Effects of nicotine deprivation on current pain intensity among daily cigarette smokers

Animal research has consistently demonstrated increased pain in the context of nicotine deprivation, and there is cross-sectional evidence that tobacco smokers may experience greater pain following periods of smoking abstinence. This study aimed to examine current pain intensity as a function of nicotine deprivation among 137 daily tobacco smokers who did not endorse chronic pain and were recruited to participate in a primary study of the effects of smoking abstinence on experimental pain reactivity. Participants were randomized to either deprivation (12-24 hr abstinence) or continued ad lib smoking conditions. Compliance with the manipulation was biochemically verified via expired carbon monoxide (CO). Current pain intensity was assessed at baseline (Session 1) and following the deprivation manipulation (Session 2) using a single item that asked participants to indicate their current level of pain on a scale ranging from 0 (no pain) to 10 (pain as bad as you can imagine). At baseline, the majority of participants (51.1%) reported no pain (M = 1.75). As hypothesized, participants randomized to nicotine deprivation (vs. continued smoking) reported greater current pain intensity following the manipulation. Among smokers who reported no pain at baseline, those who abstained from smoking were nearly 3.5 times more likely to endorse pain at Session 2. These results suggest that daily tobacco smokers may experience greater pain during the first 12-24 hr of smoking abstinence. Future research should examine the role of pain in nicotine withdrawal, and whether tailored interventions may be needed to account for nicotine deprivation-induced amplification of pain.