Smoking linked to chronic pain in women

More than 6,000 Kentucky women over the age of 18 were surveyed on their smoking habits and symptoms of chronic pain. Syndromes included in the analysis were fibromyalgia, sciatica, chronic neck pain, chronic back pain, joint pain, chronic head pain, nerve problems, and pain all over the body.

Results showed that women who smoke, or who were former smokers, had a greater chance of reporting at least one chronic pain syndrome in comparison to nonsmokers. Former smokers showed a 20 percent increase, occasional smokers showed a 68 percent increase, and in daily smokers the odds more than doubled (104 percent).

In addition, daily smoking was associated more strongly with chronic pain than older age, lower educational attainment, obesity, or living in an Appalachian county.

There's a definite connection, but the direction of it is uncertain, says Dr. David Mannino, a pulmonary physician in the UK College of Public Health and co-author of the study.

"This study shows a strong relationship between heavy smoking and chronic pain in women," Mannino said. "But what is the direction of this association? Does smoking cause more chronic pain, or do more women take up smoking as a coping mechanism for experiencing chronic pain?"

Mannino describes acute pain as a "protective response" and theorizes that perhaps female smokers experience acute pain that develops into chronic pain because their normal protection and mechanisms are damaged by exposure to smoke.

From here, researchers should look into a link between smoking, smoking cessation, psychopathology, and management of chronic pain, says Dr. Leslie Crofford, director of the Center for the Advancement of Women's Health and co-author of the study.

"Our results show there is a dose-response relationship between smoking classification and chronic pain syndromes," Crofford said. "It's possible that patients experiencing chronic pain could benefit from smoking cessation treatment in addition to the treatment for their pain. Similarly, it's possible that appropriate treatment of chronic pain could increase a smoker's chances of successfully quitting. Right now, more research is needed on these interventions."

The study was conducted through the Kentucky Women's Health Registry, a database created by UK's Center for the Advancement of Women's Health and run by Crofford. The registry is open to all Kentucky women ages 18-89, and includes questions pertaining to an individual's health, demographic, and socioeconomic status. So far, nearly 15,000 Kentucky women have joined the registry, though Crofford's goal is to reach 25,000 members.