The role of pain intensity and smoking expectancies on smoking urge and behavior following experimental pain induction.

INTRODUCTION: Contemporary models of pain and smoking posit a cyclical relationship wherein smoking reduces pain in the short term but, ultimately, serves to exacerbate it in the long term. Such models were influenced by initial experimental findings suggesting situational pain is sufficient to increase smoking-urge and behavior. The initial experimental findings have not yet been replicated and potential mediating smoking motives and anxiety variables have not been explored.
METHODS: The current investigation was designed with the aims of exploring whether (a) electrical heat-pain is sufficient to increase smoking-urge, (b) pain intensity, anxiety sensitivity, and smoking expectancies for pain relief account for variance in post-pain smoking-urge, and (c) individuals are more likely to smoke following a pain experience.
RESULTS: Participants in the heat-pain condition (n=16) reported greater smoking-urge than those in the no-pain control condition (n=16). In the heat-pain condition, approximately 31% of variance in smoking-urge was accounted for by the belief that smoking would help with pain coping or relief. Anxiety sensitivity and pain intensity ratings were not significant predictors of smoking-urge. Significantly more individuals in the heat-pain condition attempted to smoke (100%) after the pain manipulation than those in the no-pain control condition (62.5%).
CONCLUSIONS: Acute heat-pain increases smoking-urge and behavior, especially for individuals with expectancies that smoking will help with pain coping. Pain and pain-related smoking expectancies may serve as barriers to smoking cessation for those experiencing pain. Findings provide support for smoking cessation interventions strategies aimed at pain management and challenging smoking expectancies for pain coping/relief.