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03-10-2011 | General practice | Article

Link between smoking and chronic pain in women


Free abstract

MedWire News: Women who smoke may experience more chronic musculoskeletal pain than those who do not, indicate findings of a US study.

"These results suggest that smoking cessation may be an important adjunct treatment of chronic pain syndromes," remark David Mannino (University of Kentucky, Lexington) and colleagues. "Similarly, it is possible that appropriate treatment of a chronic pain syndrome may increase the possibility that a woman will be able to successfully stop smoking," they add.

Writing in The Journal of Pain, the researchers explain that use of tobacco is the single most preventable cause of disease and death in the USA. Furthermore, smoking is thought to be important in chronic pain syndromes.

Kentucky has the third highest prevalence of current smokers in the USA, at 25.2%, and the annual smoking-attributable mortality for women in this state is one of the highest in the country, at 3040 per capita.

The team therefore analyzed data from 6092 participants of the Kentucky Women's Health Registry (2006-2008) to determine the relationship between smoking and the presence of different types of chronic musculoskeletal pain syndromes in Kentucky women.

Overall, 62.3% of women were "never" smokers, 26.9% were "former" smokers, 7.7% were "daily" smokers, and 3.0% were "occasional" or "some-day" smokers. Approximately 44.0% reported having pain in at least one of the following eight pain categories: pain all over the body, pain associated with nerves, chronic head, neck, back and joint pain, sciatica, and fibromyalgia.

Mannino et al found that women who were daily smokers were more than twice as likely to report at least one chronic pain syndrome in comparison with nonsmokers. Similarly, a former smoker had increased odds of reporting a pain syndrome, at 20%, while an occasional smoker had increased odds of 68%.

Of note, there was a significant dose-response relationship between smoking classification and the number of reported chronic pain syndromes, say Mannino and team.

When the researchers analyzed each of the eight chronic pain syndromes individually, they found that chest pain and pain all over the body had no observable association with smoking. However, chronic joint pain, chronic head pain, nerve problems, stomach pain, pelvic pain, and other body pains showed an association with smoking when comparing nonsmokers to daily smokers, with respective odds ratios of 1.57, 1.77, 3.08, 1.60, 1.97, and 1.66.

In addition, there were increasing odds for reporting a form of chronic pain with increasing age and obesity; an overweight women had 17% higher odds of reporting chronic pain than a normal-weight woman, and an obese woman had a 90% increase.

Having a high school diploma or less put a woman at 52% greater odds compared with a woman with a graduate or professional degree, while a college-educated woman was at 22% greater odds.

The researchers conclude: "Additional studies looking at the relation between smoking, smoking cessation, psychopathology, and management of chronic pain are needed."

By Nikki Withers

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