Chronic pain and cigarette smoking and nicotine dependence among a representative sample of adults

Individuals with chronic pain problems are at an increased risk for certain types of substance abuse and dependence. Recent work suggests that there is a significant association between chronic pain and cigarette smoking; however, it is unclear as to whether pain-smoking effects are evident above and beyond sociodemographic factors and cooccurring substance use disorders. The present investigation examined the relation between lifetime and current (past year) chronic pain and cigarette smoking status and nicotine dependence. This investigation comprised a large representative sample of English-speaking adults (n = 9,282) residing in the United States. Data were collected primarily through face-to-face interviews conducted between February 2001 and April 2003. After adjusting for sociodemographic variables and the presence of a lifetime substance use disorder, individuals with a lifetime history of chronic neck or back pain were significantly more likely to be current smokers and to be diagnosed with lifetime as well as current nicotine dependence. Although there was no significant incremental relation between current chronic neck and back pain and being a current smoker, there was a significant association with lifetime and current nicotine dependence. Similar relations were evident among those with and without medically unexplained chronic pain in regard to smoking status and lifetime and current nicotine dependence. Findings are discussed in terms of better understanding the chronic pain-smoking association.