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Adults Who Smoke Have More Chronic Pain, Use More Opioids

Rates of chronic pain, prescription opioid use, and severe work limitations rise with the number of cigarettes smoked daily, according to study results published in the American Journal of Preventive Medicine.

“Our research shows that adults who smoke 11 to 20 cigarettes per day use 5 times more prescription opioids than adults who never smoked. Adults who smoke more than a pack of cigarettes a day use almost 3 times as many opioids than adults who smoke 11 to 20 cigarettes per day,” said study authors William Encinosa, PhD, Didem Bernard, PhD, and R. Burciaga Valdez, PhD, MHSA, of the Agency for Healthcare Research and Quality, Rockville, Maryland, in a press release. “Thus, integrating smoking cessation programs into substance use treatments would be a prudent way of reducing prescription opioid use.”

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The study is the first to present national statistics on the connection between heavy compared with light smoking on pain and opioid use. Researchers analyzed data from the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey linked to the Centers for Disease Control and Prevention’s National Health Interview Survey for the years 2013 to 2021. The data included 81,400 adult-years.

Although just 37% of the US population has ever smoked, smokers used 69% of the country’s annual prescription opioids, according to the study. Adults who smoked more than 5 cigarettes a day made up 12% of the population but used as many opioids as the 63% who never smoked. Adults who smoked previously used 16% fewer opioids than adults who currently smoke.

Rates of chronic pain during the year were 12.2% among adults who never smoked, 14.2% among those who smoked lightly, and 16.5% among those who smoked more than a pack a day. Meanwhile, rates of severe work limitations due to pain were 7.3% among adults who never smoked and 16.9% for those smoking more than a pack a day.

Additionally, rates of self-reported poor or fair mental health were 29.2% among adults who smoked more than a pack a day compared with 13.6% among adults who never smoked.

“Combining smoking cessation with substance abuse treatment could be crucial in addressing the opioid epidemic,” researchers wrote. “Many states and localities are attempting to ban various types of cigarettes. Our research shows that any resulting smoking cessation from these bans may also contribute to easing the opioid crisis.”

 

References

Encinosa W, Bernard D, Valdez RB. Heavy versus light smoking: its association with opioid use, chronic pain, and mental health. Am J Prev Med. Published online July 16, 2024. doi:10.1016/j.amepre.2024.07.010 

Novel research suggests quitting smoking may help alleviate opioid crisis. News release. Elsevier; October 9, 2024. Accessed October 11, 2024.