It is noteworthy that we also conducted a supplementary set of post-hoc analyses. These analyses were identical to the a priori set of tests with the exception that we included an additional covariate of any lifetime anxiety or mood disorder at the same step selleck chemicals llc as the other covariates. Results of these analyses indicated a generally similar pattern of findings to those reported earlier. Specifically, individuals with a lifetime history of chronic neck or back pain were significantly more likely to be current smokers and to be diagnosed with lifetime or current nicotine dependence. A similar, but not entirely uniform, pattern of findings was evident when current (past year) chronic neck or back pain was examined.

Here, individuals with current (past year) chronic neck or back pain were significantly more likely to meet criteria for lifetime or current nicotine dependence than their counterparts. No such effect was evident for current smoking status. In regard to medically unexplained chronic pain, whether indexed from a lifetime or current (past year) timeframe, there was a significant association only for current (past year) nicotine dependence. Collectively, these data are consistent with the perspective that chronic pain, particularly neck or back pain, is systematically associated with nicotine dependence, even after adjusting for cooccurring mood and anxiety disorders. Overall, the current findings add uniquely to extant scientific knowledge concerning chronic pain and smoking. The results suggest that chronic pain is often related to cigarette smoking and nicotine dependence from a lifetime and current (past year) perspective.

Such relations invite theorizing as to why such an association may exist and (a) what role smoking may play in the onset and course of chronic pain and (b) the role of chronic pain in smoking onset and maintenance. Although the present data cannot disentangle such complex and intriguing questions, it is notable that basic research has found that the presence of chronic pain may alter the reinforcing effects of drugs (e.g., Jacobs, Smith, de Vries, & Schoffelmeer, 2003). Although it is unclear whether chronic pain affects nicotine administration or its reinforcing value per se, smoking may serve important affect regulation functions for smokers with chronic pain.

These individuals, specifically, may expect tobacco use to help alleviate aversive mood and somatosensory states and be especially motivated to smoke for affect regulation purposes. Although the objective Cilengitide mood-dampening qualities of smoking are quite complex (Kassel, Stroud, & Paronis, 2003), in the absence of other more adaptive coping strategies, smokers with chronic pain may learn to rely on smoking to manage noxious internal states in the relatively short term.