A new study has demonstrated that pain can increase the desire to smoke cigarettes.
The
study, conducted by researchers from USF and the H. Lee Moffitt Cancer
Center and Research Institute, could have important implications for
smokers who suffer from chronic pain.
In the May issue of the
Journal of Abnormal Psychology, researchers Joseph W. Ditre, a doctoral
candidate in clinical psychology at USF, and Thomas H. Brandon, a USF
professor and director of Moffitt's Tobacco Research and Intervention
Program, wrote that the prevalence of smoking among people with
chronically painful conditions, such as rheumatoid arthritis, is
approximately double that of the general population.
Although
other studies have associated smoking with the development and
aggravation of chronic pain, Ditre and Brandon's research investigated
the link between smoking and pain from a different angle.
Rather
than examining smoking as a possible contributing cause or aggravator
of chronic pain conditions, they tested whether the pain itself may
promote increased or continued smoking. If pain stimulates the desire
to smoke, and smoking exacerbates painful conditions, then smokers with
chronic pain get caught in a devastating cycle that can worsen their
pain while maintaining and even increasing their dependency on
cigarettes.
"With smoking so prevalent among people with chronic
pain, it was important to provide experimental evidence that pain can
be a strong motivator of smoking," Ditre said. "That hadn't been done
before."
The experiment consisted of 132 adults who smoke at
least 20 cigarettes a day. Half of the participants underwent a
pain-induction procedure by immersing their non-dominant hands in a
circulating cold-water bath (0 degrees to 1 degree Celsius) until the
pain became intolerable. The other half immersed their non-dominant
hands in room-temperature water.
After removing their hands
from the water, participants completed questionnaires aimed to elicit
their urges to smoke. They were then given the opportunity to have a
cigarette.
Participants who experienced the painful cold-water
procedure reported worse moods and greater urges to smoke than before
the procedure. They were also quicker to smoke than those in the
non-pain group.
From the experiment, Brandon and Ditre hypothesized that the participants used smoking as a way to ease the pain.
"Pain
has a negative impact on mood state," Brandon said, "and that could be
part of the mechanism at work when smoking is motivated by pain. But
what is significant about this particular study is that it shows
scientifically that situational pain does in fact motivate smoking.
Future studies can build from this."
Ditre said that this
research points out a new direction for science to investigate. He also
said a systematic analysis of the link between pain and smoking
motivation would be an appropriate next step.
"Further research
into this area may help provide a greater understanding of smoking
addiction within the chronic pain population," Ditre said. "And
smoking-cessation treatments may benefit from that research."
The
evidence presented in the study could be another step toward helping
people overcome a self-defeating loop in which many chronic-pain
sufferers cannot quit smoking because they use cigarettes to ease their
pain, Brandon said.
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