Cited by 177Pain Management and Placebo EffectPain Mechanisms and TreatmentsSmoking Behavior and Cessation

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Cigarette smoking, stress-induced analgesia and pain perception in men and women

Girdler, Susan S., Maixner, William, Naftel, Herman A., Stewart, Paul W., Moretz, Rebecca L., Light, Kathleen C.·2005·Pain

DOI 10.1016/j.pain.2004.12.035

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Abstract

This study examined gender differences in smoking-related analgesia and stress-induced analgesia (SIA), as a function of pain modality. Forty men (20 smokers, 20 nonsmokers) and 37 women (17 smokers) were tested twice for pain sensitivity to tourniquet ischemia, thermal heat, and cold pressor tests; once following mental stress and once following rest control, counterbalancing order. Cardiovascular and neuroendocrine responses to mental stress were also examined. While expected gender differences in pain sensitivity were observed, women smokers had greater threshold and tolerance times to ischemic pain than women nonsmokers (P<0.05) when pain testing followed rest. Male smokers had greater threshold and tolerance to cold pressor pain than male nonsmokers (P<0.05) after both rest and stress. Only women showed evidence for SIA, since women nonsmokers demonstrated greater ischemic pain threshold and tolerance following mental stress versus rest (P<0.05), and all women reported lower thermal heat pain unpleasantness after stress versus rest (P=0.05). Only nonsmokers showed expected inverse relationships between sympathetic and hypothalamic-pituitary-adrenal (HPA) axis reactivity measures and sensitivity to pain. Smokers showed evidence for blunted HPA-axis function at rest and stress. These results indicate that analgesia related to both being a smoker and stress is influenced by gender and pain modality. The reduced pain perception in smokers and absence of relationships between endogenous pain regulatory mechanisms and pain sensitivity may reflect a maladaptive response to chronic smoking.

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Self-citation

Authors: Girdler, S. S., Maixner, W., Naftel, H. A., Stewart, P. W., Moretz, R. L., & Light, K. C.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Girdler, Susan S.
ORCID: Girdler, Susan S.
Stewart, Paul W.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2005-04
Volume: 114
Issue: 3
Pages: 372-385
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/j.pain.2004.12.035
OpenAlex: W2027714672
Cited by: 177
References: 79
Citations by year: 2026: 6 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 5 · 2021: 8 · 2020: 8 · 2019: 9 · 2018: 5 · 2017: 9 · 2016: 9 · 2015: 6 · 2014: 8 · 2013: 7 · 2012: 12
FWCI: 4.78
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsches Krebsforschungszentrum
National Institutes of Health
Centers for Disease Control and Prevention
National Institute on Drug Abuse (R01DA013705, DA13705)
National Center for Research Resources (RR00046, M01RR000046)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Keywords: cigarette smoking, stress-induced analgesia, pain perception, gender differences, pain threshold, pain tolerance, ischemic pain, cold pressor pain, thermal pain, psychological stress, hypothalamic-pituitary-adrenal axis, sympathetic nervous system, cardiovascular response, chronic smoking
MeSH terms: Adrenocorticotropic Hormone, Adult, beta-Endorphin, Blood Pressure, Cold Temperature, Female, Heart Rate, Hot Temperature, Humans, Hydrocortisone, Ischemia, Male, Nicotine, Nociceptors, Norepinephrine, Perception, Sex Characteristics, Smoking, Stress, Psychological, Substance Withdrawal Syndrome, Pain Threshold

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Cigarette smoking, stress-induced analgesia and pain perception in men and women

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