Quitting smoking can reduce opioid prescriptions: study

Smoking is recognized as one of the leading causes of preventable disability and death. New research shows that as smokers increase their daily cigarette count, they are more likely to experience chronic pain, increased prescription opioid use, severe work limitations due to pain and poor mental health.

A novel study in the American Journal of Preventive Medicine describes the results of an analysis of nationally representative data from the U.S. Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS), revealing a strong association between smoking and opioid use and highlighting the need for integrated treatment programs.

Key findings of the study are summarized by the study authors, William Encinosa, Ph.D., Didem Bernard, Ph.D., and R. Burciaga Valdez, Ph.D., MHSA, Division of Research and Modeling, Center for Financing, Access, and Cost. Trends, Agency for Healthcare Research and Quality, and the McCourt School of Public Policy, Georgetown University, say: “Our research shows that adults who smoke 11-20 cigarettes per day use five times more prescription opioids than adults who have never smoked Thus, smoking more than a pack of cigarettes per day use almost three times as many opioids as adults who smoke 11 to 20 cigarettes per day reduce prescription.

The team of researchers analyzed data from 2013 to 2021 from MEPS and the Centers for Disease Control and Prevention’s National Health Interview Survey. Findings show that although only 37% of the population has ever smoked, smokers are responsible for 69% of annual prescription opioid use. Heavy smokers, only 12% of the population, use as many opioids as the 63% who have never smoked. Smokers also report higher rates of chronic pain, severe work limitations due to pain and poor mental health.

This article reports the first nationally representative estimates of the association between smoking, pain, and opioid use and how it has persisted from the peak of prescription opioid use in 2013 to its recent trough in 2021.

Opioid dispensing has fallen from 81.3 prescriptions per 100 people in 2012 to 43.3 per 100 people in 2020. Many policy factors have led to this decline in opioid prescriptions, such as pill mill laws, state caps on the number of prescriptions per patient , prescription drug monitoring systems, and the Centers for Disease Control and Prevention guidelines for the treatment of chronic pain, which address concerns that high doses and long-term use of opioids for chronic pain can lead to opioid use disorders and its adverse health effects. Despite this decline, prescription opioid hotspots remain in the US.

The researchers conclude: “Combining smoking cessation with substance abuse treatment could be critical in addressing the opioid epidemic. Many states and localities are trying to ban different types of cigarettes. Our research shows that any smoking cessation resulting from these bans could also help ease the opioid crisis.”