3 myths about mental health and quitting nicotine

Young people today are experiencing two colliding crises: the ongoing youth mental health crisis – an urgent public health issue addressed in the U.S. Surgeon General’s Advisory in 2021 – as well as a youth e-cigarette use crisis. Current youth e-cigarette use decreased from 2.13 million in 2023 to 1.63 million in 2024 according to the National Youth Tobacco Survey - however, more than 1 in 3 (38.4%) youth e-cigarette users report frequent use (at least 20 of the last 30 days) raising concerns about nicotine addiction. This has implications for mental health because nicotine harms the developing brain and can intensify anxiety symptoms and feelings of depression.

In addition, the tobacco industry has historically targeted groups that are economically and socially marginalized, including people with mental health conditions. Industry influence, combined with other factors, has contributed to a higher prevalence of tobacco use among people with mental health conditions compared to the general population.

When it comes to nicotine and mental health, there are some common myths that can bring about challenges and questions. To bust these myths, we turned to the experts who run This is Quitting, now part of EX Program, a free, digital quitting resource that can increase the odds of quitting by up to 40%. 

EX Program offers users a free personalized quit plan, interactive reminders, and access to the nation's most established online quitting community. The EX Community is a resource where people of all ages, including those struggling with mental health conditions, can come together to discuss their experiences and share tips about quitting any kind of tobacco or nicotine product. 

Myth: e-cigarette users with mental health conditions don’t want to quit.

Fact: people with mental health conditions who vape nicotine want to quit just as much as people without mental health conditions.

A 2020 study of intentions to quit vaping nicotine among U.S. teens ages 12-17 showed similar motivation to quit among teens with and without anxiety and depression symptoms. The study, which analyzed data from a text message quit vaping platform now part of EX Program, also found that the number of quit attempts was largely consistent across users with past-year depression and anxiety symptoms and those without.

Why does this myth prevail? Decades of targeted messaging by the tobacco industry has given rise to the idea that tobacco products are “relaxing” and “stress relieving.” In addition, the tobacco industry has funded research that aims to link tobacco use with mental health benefits. The truth is, nicotine use is linked with amplified anxiety and depressive symptoms. For more details on how tobacco has been marketed as a stress reliever, read our article on how tobacco companies linked cigarettes and mental health.

Myth: e-cigarette users with mental health conditions can’t quit.

Fact: with the right resources and support, people with mental health conditions who vape nicotine can quit.

A 2021 study of the effectiveness of a text message quit vaping platform for quitting vaping among young adults demonstrated no significant differences in quit outcomes among young adults with a range of mental health presentations, and those who reported no mental health issues.

Why does this myth prevail? Many people with mental health conditions have other life challenges that may make it harder to quit vaping nicotine. These may include: more proximity to other people who use tobacco, fewer quitting resources available, and stronger dependence on nicotine. While additional challenges may exist for people with mental health conditions, they can quit with the right support and treatment.

Myth: quitting nicotine can make mental health condition symptoms worse.

Fact: for people who experience depression, anxiety, or stress, quitting nicotine can make you feel better.

According to peer-reviewed research gathered in a Truth Initiative report, vaping nicotine can intensify symptoms of depression and anxiety and increase stress levels. For many people, quitting nicotine can help alleviate these symptoms and lead to an improvement in mental health.

Why does this myth prevail? When people who use nicotine try to quit, they often experience withdrawal symptoms including irritability, restlessness, trouble sleeping, or feelings of anxiety or depression. These symptoms are temporary, but they are sometimes misunderstood as worsening symptoms of mental health conditions.

For more information on mental health and nicotine use, read our report on youth mental health and nicotine use. 

Quitting nicotine is possible with EX Program

If you are planning to quit vaping nicotine, it is always a good idea to speak with a health care provider, especially if you have a serious mental health condition or are considering medication to help you quit.

For people with and without mental health conditions, quitting any type of tobacco or nicotine product can be difficult. Daily reminders and a community of support can go a long way. With EX Program by Truth Initiative and Mayo Clinic, users can create a personalized quit plan, receive interactive reminders, and tap into the nation's most established online quitting community. 

Studies show that EX Program works. A randomized clinical trial among young adults published in JAMA Intern Medicine found that EX Program text message support can increase the odds of quitting by up to 40%. A similar study also found that teens who received the program were 35% more likely to report not using nicotine 7 months later.  

Join EX Program for free by texting EXPROGRAM to 88709.

By texting EXPROGRAM to 88709, you consent to recurring messages from EX Program to help you quit vaping, and agree to the Terms & Conditions and Privacy Policy. Text STOP to opt-out. Text HELP for info. Msg & Data Rates May Apply. 

This article was originally published on May 12, 2023.