Abstract
Although animal models have consistently demonstrated acute pain inhibitory effects of nicotine and tobacco, human experimental studies have yielded mixed results. The main goal of this meta-analysis was to quantify the effects of nicotine/tobacco administration on human experimental pain threshold and tolerance ratings. A search of PubMed and PsycINFO online databases identified 13 eligible articles, including k 21 tests of pain tolerance (N 393) and k 15 tests of pain threshold (N 339). Meta-analytic integration for both threshold and tolerance outcomes revealed that nicotine administered through tobacco smoke and other delivery systems (eg, patch, nasal spray) produced acute analgesic effects that may be characterized as small to medium in magnitude (Hedges g 0.35, 95% confidence interval 0.21-0.50). Publication bias-corrected estimates remained significant and indicated that these effects may be closer to small. Sex composition was observed to be a significant moderator, such that pain threshold effects were more robust among samples that included more men than women. These results help to clarify a mixed literature and may ultimately help to inform the treatment of both pain and nicotine dependence. Pain and tobacco smoking are both highly prevalent and comorbid conditions. Current smoking has been associated with more severe chronic pain and physical impairment. Acute nicotine-induced analgesia could make smoking more rewarding and harder to give up. Future research should use dynamic measures of experimental pain reactivity and further explore biopsychosocial mechanisms of action.
Original language | English (US) |
---|---|
Pages (from-to) | 1373-1381 |
Number of pages | 9 |
Journal | Pain |
Volume | 157 |
Issue number | 7 |
DOIs | |
State | Published - Jul 1 2016 |
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Keywords
- Analgesia
- Analgesic
- Meta-analysis
- Nicotine
- Pain
- Smoking
- Tobacco
ASJC Scopus subject areas
- Clinical Neurology
- Anesthesiology and Pain Medicine
- Neurology
- Pharmacology
Cite this
Acute analgesic effects of nicotine and tobacco in humans : A meta-analysis. / Ditre, Joseph W; Heckman, Bryan W.; Zale, Emily L.; Kosiba, Jesse D.; Maisto, Stephen A.
In: Pain, Vol. 157, No. 7, 01.07.2016, p. 1373-1381.Research output: Contribution to journal › Review article
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TY - JOUR
T1 - Acute analgesic effects of nicotine and tobacco in humans
T2 - A meta-analysis
AU - Ditre, Joseph W
AU - Heckman, Bryan W.
AU - Zale, Emily L.
AU - Kosiba, Jesse D.
AU - Maisto, Stephen A
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Although animal models have consistently demonstrated acute pain inhibitory effects of nicotine and tobacco, human experimental studies have yielded mixed results. The main goal of this meta-analysis was to quantify the effects of nicotine/tobacco administration on human experimental pain threshold and tolerance ratings. A search of PubMed and PsycINFO online databases identified 13 eligible articles, including k 21 tests of pain tolerance (N 393) and k 15 tests of pain threshold (N 339). Meta-analytic integration for both threshold and tolerance outcomes revealed that nicotine administered through tobacco smoke and other delivery systems (eg, patch, nasal spray) produced acute analgesic effects that may be characterized as small to medium in magnitude (Hedges g 0.35, 95% confidence interval 0.21-0.50). Publication bias-corrected estimates remained significant and indicated that these effects may be closer to small. Sex composition was observed to be a significant moderator, such that pain threshold effects were more robust among samples that included more men than women. These results help to clarify a mixed literature and may ultimately help to inform the treatment of both pain and nicotine dependence. Pain and tobacco smoking are both highly prevalent and comorbid conditions. Current smoking has been associated with more severe chronic pain and physical impairment. Acute nicotine-induced analgesia could make smoking more rewarding and harder to give up. Future research should use dynamic measures of experimental pain reactivity and further explore biopsychosocial mechanisms of action.
AB - Although animal models have consistently demonstrated acute pain inhibitory effects of nicotine and tobacco, human experimental studies have yielded mixed results. The main goal of this meta-analysis was to quantify the effects of nicotine/tobacco administration on human experimental pain threshold and tolerance ratings. A search of PubMed and PsycINFO online databases identified 13 eligible articles, including k 21 tests of pain tolerance (N 393) and k 15 tests of pain threshold (N 339). Meta-analytic integration for both threshold and tolerance outcomes revealed that nicotine administered through tobacco smoke and other delivery systems (eg, patch, nasal spray) produced acute analgesic effects that may be characterized as small to medium in magnitude (Hedges g 0.35, 95% confidence interval 0.21-0.50). Publication bias-corrected estimates remained significant and indicated that these effects may be closer to small. Sex composition was observed to be a significant moderator, such that pain threshold effects were more robust among samples that included more men than women. These results help to clarify a mixed literature and may ultimately help to inform the treatment of both pain and nicotine dependence. Pain and tobacco smoking are both highly prevalent and comorbid conditions. Current smoking has been associated with more severe chronic pain and physical impairment. Acute nicotine-induced analgesia could make smoking more rewarding and harder to give up. Future research should use dynamic measures of experimental pain reactivity and further explore biopsychosocial mechanisms of action.
KW - Analgesia
KW - Analgesic
KW - Meta-analysis
KW - Nicotine
KW - Pain
KW - Smoking
KW - Tobacco
UR - http://www.scopus.com/inward/record.url?scp=84976384866&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84976384866&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000000572
DO - 10.1097/j.pain.0000000000000572
M3 - Review article
C2 - 27023418
AN - SCOPUS:84976384866
VL - 157
SP - 1373
EP - 1381
JO - Pain
JF - Pain
SN - 0304-3959
IS - 7
ER -