Observational studyJournal of the Chinese Medical Association : JCMA2023
Cigarette smoking, opioid consumption, and pain intensity after major surgery: An observational study.
Observational study in Journal of the Chinese Medical Association : JCMA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Examining the role of smoking on clinical outcomes after arthroscopic surgery of the hip: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Pooled it
- Effects of preoperative anti-PD-1 therapy on intraoperative and postoperative analgesia in patients undergoing radical esophagectomy: a retrospective cohort study.Scientific reports · 2026Article
- Nicotine use is Associated With Elevated Risk of Opioid use Disorder Following Total/Hemi Hip Arthroplasty Procedures.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Incidence, risk factors, and clinical impact of subcutaneous emphysema following laparoscopic totally extraperitoneal inguinal herniorrhaphy: a retrospective cohort study.BMC anesthesiology · 2026Article
- Risk factors for morphine-associated sedation in intravenous patient-controlled analgesia for postoperative pain.BMC anesthesiology · 2025Article
- Incidence and influential factors of postoperative pruritus in morphine-based intravenous patient-controlled analgesia.Journal of the Chinese Medical Association : JCMA · 2025Article
- Observational
- Influence of smoking and socioeconomic status on labor analgesia: a nationwide register-based study in Finland.Archives of gynecology and obstetrics · 2024Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic exposure to nicotine may change pain perception and promote opioid intake. This study aimed to evaluate the putative effect of cigarette smoking on opioid requirements and pain intensity after surgery.
methodsPatients who underwent major surgery and received intravenous patient-controlled analgesia (IV-PCA) at a medical center between January 2020 and March 2022 were enrolled. Patients' preoperative smoking status was assessed using a questionnaire by certified nurse anesthetists. The primary outcome was postoperative opioid consumption within 3 days after surgery. The secondary outcome was the mean daily maximum pain score, assessed using a self-report 11-point numeric rating scale, and the number of IV-PCA infusion requests within three postoperative days. Multivariable linear regression models were used to calculate the regression coefficient (beta) and 95% confidence interval (CI) for the association between smoking status and outcomes of interest.
resultsA total of 1162 consecutive patients were categorized into never smokers (n = 968), former smokers (n = 45), and current smokers (n = 149). Current smoking was significantly associated with greater postoperative opioid consumption (beta: 0.296; 95% CI, 0.068-0.523), higher pain scores (beta: 0.087; 95% CI, 0.009-0.166), and more infusion requests (beta: 0.391; 95% CI, 0.073-0.710) compared with never smokers. In a dose-dependent manner, smoking quantity (cigarette per day) was positively correlated with both intraoperative (Spearman's rho: 0.2207, p = 0.007) and postoperative opioid consumption (Spearman's rho: 0.1745, p = 0.033) among current smokers.
conclusionCurrent cigarette smokers experienced higher acute pain, had more IV-PCA infusion requests, and consumed more opioids after surgery. Multimodal analgesia with nonopioid analgesics and opioid-sparing techniques, along with smoking cessation should be considered for this population.
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