ArticleDrug and alcohol dependence2025
The bidirectional relationship between pain and tobacco use: Insights from the longitudinal Population Assessment of Tobacco and Health (PATH) study.
Article in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Exploring tobacco, cannabis, and pain-related sleep disturbance among people with and without HIV enrolled in a tobacco smoking cessation trial.Drug and alcohol dependence · 2026Article
- Impact of cannabis use and tobacco smoking on outcomes of open carpal tunnel release surgery: a nationwide study in the United States.Archives of orthopaedic and trauma surgery · 2026Article
- The Role of Sleep Impairment in Associations Between Pain and Nicotine/Tobacco Dependence in Wave 6 of the Population Assessment of Tobacco and Health (PATH) Study.Substance use & misuse · 2026Article
- Patterns of Comorbidity Between Chronic Pain and Chronic Diseases in US Adults: A Cross-Sectional Analysis of NHANES Data.Journal of pain research · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundTobacco smoking remains the leading preventable cause of death, whereas chronic pain is the leading cause of disability. Chronic pain and tobacco smoking are closely interrelated. We investigated whether pain predicts daily cigarette smoking and if daily cigarette smoking predicts the development of pain.
methodsWe analyzed eight years of longitudinal data from the Population Assessment of Tobacco and Health study. We examined whether baseline pain (scored ≥4 on a 0-10 scale) predicts transition to daily smoking among individuals who do not smoke, and whether baseline daily smoking predicts the development of pain among those with no/low pain (scored 0-3). The pain and smoking outcomes were only included in the survival analysis if they persisted consistently throughout all subsequent years after the initial onset. Our analysis incorporated survey population controlled for alternative tobacco product use, gender, age categories, and race/ethnicity.
resultsAmong the 32,320 participants, 49.5 % were women, the largest age cohort was 18-24 (28.2 %). Racial and ethnic distribution was 73.9 % White, 15.6 % Black, and 17.2 % Hispanic. Survival analysis revealed that baseline pain (scored ≥4) significantly increased the risk of transitioning to daily smoking (HR=2.40, 95 % CI=1.62-3.55, p < 0.001, n = 5731). Further, daily smoking at baseline was associated with an increased risk of developing persistent pain (scored ≥4) over the study period (HR=2.00, 95 % CI=1.86-2.16, p < 0.001, n = 12,099).
conclusionThis study provides evidence for the existence of a bidirectional relationship between chronic pain and cigarette smoking. Treatment strategies should consider this relationship early, aiming to prevent development of persistent pain at its earliest stages.
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