The Impact of Smoking on the Development and Severity of Chronic Pain

Curr Pain Headache Rep. 2022 Aug;26(8):575-581. doi: 10.1007/s11916-022-01060-8. Epub 2022 Jun 22.


Purpose of review: The purpose of this review is to examine the impact of smoking and its role on the development of chronic pain and provide a critical review of recent literature.

Recent findings: Recent studies demonstrate the bidirectional and dependent relationship between smoking and chronic pain. Those who are in pain have a more difficult time in the cessation of smoking as well as an increased sensitivity to pain during abstinence, lower confidence, and higher relapse rates. The fear of pain and the anxiety and depression that abstinence causes results in a grim outcome for long-term cessation. The dependent nature between chronic pain and smoking is affected by numerous variables. Providers should consider a multiprong approach to treating chronic pain and targeting smoking cessation treatment by providing motivational therapy, nicotine replacement, and medication therapies to prevent relapse, and providing those who are more likely to relapse with a higher level of care.

Keywords: Bidirectional relationship; Chronic pain; Chronic pain development; Nicotine; Smoking; Smoking cessation.

Publication types

  • Review

MeSH terms

  • Chronic Pain* / drug therapy
  • Chronic Pain* / therapy
  • Humans
  • Nicotine / adverse effects
  • Recurrence
  • Smoking / adverse effects
  • Smoking / drug therapy
  • Smoking Cessation* / methods
  • Tobacco Use Cessation Devices


  • Nicotine