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Lifetime cigarette smoking and chronic widespread and regional pain in later adulthood: Evidence from the 1946 British birth cohort study

Lookup NU author(s): Professor Rachel CooperORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ. Objective To examine whether different lifetime patterns of cigarette smoking are associated with chronic widespread pain (CWP) and chronic regional pain (CRP) at age 68. Design Prospective cohort study. Setting England, Scotland and Wales. Participants Up to 2347 men and women from the Medical Research Council National Survey of Health and Development, who have been followed up since birth in 1946 and provided sufficient information on cigarette smoking across adulthood to be classified as never smoker, predominantly non-smoker, predominantly smoker or lifelong smoker and pain assessment at age 68. Primary outcome measures Pain was self-reported at age 68, and CWP was defined according to American College of Rheumatology criteria. Participants who reported having pain for ≥3 months but who did not meet the CWP definition were classified as having CRP; those who reported pain which had lasted for <3 months were classified as 'other' pain. No pain was the reference group. Results Findings from multinomial logistic regression models indicated that compared with never smokers, predominantly non-smokers, predominantly smokers and lifelong smokers all had an increased risk of CWP; relative risk ratios=1.70(95% CI 1.16 to 2.49); 2.10(95% CI 1.34 to 3.28) and 1.88(95% CI 0.99 to 3.57), respectively, after adjusting for sex, own occupational class, educational level, body mass index, leisure time physical activity, alcohol intake, long-standing illness and symptoms of anxiety and depression. No association was observed between smoking history and CRP or other pain. Conclusions These results suggest that exposure to cigarette smoking at any stage in adulthood was associated with higher risk of CWP in later adulthood; highlighting the ongoing importance of smoking prevention programmes. It also suggests that assessment of lifetime smoking behaviour may be more useful in identifying those at greater risk of CWP in later life than assessment of current smoking status.

Publication metadata

Author(s): Bendayan R, Cooper R, Muthuri SG

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2018

Volume: 8

Issue: 8

Online publication date: 29/08/2018

Acceptance date: 30/06/2018

Date deposited: 21/01/2022

ISSN (electronic): 2045-2322

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2018-021896

PubMed id: 30158227


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