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Purpose of Review <p>Despite high co-occurrence and bidirectional relationships between chronic pain and tobacco use, these conditions are typically treated separately. This review evaluates integrated treatment approaches and identifies methodological limitations impeding evidence-based care for this challenging comorbidity. We organize findings thematically around: <OrderedList> <ListItem> <ItemNumber>(1)</ItemNumber> <ItemContent> <p>Integrated smoking cessation interventions</p> </ItemContent> </ListItem> <ListItem> <ItemNumber>(2)</ItemNumber> <ItemContent> <p>Brief motivational approaches</p> </ItemContent> </ListItem> <ListItem> <ItemNumber>(3)</ItemNumber> <ItemContent> <p>Mechanisms underlying treatment efficacy and relapse</p> </ItemContent> </ListItem> <ListItem> <ItemNumber>(4)</ItemNumber> <ItemContent> <p>Future directions for research and clinical practice</p> </ItemContent> </ListItem> </OrderedList></p> Recent Findings <p>Integrated interventions combining smoking cessation with pain management demonstrate preliminary feasibility. Brief motivational interventions targeting pain-smoking links enhance readiness to quit but reveal a persistent motivation-action gap. Mechanistic studies using ecological momentary assessment identify pain-related stress as a key mediator of smoking relapse through increased outcome expectancies about mood benefits.</p> Summary <p>While conceptually promising, the evidence base remains constrained by methodological limitations including small samples, inadequate follow-up periods, and population heterogeneity. Advancing care requires transitioning from isolated treatment to rigorous integrated models. Priorities include well-powered randomized controlled trials with extended follow-ups, dynamic assessment methodologies capturing real-time pain-smoking interactions, and interventions targeting identified mechanisms linking pain to relapse.</p>

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Tobacco use Disorder and Chronic Pain: a Narrative Review of Integrated Treatment Approaches, Underlying Mechanisms, and Future Research Directions

  • 期刊论文

  • 发表日期：

    2025年10月14日

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  • Lucas R. da Rocha,
  • Gabriel P.A. Costa,
  • Mehmet Sofuoglu,
  • João Mauricio Castaldelli-Maia,
  • Joao P. De Aquino

摘要

Purpose of Review

Despite high co-occurrence and bidirectional relationships between chronic pain and tobacco use, these conditions are typically treated separately. This review evaluates integrated treatment approaches and identifies methodological limitations impeding evidence-based care for this challenging comorbidity. We organize findings thematically around: (1)

Integrated smoking cessation interventions

(2)

Brief motivational approaches

 (3)

Mechanisms underlying treatment efficacy and relapse

 (4)

Future directions for research and clinical practice

Recent Findings

Integrated interventions combining smoking cessation with pain management demonstrate preliminary feasibility. Brief motivational interventions targeting pain-smoking links enhance readiness to quit but reveal a persistent motivation-action gap. Mechanistic studies using ecological momentary assessment identify pain-related stress as a key mediator of smoking relapse through increased outcome expectancies about mood benefits.

Summary

While conceptually promising, the evidence base remains constrained by methodological limitations including small samples, inadequate follow-up periods, and population heterogeneity. Advancing care requires transitioning from isolated treatment to rigorous integrated models. Priorities include well-powered randomized controlled trials with extended follow-ups, dynamic assessment methodologies capturing real-time pain-smoking interactions, and interventions targeting identified mechanisms linking pain to relapse.