Pain as a predictor and consequence of tobacco abstinence effects amongst African American smokers.

Mariel S. Bello, Julia F. McBeth, Joseph W. Ditre, Matthew G. Kirkpatrick, Lara A. Ray, Kelly E. Dunn, Adam M. Leventhal

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


African Americans are subject to health disparities in smoking and chronic pain. Given that nicotine has analgesic properties, increases in acute pain may be an expression of the tobacco abstinence syndrome, particularly among African American smokers with chronic pain. This report is a secondary analysis of data from an ongoing study of individual differences in laboratory-derived tobacco abstinence phenotypes in African American smokers. We tested whether overnight smoking abstinence increased acute pain and whether abstinence-induced changes in acute pain were correlated with other expressions of tobacco abstinence and amplified among smokers with chronic pain. African American smokers (N = 214; 10+ cig/day) attended a baseline visit (when chronic pain was reported), and two counterbalanced experimental sessions (ad libitum smoking vs. 16-hr smoking abstinence). At both experimental sessions, measures of self-reported acute pain and other tobacco abstinence symptoms were administered. Smoking abstinence significantly increased acute pain (d =.17, p =.01). Correlations between abstinence-induced changes in acute pain and abstinence-induced changes in negative affect, r =.15, p =.02, smoking urges, r =.13, p =.05, and composite nicotine withdrawal symptoms, r =.13, p =.06, were small and nonsignificant after correction for multiple tests, indicating that phenotypic variation in abstinence-provoked changes in acute pain and other tobacco abstinence expressions were largely independent. Baseline levels of chronic pain predicted greater abstinence-induced pain amplification at experimental sessions (βs =.29-.31; ps <.001). Acute pain is greater following overnight tobacco abstinence (vs. satiation) among African American smokers, predominantly among those with chronic pain. Addressing pain in tobacco addiction science, treatment, and health equity programming warrants consideration.

Original languageEnglish (US)
Pages (from-to)683-694
Number of pages12
JournalJournal of abnormal psychology
Issue number7
StatePublished - Oct 2018


  • African Americans
  • chronic pain
  • health disparities
  • pain
  • tobacco abstinence

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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