Smoking

Last updated: Wed, Jul 31, 2024

From 15 to 37% of chronic pain patients are smokers. This may be higher than among the population in general. Smokers are more likely to have chronic low back pain than non-smokers. Higher levels of smoking go with higher levels of disability and poorer treatment outcomes.

It is believed that nicotine in the bloodstream tends to break down proteins, and this might explain why smokers have more back problems. Nicotine is known to reduce pain. Nicotine interferes with the function of the neurotransmitter serotonin. Many modern anti-depressants work by increasing available levels of serotonin.1

Based on the available science, it is likely that smoking has harmful effects on the body or its pain system that increase pain. On the other hand, it seems likely that pain sufferers would use nicotine as a self-administered drug to mask or reduce pain salience despite the long-term negative effects of the drug.