A scoping review of pain and tobacco use among cancer survivors.

BACKGROUND

Pain and tobacco use frequently co-occur in the general population; however, less is known about whether these relationships extend to cancer survivors, who report high levels of chronic pain.

PURPOSE: This scoping review aimed to inform future research by identifying, characterizing, and synthesizing the research literature on pain and nicotine/tobacco use among cancer survivors.

METHODS

We developed and executed a comprehensive search strategy in December 2023 and September 2024, identifying 5901 peer-reviewed citations after systematic search of Embase (Elsevier), MEDLINE (Ovid), PsycINFO (EBSCO), Cochrane Library (Wiley), and ClinicalTrials.gov. Fifty-four studies published from 2004 to 2024 met inclusion criteria.

RESULTS

Most studies focused on combustible cigarette smoking (∼94%), and minimal research focused on treatment and tobacco cessation. Approximately half (n = 27) of studies were prospective/longitudinal in design, followed by cross-sectional (n = 25), qualitative (n = 1), and a pilot randomized controlled trial (n = 1). Most studies (∼74%) demonstrated a positive relationship between pain and cigarette/tobacco use. Former smoking was linked to lower pain levels, although findings were more mixed in this area. Only 2 studies found a negative relationship between pain and tobacco use.

CONCLUSIONS

This review demonstrates that associations between pain and cigarette smoking in cancer survivors are the same as those found in the general population. Future research would benefit from: (1) incorporating more rigorous designs capable of determining causality, (2) focusing on use of other nicotine/tobacco products (eg, electronic cigarettes), (3) elucidating mechanisms in pain and tobacco use, and (4) considering impact of pain on smoking cessation and treatment among cancer survivors.