Prevalence of Anxiety in Smoking Cessation: A Worldwide Systematic Review and Meta-analysis

Objectives: Smoking cessation can have a significant impact on mental health, so this study aimed to investigate the prevalence of anxiety after smoking cessation by a worldwide systematic review and meta-analysis. Methods: PubMed and Scopus were selected for the study and these were systematically searched until October 2020 based on a syntax of keywords. This search in these 2 databases is limited to English. The event and sample size were used to assess the prevalence of anxiety. The prevalence of anxiety was also assessed based on anxiety disorders and continents. The odds ratio (OR) was used to compare the odd of anxiety in smoking cessation versus nonsmokers and smokers as reference groups based on a random-effects method. Heterogeneity and publication bias were assessed. Results: The prevalence of anxiety after smoking cessation is 19% with a confidence interval (CI) of 14%-24%. Among anxiety disorders, it was the highest prevalence for social anxiety with 29% prevalence. The prevalence of anxiety after smoking cessation in America is 15% and in Europe is 29%. Smoking cessation has a higher odd of anxiety than nonsmokers (OR=1.20; CI: 1.12-1.29). Smoking cessation has a lower odd of anxiety than smokers (OR=0.77; CI: 0.66-0.89). Discussion: Since smoking cessation is a factor that reduces anxiety, so in studies in this area as well as therapeutic interventions, it is necessary to consider this issue.