Pain may lead to increased cigarette and cannabis use in cancer survivors

Experiencing pain may increase the odds that cancer survivors will use cigarettes and cannabis, according to a recent study published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society. The study also found that cigarette smoking and pain are linked to more treatment-related side effects and worse health among cancer survivors.

Pain and use of cigarettes, e-cigarettes, alcohol, and cannabis commonly occur together in the general population. To characterize pain in relation to such non-opioid substance use specifically among cancer survivors (who often experience pain), investigators analyzed data from two national samples of individuals with a past diagnosis of cancer in the United States: 1,252 adults from Wave 6 (2021) of the Population Assessment of Tobacco and Health (PATH) Study and 4,130 adults from the 2020 National Health Interview Survey.

PATH data indicated that higher past-week pain intensity was associated with a greater likelihood that cancer survivors would use cigarettes, e-cigarettes, and cannabis, and a lower likelihood that they would drink alcohol. National Health Interview Survey data indicated that chronic pain was associated with a greater likelihood of cigarette smoking and a lower likelihood of alcohol use. In both studies, cigarette smoking and pain were linked to fatigue, sleep difficulties, poorer mental/physical health, and lower quality of life.

These findings show that because pain and substance use are interconnected among cancer survivors, it's important to focus on treating both together in cancer care. Pain can drive substance use, and substance use can worsen pain, creating a cycle that's hard to break. While cancer survivors might smoke cigarettes or use substances to get immediate relief from their pain and cope with other symptoms, this can be incredibly harmful for their health by reducing the effectiveness of cancer treatments and increasing risk for cancer recurrence."

Jessica M. Powers, PhD, lead author of Northwestern University's Feinberg School of Medicine