Chronic pain and cigarette smoking: The elucidation of a synergistic relationship



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Chronic pain and smoking commonly co-occur, and their combination appears to have synergetic degenerative effects. While the literature investigating the association between chronic pain and smoking is relatively modest, the existent research reveals some important findings. Specifically, smoking is likely reinforced among individuals with chronic pain via the analgesic properties of nicotine, and that this effect is moderated by gender and cigarette consumption. However, little is known regarding the effects of chronic pain on factors believed to influence smoking relapse. The purpose of this study was to investigate the affect of chronic pain on nicotine withdrawal (NW) and readiness to quit (RTQ) smoking among two groups of regular smokers: those with and without chronic pain. Participants attended a baseline session (nicotine satiated) and a 24-hour nicotine deprivation session. It was hypothesized that: 1) nicotine deprivation would exacerbate pain severity, 2) NW severity would be more pronounced in the pain group, and moderated by gender, and 3) there would be a negative relationship between RTQ and the experience of chronic pain. Time invariant variables (i.e. demographics, RTQ) were collected at the baseline session, and time variant variables (i.e. NW severity, pain severity) were collected at both sessions. Data were analyzed via chi-square, ANOVA, and linear regression analyses where appropriate. Analyses revealed that, contrary to prediction, nicotine deprivation decreased pain experience in women, but did not affect pain in men. Further, no relationship was found between chronic pain, NW severity, or RTQ. The clinical and theoretical implications of these results are discussed.