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

Abstract

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.