Is There A Connection Between Nicotine And Depression?

Reviewed by Laura Angers, LPC

Published 12/30/2020

Have you ever noticed you or someone you know smoking or vaping more during depression? What’s that about? Researchers are just beginning to explore the connection between nicotine and depression. While no one suggests that smoking or vaping is the right solution for mental illness, there may be some fascinating possibilities ahead.

Do People With Depression Use Nicotine More?


Many studies have been done on nicotine and depression. They all seem to agree that people who smoke are more likely to be depressed. What’s more, the more they smoke, the more severe their depression. And the connection is there in depressed people of every age group and gender.

Let’s get a bit more specific. A CDC statistics page from the NCHS shows the details. For example, among people under 55 years old, about half of those with depression smoked. But for the same age group, only about one-fourth of those without depression smoked. Not everyone who has depression smokes, and not everyone who doesn’t have depression is a non-smoker. Nonetheless, it’s enough of a difference to suggest that there’s some kind of connection beyond coincidence.

Most studies of nicotine use and depression have focused on smokers and non-smokers. But a 2016 study of e-cigarette users found similar results. This study found that both current and former e-cigarette users were also more likely to have a history of depression than those who never used vaped.

Which Comes First – Nicotine or Depression?

One of the most interesting questions in this field of study has puzzled scientists so far. That is, does using nicotine cause depression? Or does depression make you more likely to smoke? At this point, the studies haven’t revealed a clear answer.

One review of nicotine depression studies found that the conclusions of the studies were very inconsistent. In half of the studies from the review, people with depression later increased their smoking. After being depressed, they either started smoking or smoked more heavily.

But that’s not the end of the story. About a third of the studies showed the opposite direction—those who smoked first later developed depression. There could be several reasons for this seemingly conflicting evidence, many of which have to do with how the studies were designed.

However, there’s also another possibility. It could be that it works both ways. Depression might lead to nicotine use for some. And nicotine use may lead to depression for others. The bottom line is that neither smoking nor depression is healthy. So, if avoiding one helps you avoid the other, it’s worth doing whatever you can do about whichever you’re dealing with now.

Why The Connection?


The evidence of a link between nicotine and depression is beginning to stack up. But along with it, researchers have another question. How are these two things related? Why do they so often occur together? This is an important question to answer because once that is known, it may suggest solutions for both problems.

Genetic Factors

Your genes may make you more likely to smoke or vape and to have depression. Many of the same genes impact both nicotine dependence and depression. But does this mean that you can’t do anything about smoking or depression?

The answer to that is no, but you may have more work to do than someone without your genetic makeup. Quitting nicotine use may be harder for you. Dealing with your depression might not be as easy for you as for someone who doesn’t have the same genes. However, both are possible, and both are well worth the effort.


The gender differences in smoking and depression bring up even more questions. If you count all the adults in the U.S., men are more likely to smoke than women. However, if you only consider the connection between depression-like behavior and smoking, the results are different. Women are about twice as likely to have both depression and nicotine use as men. Finding out why this difference exists is another current research goal.

Nicotine Receptors and Dopamine

When you smoke or vape, nicotine enters your system. In your brain, it matches up with nicotine receptors. These receptors then boost the release of neurotransmitters. Among them is dopamine. You may know dopamine as the “happy brain chemical.” It’s the one that lights up to reward you when you do something to release it.

But like with drugs like cocaine, the more you use it, the harder it is to get that reward. And your brain begins to produce less dopamine the longer you use nicotine. So, if smoking does come before depression, this may be at least a part of how it happens.

Mood Changes

Many people, especially women, use nicotine to boost their mood. Smoking or vaping may seem to help you with your depression because it lifts your mood. When you try to quit, you may feel sad or have other mood changes.

You can do several things to improve your mood and relieve your depression if you’re quitting nicotine. You can exercise more. You can spend more time with your friends and family. And you can learn to reward yourself in healthier ways. A counselor can also offer support and teach you techniques for easing your depression.

Do Antidepressants Help?


Antidepressants are typically the first medication prescribed for depression. However, the problem is that when you have nicotine in your system, the antidepressants aren’t as effective. They do help to a certain degree, but they would help you more if you aren’t using nicotine.

It’s interesting to note, though, that taking antidepressants might help you quit smoking. Even though they aren’t as effective as they might be otherwise, antidepressants may curb your need to boost your mood by smoking or vaping. That’s why many smoking cessation programs include prescribing antidepressants. They help get you through the process of quitting. Then, after your system is clear of nicotine, they can work even better to relieve any lingering depression.

Mental Health Reasons To Avoid Self-Medicating With Nicotine

You probably already know about many of the reasons not to use nicotine. Not only are these products expensive, but they can severely damage your physical health. But what about your mental health? As it turns out, quitting smoking can have excellent rewards for your mental health.

If you stop smoking, it will eventually become easier to manage your depression as well as anxiety and many other mental health problems. Also, with all the negative attitudes about smoking in today’s society, you may find it easier to connect with other people if you don’t smoke. That’s important because humans are naturally social creatures. You need to have good relationships with others to have good mental health.

Can Nicotine Help With Depression?

Now for the fascinating question of this whole area of study: Is there a safe way to use nicotine to decrease depression? There just might be. Right now, researchers are working on developing nicotine-based antidepressants.

No one knows yet how safe and effective they’ll be. It could be that when these drugs are finally prescribed, they can help people who don’t respond well to the usual antidepressants and depression treatments. Nothing is certain yet, but the idea of using nicotine in an antidepressant offers hope for people who are struggling with depression and nicotine dependence.

What To Do If You Have Depression


Maybe you’re wondering whether you’re depressed. Especially if you smoke or vape, it’s a critical question to ask. It’s always best to deal with depression as soon as possible. Depression can be just as destructive to your life as using nicotine. So, what can you do if you suspect you have depression?

First, take a depression screening test to check for symptoms. With a simple online quiz, you can get some objective feedback on whether your words, behaviors, thoughts, and feelings indicate you have depression. You get one question with a group of answers to choose from on each page. Then, you only have to click the one that describes what’s true for you. It’s free and confidential, so no one needs to know you took the test if you don’t want to reveal that.

At the end of the test, you get a rapid read-out showing how likely it is you have depression. You can also print a report to take with you if you go to a psychiatrist or therapist. Trying to manage depression on your own is usually a losing battle. When you use nicotine to self-medicate, it causes more problems than it solves. So, getting medication help from a psychiatrist and therapy from a counselor may be the very best options available to you.


New developments in science are increasing researchers’ knowledge of the connection between nicotine and depression year by year. There are still a lot of questions to answer and probably even more questions to discover.

What’s important right now is that you get mental health help if you have depression. Once you deal with your depression, quitting nicotine use might become much more manageable. In the meantime, improving your mood alone can have a profound impact on your quality of life.