Longitudinal Associations Between Pain and Use of Cigarettes and E-Cigarettes in the Population Assessment of Tobacco and Health (PATH) Study.

This is the first prospective study to show that pain serves as an important risk factor for initiation and maintenance of cigarette and e-cigarette use/co-use over time. Weighted prevalence estimates further demonstrated that individuals with moderate/severe pain endorsed rates of cigarette and e-cigarette use/co-use approximately two times greater compared to those with no/low pain. These findings highlight a subpopulation of nicotine users more susceptible to greater health-care burden, nicotine dependence, and physical impairment. Nicotine users with comorbid pain may benefit from integrated interventions that address pain in the context of cessation.