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McDermott MS, Marteau TM et al. Br J Psychiatry 2013; 202: 62–67

The received wisdom that smoking relieves stress is a major barrier for quitting smoking. Nevertheless, unequivocally anxiety increases during the first few days of a 'quit attempt', but what happens in the long term? This paper describes secondary analysis of data obtained in a smoking cessation trial. Support included behavioural approaches, education and pharmacotherapy. Anxiety was measured using Spielberger State-Trait Anxiety Inventory. Using linear regression, it was shown that those who quit smoking were significantly less anxious. However, anxiety increased for those that had a 'failed quit attempt', particularly for those who report that they smoke to cope with stress. The smoking cessation support worker, must therefore maximise the chances of success for those who have decided they wish to stop smoking.