Enhanced pain perception prior to smoking cessation is associated with early relapse

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20 Scopus citations


Accumulated evidence suggests that nicotine induces analgesia, and endogenous pain regulatory mechanisms may be altered by chronic smoking. The extent to which individual differences in pain perception are related to smokers' ability to abstain from smoking has not been directly examined. Seventy-one smokers who were interested in quitting completed a pre-cessation laboratory session which included the cold pressor test (CPT). Pain ratings were collected during and after CPT. Also, mood changes, cardiovascular measures, and salivary cortisol samples were evaluated prior to, during, and after CPT. Participants attended 4 weekly follow-up assessment sessions after their quit day. Cox regression analysis revealed that higher pain ratings during and after CPT predicted greater risk for smoking relapse. These results remained significant after affective and physiological responses to CPT were controlled, suggesting that pain ratings prior to smoking cessation are potentially useful in identifying smokers who are at greater risk of early smoking relapse and may reflect underlying putative risk for nicotine dependence and relapse.

Original languageEnglish (US)
Pages (from-to)141-146
Number of pages6
JournalBiological Psychology
Issue number1
StatePublished - Sep 2011

Bibliographical note

Funding Information:
We thank Koji Fujiwara for assistance with data analysis. This research was supported in part by a grand to Dr. al’Absi from the National Cancer Institute ( CA 88272 ). Dr. al’Absi was also supported by grants from the National Institute on Drug Abuse ( DA 013435 and DA 016351 ). The authors have no conflicts of interest regarding this manuscript.


  • Cold pressor test
  • Cortisol
  • Pain
  • Relapse
  • Smoking


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