The Opioid Epidemic and Smoking

Roxana Said, MPH

Prescription Opioid Misuse & Smoking
It is a vital time for public health to address smoking as a risk factor for opioid misuse.

The opioid epidemic has been a growing public health crisis for years, and given the recent rise of overdose deaths, there’s no time like the present for health care providers to address associated risk factors, such as smoking.
Currently, research and literature on the association between smoking/nicotine dependence and prescription opioid misuse among the general population are limited, but the available facts are alarming.


Furthermore, empirical evidence has shown that there is a significant association between smoking and pain, and smokers tend to have a higher intensity of pain compared to non-smokers, putting them at higher risk of opioid misuse/dependency.

A key takeaway for providers: Addressing tobacco use with patients being treated for pain may be useful in reducing pain, as well as reducing the need for pain medication.




Jin H. Yoon, Scott D. Lane & Michael F. Weaver (2015) Opioid Analgesics and Nicotine: More Than Blowing Smoke, Journal of Pain & Palliative Care Pharmacotherapy, 29:3,
281-289, DOI: 10.3109/15360288.2015.1063559

Ditre, J. W., Brandon, T. H., Zale, E. L., & Meagher, M. M. (2012). Pain, Nicotine, and Smoking: Research Findings and Mechanistic Considerations. Psychol Bull. Author manuscript.

Guydish, J., Passalacqua, E., Pagano, A., Martinez, C., Le, T., Chun, J., & Tajima, B. (2015). An International Systematic Review of Smoking Prevalence in Addiction Treatment. Society for the Study of Addiction.
Zale, E. L., Dorfman, M. L., Hooten, M., Warner, D. O., Zvolensky, M. J., & Ditre, J. W. (2015). Tobacco Smoking, Nicotine Dependence, and Patterns of Prescription Opioid Misuse: Results From a Nationally Representative Sample. Nicotine & Tobacco Research