IMPACT smoking and mental health resources

The IMPACT project and training has now come to an end, but the resources that explore the link between smoking and mental health are still available.


The relationship between smoking and mental health

We know that a lot of people say that smoking helps them calm down or relax,
especially in stressful situations; others state that it can be a kind of ‘mindful’
activity (particularly for roll-your-own cigarettes).

These are understandable reasons that
people have for smoking – but there is no
‘safe’ level of consumption and tobacco use
will kill 50% of long-term smokers. A mental
health practitioner’s role should include trying to reduce such harm where possible.

Smoking releases nicotine – which in turn
changes brain chemistry and sets up a ‘reward’ pathway to release dopamine. But this ‘feelgood’ factor quickly drops after a cigarette is finished and the withdrawal from nicotine is what can add to – or worsen – anxiety, stress and depression.

So when somebody says that smoking calms
them down, it’s often really a combination
of moving away from a stressful situation,
taking deep breaths (needed for smoking) and topping up on dopamine – but it comes at a high mental and physical price.

Smoking and Mental Health Facts

At least one-third of all tobacco consumed
in the UK is used by people with mental
health issues.

Smoking is at least twice as common amongst
people experiencing poor mental health than
by the wider population (and this increases
with severity of illness).

Over 60% of people who have a diagnosis
of schizophrenia smoke tobacco.

Almost 60% of people who experience a
first episode of psychosis are smokers.

Smoking is linked with poorer outcomes
and increased severity for those with
bipolar disorder.

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The effects of smoking upon some mental health medications

Smoking has an effect on the metabolism of some medications – and it’s specifically the tobacco smoke, not the nicotine, carbon monoxide or tar inhaled from a cigarette which affects blood plasma levels. This in turn means that a higher dose of prescribed medications (such as Clozapine, Olanzapine and some tricyclic anti-depressants) can be needed in order to be effective.

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Services available to help people stop smoking

For anybody who does want to quit smoking,
the NHS provides a range of free services
(one-to-one support and/or groups), which
are available for all to access either directly
or through referral from their GP.
To find out what’s available in your area, visit

Quit Your Way Scotland is Scotland’s free
national stop-smoking service, run by NHS 24. It is open daily, and can be accessed by phone or webchat. Advisers can offer tips on quitting, support during cravings, information on using Nicotine Replacement Therapy or e-cigarettes, and provide referrals to local NHS stop smoking services.

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IMPACT training

ASH Scotland's IMPACT project has now come to an end. You can still access the guidance booklet on smoking and mental health in a PFD format below.

It is aimed at staff and volunteers supporting people with mental health issues and provides insights into how smoking can have a major impact on mental health, medications and how this leads to further health inequalities. Note that some of the details in this PDF are now out of date.

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You can find more resources that explore mental health and smoking on our e-learning site.

Smoking harms

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The law on smoking

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The tobacco industry

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