The Role of Tobacco Smoking in the Transition from Acute to Chronic Pain

Tobacco smoking is highly prevalent among patients with chronic pain. The prevalence of smoking has been found to range between 30-60% among patients with chronic pain, and to be approximately 15% in the general population. To date, however, the degree to which tobacco smoking contributes to the development of chronic pain remains unclear. The main objective of this study was to examine the role of tobacco smoking in the transition from acute pain to chronic pain. The sample consisted of adult patients enrolled in the UK Biobank, a large prospective cohort study involving more than 500,000 patients receiving medical care through the UK National Health Service (NHS). Patients were asked to complete self-report questionnaires at three separate time points (i.e., between 2006 and 2014) that assessed a host of demographic, lifestyle, pain, and psychological variables. Across different types of pain diagnoses, analyses indicated that patients smoking tobacco were significantly more likely to develop chronic pain symptoms after an acute pain episode than patients who never smoked (OR = 1.4, p < .05). This effect remained significant even after controlling for relevant demographic and psychological variables. Smoking emerged as a particularly strong determinant of chronic back pain, as patients smoking tobacco were roughly 3 times more likely to transition from acute to chronic back pain than patients who never smoked (OR = 3.1, p < .05). Our findings suggest that smoking plays a role in the etiology of chronic pain. Smoking appears to play a particularly important role in the transition from acute to chronic back pain. Further research will be needed to determine the specific mechanisms through which smoking leads to the development of chronic pain and/or interferes with recovery after an acute pain episode.

Duke Scholars

Author Luda Diatchenko Anesthesiology