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Pain, Parkinson's and COPD

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Smoking and chronic pain
J Pain 2012; 13:285-292

Nicotine is an analgesic and alleviates emotional distress; people enduring chronic pain are more than twice as likely to become nicotine dependent as the general population. Yet, ironically, previous studies suggested smoking to cope with chronic pain might exacerbate pain and increase the risk of pain-related disability, depression and suicidal ideation.

To further examine this relationship, American researchers enrolled 72 non-smokers with chronic pain; 39 patients who admitting smoking to help them cope with chronic pain; and 40 smokers who said that they did not smoke to cope. Chronic neck or joint pain (73 per cent), chronic low back pain (59 per cent) and rheumatism or arthritis (54 per cent) were the most common causes of chronic pain.

The two groups of smokers did not differ in terms of how often they smoked nor the severity of their nicotine dependence. After allowing for confounders, pain-related measures - such as intensity and interference with everyday life - did not differ between non-smokers and those smokers who said that they did not smoke to cope.

However, smoking to cope with pain was associated with increased pain intensity, pain interference and fear of pain. The authors suggest that alternative coping strategies - such as cognitive behavioural therapy (CBT), exercise and relaxation - may benefit patients who smoke to cope with chronic pain.

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