Yoga May Offer A Powerful Counter To Tobacco Addiction, Says AIIMS Study

As the world marks the International Day of Yoga on June 21 with ‘Healthy Ageing’ as its theme, researchers are highlighting another powerful benefit of the ancient practice: its potential to help people quit tobacco, supporting healthier and longer lives.

The study from the AIIMS Delhi, comes at a time when the tobacco industry is rapidly reinventing itself to attract younger consumers through new products, aggressive marketing strategies and digital outreach

The researchers found that yoga could serve as an effective complementary intervention for tobacco cessation, helping users cope with cravings, withdrawal symptoms and the psychological distress that often leads to relapse.

Tobacco use remains one of the leading preventable causes of death globally. According to the World Health Organisation (WHO), tobacco kills more than eight million people every year. India alone accounts for over 270 million tobacco users, making it one of the world's largest consumers of both smoking and smokeless tobacco products.

Despite increasing awareness about the dangers of tobacco, quitting remains a difficult journey for many users.

Researchers led by Dr. Gautam Sharma from the Department of Cardiology and Centre for Integrative Medicine and Research (CIMR) at AIIMS undertook a meta-analysis to assess whether yoga could improve tobacco cessation outcomes. The review analysed five randomised controlled trials published up to September 2024 involving adults aged 18 years and above who used various forms of tobacco.

The study’s co-authors are Dr. Shruti Singh and Dr. Dhanlika Dhanlika, both from CIMR and Dr. Partha Haldar from Community Medicine Department

The participants were assigned either to yoga interventions alone or yoga combined with conventional cessation therapies. The primary outcome examined was the seven-day point prevalence abstinence rate, a widely used measure in tobacco cessation studies.

Secondary outcomes included quality of life, depression, anxiety and mood-related parameters.

The findings indicate that yoga may be moderately effective in helping individuals quit tobacco, with an estimated effectiveness of around 50%.

The significance of the findings lies not merely in improved abstinence rates but also in yoga's ability to address the emotional and psychological dimensions of addiction. Tobacco dependence is often sustained by stress, anxiety, depression and negative emotions.

These factors also contribute significantly to relapse among those attempting to quit.

The researchers found that active forms of yoga such as Hatha, Vinyasa and Iyengar yoga appeared to improve cessation outcomes by reducing stress and depressive symptoms while enhancing overall emotional well-being.

Particularly noteworthy was the role of pranayama, or yogic breathing exercises. The study reported that controlled breathing practices helped reduce cravings and negative emotional states associated with nicotine withdrawal. This, in turn, made it easier for participants to navigate the challenging early stages of quitting.

The review highlighted that successful tobacco cessation requires more than simply overcoming physical dependence on nicotine. Psychological distress often acts as a major barrier. By improving emotional regulation and resilience, yoga may help individuals sustain abstinence over longer periods.

Researchers also explored the biological mechanisms that could explain these benefits.

Nicotine exerts its addictive effects by stimulating nicotinic cholinergic receptors in the brain, triggering the release of neurotransmitters associated with pleasure and reward. However, when tobacco use is discontinued, the body experiences withdrawal, characterised by heightened stress responses, anxiety, irritability and intense cravings.

According to the study, yoga may counter these effects by shifting the body's physiological state from sympathetic nervous system dominance — commonly known as the "fight or flight" response — to parasympathetic dominance, often referred to as the "rest and digest" state.

This shift is believed to reduce activation of the hypothalamic-pituitary-adrenal (HPA) axis, lower cortisol levels and decrease the production of stress hormones. Such changes may help individuals better manage cravings and withdrawal symptoms.

The researchers also noted that breathing practices can significantly influence emotional states. Voluntary regulation of breathing has been shown to affect feelings such as fear, anger and joy, suggesting that pranayama may play a critical role in stabilising emotions during the cessation process.

The findings assume particular importance in the Indian context. While several pharmacological therapies are available for smoking cessation, their effectiveness among users of smokeless tobacco — a form widely consumed across India — remains limited. In many parts of the country, chewing tobacco, gutka and other smokeless products continue to be deeply entrenched in social and cultural practices.

Against this backdrop, yoga offers several advantages. It is inexpensive, culturally familiar, widely accessible and largely free from adverse effects. Unlike medications, yoga can be practised in community settings, schools, workplaces and healthcare facilities, making it a potentially scalable public health intervention.

As India grapples with the twin challenges of preventing tobacco initiation and helping millions of users quit, the researchers argue that integrating yoga into cessation programmes could strengthen existing strategies.

However, they caution that the evidence base remains limited. Larger, well-designed and standardised clinical trials are needed to confirm the findings and determine the most effective yoga protocols for tobacco cessation.