Why are abstinent smokers more sensitive to pain?

Abstinent smokers experience increased pain sensitivity during withdrawal, to the point that they often require more pain relief after surgery. Why? New from JNeurosci, Zhijie Lu, from Fudan University Minhang Hospital, and Kai Wei, from Shanghai Eastern Hepatobiliary Surgery Hospital, led a team of researchers to explore brain activity linking nicotine withdrawal and pain sensitivity. 

The researchers found that 30 abstinent smokers had altered functioning of specific brain areas, increased pain sensitivity, and a need for more postoperative pain relief—particularly with opioids—compared to 30 nonsmokers. The longer that smokers abstained from their use, the more sensitive they were to pain, which was associated with a distinct set of brain regions. Notably, this effect was constrained to a specific timeframe of abstinence, supporting previous findings that pain sensitivity may return to normal levels once abstinence exceeds 3 months. The relationship between postoperative care requirements and withdrawal symptoms from abstinence was linked to a different set of brain regions. 

Says Wei, “We’d like to emphasize that our study does not discourage smokers from quitting before surgery. Our aim is to encourage researchers to delve deeper into the mechanisms underlying elevated pain sensitivity during short-term abstinence, with the goal of developing strategies to mitigate the clinical challenge of increased analgesic (especially opioid) use associated with preoperative smoking cessation.” The researchers have already begun exploring the mechanisms of a postoperative pain reliever that may be more effective than opioids in abstinent smokers as well as the mechanisms and effectiveness of preoperative nicotine replacement therapies. 

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About JNeurosci 

JNeurosci was launched in 1981 as a means to communicate the findings of the highest quality neuroscience research to the growing field. Today, the journal remains committed to publishing cutting-edge neuroscience that will have an immediate and lasting scientific impact, while responding to authors' changing publishing needs, representing breadth of the field and diversity in authorship. 

About The Society for Neuroscience 

The Society for Neuroscience is the world's largest organization of scientists and physicians devoted to understanding the brain and nervous system. The nonprofit organization, founded in 1969, now has nearly 35,000 members in more than 95 countries.