Understanding the relationship between smoking and pain

Parkerson, Holly A.; Zvolensky, Michael J.; Asmundson, Gordon J.G.

doi:10.1586/14737175.2013.859524

Cited by 47 publications

(33 citation statements)

References 79 publications

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“…Depression has been considered as a key mechanistic factor in complex pain‐smoking relations , and these findings are consistent with previous evidence that depression may help to explain why smokers with chronic pain tend to endorse more severe pain . Indeed, it is possible that an underlying vulnerability (e.g., neurobiological, behavioral, affective, cognitive) is explanatory.…”

Section: Discussionsupporting

confidence: 89%

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients

et al. 2015

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Objective As smoking impacts physiological pathways in the central nervous system, it is important to consider the association between smoking and fibromyalgia, a pain condition caused predominantly by central nervous system dysfunction. The objectives were to assess the prevalence of current smoking among treatment-seeking chronic pain patients with (FM+) and without (FM−) a fibromyalgia-like phenotype; test the individual and combined influence of smoking and fibromyalgia on pain severity and interference; and examine depression as a mediator of these processes. Methods Questionnaire data from 1566 patients evaluated for a range of conditions at an outpatient pain clinic were used. The 2011 Survey Criteria for Fibromyalgia were used to assess the presence of symptoms associated with fibromyalgia. Results Current smoking was reported by 38.7% of FM+ patients compared to 24.7% of FM− patients. FM+ smokers reported higher pain and greater interference compared to FM+ nonsmokers, FM− smokers, and FM− nonsmokers. There was no interaction between smoking and fibromyalgia. Significant indirect effects of fibromyalgia and smoking via greater depression were observed for pain severity and interference. Conclusions Current smoking and positive fibromyalgia status were associated with greater pain and impairment among chronic pain patients, possibly as a function of depression. Although FM+ smokers report the most negative clinical symptomatology (i.e., high pain, greater interference) smoking does not appear to have a unique association with pain or functioning in FM+ patients, rather the effect is additive. The 38.7% smoking rate in FM+ patients is high, suggesting FM+ smokers present a significant clinical challenge.

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Section: Discussionsupporting

confidence: 89%

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients

et al. 2015

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“…Additionally, some other factors such as smoking may be associated with pain and both cancer and CVD mortality. There is some evidence that pain is associated with smoking behaviors and vice versa,56,57 a habit that contributes to worsening health status, including cancer and CVD morbidity 56. However, in our study nicotine intake was not associated with pain categories.…”

Section: Discussioncontrasting

confidence: 72%

Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+)

Dragioti

Larsson

Bernfort

et al. 2016

JPR

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Background and objectiveThere is limited knowledge about the prevalence of pain and its relation to comorbidities, medication, and certain lifestyle factors in older adults. To address this limitation, this cross-sectional study examined the spreading of pain on the body in a sample of 6611 subjects ≥65 years old (mean age = 75.0 years; standard deviation [SD] = 7.7) living in southeastern Sweden.MethodsSex, age, comorbidities, medication, nicotine, alcohol intake, and physical activity were analyzed in relation to the following pain categories: local pain (LP) (24.1%), regional pain medium (RP-Medium) (20.3%), regional pain heavy (RP-Heavy) (5.2%), and widespread pain (WSP) (1.7%).ResultsRP-Medium, RP-Heavy, and WSP were associated more strongly with women than with men (all p<0.01). RP-Heavy was less likely in the 80–84 and >85 age groups compared to the 65–69 age group (both p<0.01). Traumatic injuries, rheumatoid arthritis/osteoarthritis, and analgesics were associated with all pain categories (all p<0.001). An association with gastrointestinal disorders was found in LP, RP-Medium, and RP-Heavy (all p<0.01). Depressive disorders were associated with all pain categories, except for LP (all p<0.05). Disorders of the central nervous system were associated with both RP-Heavy and WSP (all p<0.05). Medication for peripheral vascular disorders was associated with RP-Medium (p<0.05), and hypnotics were associated with RP-Heavy (p<0.01).ConclusionMore than 50% of older adults suffered from different pain spread categories. Women were more likely to experience greater spreading of pain than men. A noteworthy number of common comorbidities and medications were associated with increased likelihood of pain spread from LP to RP-Medium, RP-Heavy, and WSP. Effective management plans should consider these observed associations to improve functional deficiency and decrease spreading of pain-related disability in older adults.

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“…Pain and tobacco smoking are both highly prevalent and comorbid conditions, and accumulating research indicates that relations between pain and smoking are likely complex and bidirectional in nature (Ditre, Brandon, Zale, & Meagher, 2011; Parkerson, Zvolensky, & Asmundson, 2013). For example, pain has been shown to be a potent motivator of smoking (Ditre & Brandon, 2008; Ditre, Heckman, Butts, & Brandon, 2010); smoking has been identified as a unique causal factor in the onset and exacerbation of painful conditions (e.g., Sugiyama et al, 2010); and, there is evidence that pain may pose a significant barrier to smoking cessation (Zale & Ditre, 2013; Zale, Ditre, Dorfman, Heckman, & Brandon, 2014).…”

mentioning

confidence: 99%

Relations between pain-related anxiety, tobacco dependence, and barriers to quitting among a community-based sample of daily smokers

Ditre

Langdon

Kosiba

et al. 2015

Addictive Behaviors

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There is increasing recognition that complex and potentially bidirectional relations between pain and smoking may be relevant to the maintenance of tobacco addiction. Pain-related anxiety has been identified as a mechanism in the onset and progression of painful disorders, and initial evidence indicates that pain-related anxiety may be associated with essential features of tobacco dependence among smokers with chronic pain. However, there has not been an empirical study of pain-related anxiety in relation to tobacco dependence and self-reported barriers to quitting among a community-based sample of daily smokers. The current sample was comprised of 122 daily smokers who were recruited from the local community to participate in a larger study that included an initial assessment of pain, smoking history, and pain-related anxiety. Approximately 17% of our sample endorsed moderate or severe past-month pain, nearly half met criteria for current anxiety or mood disorder, and about 30% met criteria for a current substance use disorder, exclusive of tobacco dependence. Results indicated that pain-related anxiety was uniquely and positively associated with both tobacco dependence severity scores and self-reported barriers to quitting. These findings lend support to the notion that pain-related anxiety may contribute to the maintenance of tobacco addiction among smokers who experience varying levels of pain severity.

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Understanding the relationship between smoking and pain

Cited by 47 publications

References 79 publications

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients

Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+)

Relations between pain-related anxiety, tobacco dependence, and barriers to quitting among a community-based sample of daily smokers

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