• Smoking;
  • Chronic Pain;
  • Affective Disorders;
  • Drug Use Disorders;
  • Alcohol Use Disorders


Objectives.  Smokers may report more pain and may be at greater risk for psychiatric comorbidity. Smoking may be a major problem in chronic pain patients (CPPs). The goal of this study was to determine if pain and psychiatric comorbidity are associated with smoking status in CPPs.

Design.  As part of a return-to-work grant study CPPs who could potentially return to work identified themselves as either current smokers (N = 81) or nonsmokers (N = 140). These two groups were compared on a large number of demographic, function, pain, disability, behavior, and psychiatric diagnoses variables gathered at admission into the grant study. The incidence of smoking was tested with either the student’s t-test or chi-square to detect differences in continuous and categorical variables, respectively. Logistic regression was utilized to determine the predictive variables for smoking status by inputting significant independent variables (P < 0.01) from the prior analyses.

Setting.  Pain facility.

Results.  Five variables were found to explain 38.8% of the variance for smoking status. These were education; race (Caucasian); cups of coffee per day; a diagnosis of current alcohol abuse/dependence; and personality disorder.

Conclusions.  Smoking status in CPPs is associated with some variables that are similar for smoking in the general and psychiatric populations (education, race, alcoholism). However, a number of variables expected to be relevant (e.g., mood disorders) were not associated with smoking status in CPPs. These results may not be generalizable to all CPPs as they are derived from CPPs who are return-to-work candidates.