AJPM: Chronic Pain Nearly Doubles the Likelihood of Smoking

A new study published in the American Journal of Preventive Medicine has found that people with chronic pain are significantly more likely to smoke cigarettes and use electronic vaping devices.

The research is based on an analysis of data from more than 195,000 adult U.S. residents collected through a national health survey between 2014 and 2023.

Scientists from the University of Kansas concluded that chronic pain is associated with nearly a twofold increase in the likelihood of both traditional smoking and e-cigarette use. Moreover, individuals with chronic pain are more likely to use multiple types of nicotine products simultaneously.

Researchers explain this through the formation of a vicious cycle: pain encourages individuals to use nicotine as a means of short-term relief, but in the long run, smoking may actually worsen pain and contribute to its persistence.

The study also found that despite the overall decline in smoking rates in the United States, this trend is progressing much more slowly among people with chronic pain. Furthermore, the more severe the limitations caused by pain in daily life, the higher the likelihood that a person continues to smoke or use e-cigarettes.

Special attention was given to electronic cigarettes. Although they are often considered a less harmful alternative to traditional tobacco, nicotine’s impact on the nervous system may also intensify pain, and this mechanism remains insufficiently studied.

The authors emphasize that these findings highlight the need for a comprehensive approach to treating patients with chronic pain. Such a strategy should simultaneously address pain management and support for quitting nicotine, as the combination of these factors creates a self-reinforcing cycle of pain, addiction, and reduced quality of life.