“Relative to the general population, smokers are four times more likely to be dependent on alcohol and are more likely to experience severe pain,” wrote Lisa R. LaRowe, M.S., of Syracuse University in New York and colleagues. To examine the relationship between pain and alcohol use among smokers, the researchers analyzed measurements of pain and alcohol use in 225 people who smoked at least 15 tobacco cigarettes a day, with an average of 22 tobacco cigarettes a day.
Participants rated the amount of bodily pain they experienced in the four weeks prior to the study on a 6-point scale, with 0 representing “none” and 5 representing “very severe.” They also rated the intensity of their pain over the previous 24 hours on a scale of 0 to 10, with 10 representing the most severe. The researchers used the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol Urge Questionnaire to determine how much alcohol the participants drank, whether the participants’ alcohol use was hazardous, and whether the participants experienced a strong urge to drink. The researchers also measured the intensity of the participants’ negative emotions via the negative affect subscale of the Positive and Negative Affect Schedule.
Approximately 35% of participants who reported experiencing pain in the prior four weeks scored above the AUDIT cut-off for hazardous drinking, compared with 19% of those who reported experiencing no pain in the prior four weeks. Each one-point increase in pain severity was associated with a 47% greater likelihood of screening positively for hazardous drinking. Moreover, the higher participants scored on pain intensity, the more likely they were to experience negative moods. In turn, the more negative moods they had, the greater the urge they had to drink alcohol.
“These findings provide initial evidence that smokers with greater pain severity may also report hazardous patterns of alcohol use,” the researchers wrote. “The observed indirect association between pain intensity and urge to drink via a negative affect adds to a growing literature indicating that pain can be a potent motivator of substance use in general, and alcohol use in particular.”
For related information, see the American Journal of Psychiatry article “U.S. Adults With Pain, a Group Increasingly Vulnerable to Nonmedical Cannabis Use and Cannabis Use Disorder: 2001–2002 and 2012–2013.”