Pain as a motivator of smoking: effects of pain induction on smoking urge and behavior

J Abnorm Psychol. 2008 May;117(2):467-72. doi: 10.1037/0021-843X.117.2.467.


Tobacco smoking has been associated with the development and exacerbation of chronically painful conditions. Conversely, there is reason to believe that smokers may be motivated to use tobacco as a means of coping with their pain. To date, no controlled, experimental studies have tested for a causal relationship between pain and smoking motivation. The primary aim of the current study was to test the hypothesis that laboratory-induced cold pressor pain would enhance smoking motivation, as measured by self-reported urge to smoke and observation of immediate smoking behavior. Smokers (N=132) were randomly assigned to either pain or no pain conditions. Results indicated that situational pain increased urge ratings and produced shorter latencies to smoke. The relationship between pain and increased urge to smoke was partially mediated by pain-induced negative affect. The relationship between pain and shorter latency to smoke was fully mediated by pain-induced urge to smoke. This study provides the 1st experimental evidence that situational pain can be a potent motivator of smoking.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Cross-Over Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Pain / psychology*
  • Pain Measurement
  • Smoking / psychology*
  • Tobacco Use Disorder / psychology