Smoking and Pain

Shi, Yu; Weingarten, Toby N.; Mantilla, Carlos B.; Hooten, W. Michael; Warner, David O.

doi:10.1097/aln.0b013e3181ebdaf9

Cited by 257 publications

(133 citation statements)

References 214 publications

(208 reference statements)

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“…This is consistent with the idea that CWP and CRP may have different underlying aetiologies 7. For example, some studies have suggested that nicotine may alter pain regulatory mechanisms (eg, potential alteration of pain processing or cause structural changes to other systems) which might have long-term consequences for painful chronic conditions 29. The associations between lifetime smoking and CWP were only partially attenuated after adjustment for a range of factors including sex, socioeconomic position, body size, other health behaviour, long-standing illness and symptoms of anxiety and depression.…”

Section: Discussionsupporting

confidence: 84%

Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: evidence from the 1946 British birth cohort study

2018

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ObjectiveTo examine whether different lifetime patterns of cigarette smoking are associated with chronic widespread pain (CWP) and chronic regional pain (CRP) at age 68.DesignProspective cohort study.SettingEngland, Scotland and Wales.ParticipantsUp to 2347 men and women from the Medical Research Council National Survey of Health and Development, who have been followed up since birth in 1946 and provided sufficient information on cigarette smoking across adulthood to be classified as never smoker, predominantly non-smoker, predominantly smoker or lifelong smoker and pain assessment at age 68.Primary outcome measuresPain was self-reported at age 68, and CWP was defined according to American College of Rheumatology criteria. Participants who reported having pain for ≥3 months but who did not meet the CWP definition were classified as having CRP; those who reported pain which had lasted for <3 months were classified as ‘other’ pain. No pain was the reference group.ResultsFindings from multinomial logistic regression models indicated that compared with never smokers, predominantly non-smokers, predominantly smokers and lifelong smokers all had an increased risk of CWP; relative risk ratios=1.70(95% CI 1.16 to 2.49); 2.10(95% CI 1.34 to 3.28) and 1.88(95% CI 0.99 to 3.57), respectively, after adjusting for sex, own occupational class, educational level, body mass index, leisure time physical activity, alcohol intake, long-standing illness and symptoms of anxiety and depression. No association was observed between smoking history and CRP or other pain.ConclusionsThese results suggest that exposure to cigarette smoking at any stage in adulthood was associated with higher risk of CWP in later adulthood; highlighting the ongoing importance of smoking prevention programmes. It also suggests that assessment of lifetime smoking behaviour may be more useful in identifying those at greater risk of CWP in later life than assessment of current smoking status.

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Section: Discussionsupporting

confidence: 84%

Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: evidence from the 1946 British birth cohort study

2018

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“…These findings suggest that although smoking, pain, depression, and opioid use appear to be interrelated, greater levels of depression among smokers may not be sufficient to account for why they needed higher opioid dosages. It is possible that smoking and opioid use demonstrate unique associations (e.g., above-and-beyond the influence of depression) due to complex nicotine-opioid interactions that can result in cross-tolerance and/or sensitization to the rewarding effects of opioid medications (Shi, Weingarten, et al, 2010; Vihavainen, Piltonen, Tuominen, Korpi, & Ahtee, 2008). …”

Section: Anxiety and Depression In Bidirectional Pain–smoking Relationsmentioning

confidence: 99%

“…Second, withdrawal severity is a hypothesized mechanism by which smokers may experience greater pain during periods of abstinence (e.g., Allen et al, 2000). Third, researchers have suggested that smokers who experience greater pain and pain-related negative affect during a quit attempt may return to smoking, in part, to alleviate increased pain sensitivity (Ditre et al, 2011; Shi, Weingarten, et al, 2010). …”

Section: Implications For Smoking Cessationmentioning

confidence: 99%

Anxiety and Depression in Bidirectional Relations Between Pain and Smoking

2015

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Pain and tobacco smoking are highly prevalent and comorbid conditions that impose considerable burdens on individuals and health care systems. A recently proposed reciprocal model suggests that these conditions interact in a bidirectional manner, resulting in greater pain and the maintenance of tobacco addiction. Anxiety and depression are common among smokers in pain and have been identified as central mechanisms of interest. There is emerging evidence that smokers with anxiety/depression may experience more severe pain and functional impairment, greater pain-induced motivation to smoke, and increased sensitivity to pain during periods of smoking abstinence. Based on empirical findings, we hypothesize that these experiences may engender expectations that abstaining from smoking will exacerbate both pain and negative affect, thus eroding self-efficacy for smoking cessation and increasing perceived barriers to quitting. The goal of this narrative review is to examine the role of anxiety/depression in complex pain–smoking relations so as to advance evolving theoretical perspectives and inform the development of tailored interventions.

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“…Although animal models have consistently demonstrated acute pain-inhibitory effects of nicotine/tobacco administration for over 80 years [19; 44], human experimental studies have generated mixed and somewhat contradictory findings [22; 70]. Indeed, the question of whether nicotine may decrease sensitivity to pain in humans has been a topic of empirical debate since the effects of smoking on human pain reactivity were first examined in 1973 [45; 58].…”

Section: Introductionmentioning

confidence: 99%

Acute analgesic effects of nicotine and tobacco in humans: a meta-analysis

Ditre

Heckman

Zale

et al. 2016

Pain

123

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Although animal models have consistently demonstrated acute pain-inhibitory effects of nicotine and tobacco, human experimental studies have yielded mixed results. The main goal of this meta-analysis was to quantify the effects of nicotine/tobacco administration on human experimental pain threshold and tolerance ratings. A search of PubMed and PsychINFO online databases identified 13 eligible articles, including k = 21 tests of pain tolerance (N = 393) and k = 15 tests of pain threshold (N = 339). Meta-analytic integration for both threshold and tolerance outcomes revealed that nicotine administered via tobacco smoke and other delivery systems (e.g., patch, nasal spray) produced acute analgesic effects that may be characterized as small to medium in magnitude (Hedges’ g = .35, 95% CI = .21-.50). Publication bias-corrected estimates remained significant and indicated that these effects may be closer to small. Gender composition was observed to be a significant moderator, such that pain threshold effects were more robust among samples that included more men than women. These results help to clarify a mixed literature, and may ultimately help to inform the treatment of both pain and nicotine dependence. Pain and tobacco smoking are both highly prevalent and comorbid conditions, current smoking has been associated with more severe chronic pain and physical impairment, and acute nicotine-induced analgesia could make smoking more rewarding and harder to give up. Future research should employ dynamic measures of experimental pain reactivity and further explore biopsychosocial mechanisms of action.

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Smoking and Pain

Cited by 257 publications

References 214 publications

Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: evidence from the 1946 British birth cohort study

Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: evidence from the 1946 British birth cohort study

Anxiety and Depression in Bidirectional Relations Between Pain and Smoking

Acute analgesic effects of nicotine and tobacco in humans: a meta-analysis

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