorder if their stress levels are not reduced or moderated in some way. Specific conditions associated with unrelieved psychological distress include bipolar I disorder, major depression, schizophrenia and a number of ailments classified as anxiety disorders. The American Psychiatric Association also considers the presence of an impairing level of distress as a diagnostic criterion for a broad range of other mental health problems. Mental health professionals can detect the presence of psychological distress with the help of two brief patient questionnaires called the K6 Scale and the K10 Scale.

Smoking and Mental Health

Doctors and researchers already know that people affected by mental illness smoke more often than psychologically healthy people. A range of factors help explain this increased level of smoking, according to the authors of a report published in June 2013 in Monitor on Psychology. For example, a person affected by mental illness may use the powerful drug actions of nicotine to either self-medicate his or her symptoms or to counteract the side effects of certain medications. People affected by mental illness are also commonly exposed to socioeconomic factors that increase their chances of taking up smoking.

Other possible factors include the potential for nicotine addiction shared by all people exposed to cigarette use, as well as the tendency of many mental health treatment programs to allow smoking or even promote smoking as a reward for program participants. On the whole, people with serious forms of mental illness who receive treatment through public facilities die more than two decades earlier than their contemporaries unaffected by mental illness. Smoking-related illnesses account for a substantial portion of this loss of lifespan.

Recent Findings

In the study published in Tobacco Control, researchers from New Zealand’s University of Otago used information from a large-scale, long-term project called the New Zealand Survey of Family, Income and Employment to assess the impact of cigarette smoking on the chances of being affected by psychological distress. This survey was conducted on a yearly basis; the University of Otago researchers compared the smoking rates and the psychological distress rates for the survey years 2004/2005, 2006/2007 and 2008/2009. Information on distress rates in the survey participants was gathered through the use of the K10 Scale. Before drawing their conclusions, the researchers took steps to account for and eliminate the potential influence of socioeconomic standing and all other known factors that can increase a person’s chances of experiencing psychological distress.

After eliminating other potential influences, the researchers concluded that people who smoke cigarettes do have a higher average level of psychological distress than people who don’t smoke cigarettes. However, the impact of cigarette use ranks as “modest” rather than extreme. The researchers also concluded that when current smokers quit, they experience a brief increase in their levels of psychological distress. However, after they adjust to a cigarette-free lifestyle, their levels of distress subside and do not rise again over time. Conversely, current smokers whose quitting efforts are unsuccessful do experience a longer-term boost in their distress levels.

Significance and Considerations

The authors of the study published in Tobacco Control believe that they have uncovered a genuine link between ongoing cigarette use and increased chances of experiencing psychological distress. However, they also believe that further research on the subject is required before public health officials could safely add warnings on psychological distress to current campaigns designed to deter cigarette use or encourage smoking cessation in current users.

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