Any Exposure to Smoking May Increase Risk for Chronic Widespread Pain

Cigarette smoking at any point during adulthood may be associated with an increased risk for chronic widespread pain (CWP), chronic regional pain (CRP), or other pain, according to a study published in the British Medical Journal.

The study included participants from the Medical Research Council National Survey of Health and Development who had been followed since birth in 1946 (n=2347). Participants were classified as never smoker, predominantly nonsmoker, predominantly smoker, or lifelong smoker. Pain was self-reported at age 68 years. CWP was defined according to American College of Rheumatology criteria. Participants who reported pain for ≥3 months but who did not meet the criteria for CWP were classified as having CRP. Participants who reported pain lasting <3 months were classified as having “other” pain.

Lifelong smokers vs never smokers were found to have an increased risk for CWP (relative risk ratio, 1.88; 95% CI, 0.99-3.57). Those who were predominantly smokers also had an increased risk for CWP compared with never smokers (relative risk ratio, 2.10; 95% CI, 1.34-3.28), as did predominately nonsmokers (relative risk ratio, 1.70; 95% CI, 1.16-2.49). No associations were established between smoking history and CRP or other pain.

“The evidence provided for the long-lasting effect of smoking on this condition highlights the potential benefit of considering smoking history rather than current smoking status when identifying those at greater risk for CWP in later life, especially as opportunities to prevent CWP may be missed if only current smokers are classified as higher risk,” the researchers wrote.

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Bendayan R, Cooper R, Muthuri SG. Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: evidence from the 1946 British birth cohort study. BMJ. 2018;8:e021896.