Smokers with pain are more likely to report use of e-cigarettes and other nicotine products

Pain and tobacco cigarette smoking frequently co-occur, and smokers report using cigarettes to selfmedicate pain. Despite the growing popularity of e-cigarettes and alternative nicotine products, no research has examined their use as a function of pain status. The goal of this study was to test cross-sectional relations between the presence of pain and current use of e-cigarettes, lifetime polynicotine use, and lifetime use of individual nicotine products. The sample was comprised of current daily smokers (N = 301) who were recruited to participate in a web-based longitudinal study examining predictors of cessation milestones. Results indicated that smokers who endorsed past-2-week significant pain (vs. no past-2-week pain) were 3 times more likely to endorse current e-cigarette use, reported having used a greater number of nicotine products in their lifetime, and were nearly 3 times more likely to endorse lifetime polynicotine use. In terms of individual products, smokers with pain were approximately 4 times as likely to have tried e-cigarettes and 7 times more likely to have tried cigars. This is the first study to demonstrate that smokers who endorse significant pain are also more likely to endorse use of e-cigarettes and other combustible nicotine products. Future research is needed to examine polynicotine use in relation to pain reporting among more varied samples of smokers and nonsmokers.