Additionally, smoking cessation has been shown to have a positive impact on mental health outcomes with a reduction in depression and anxiety compared with those who continue to smoke.74 Patients prescribed varenicline were reported to have an approximately threefold increased chance of quitting smoking compared with those given placebo (odds ratio 2.88, 95% confidence interval 2.40 to 3.47)4; this could explain the reduction in anxiety observed in this meta-analysis.