The Close Connection between Opioid use Disorder and Cigarette Smoking: A Narrative Review

1
Joseph V. Pergolizzi
Joseph V. Pergolizzi
2
Peter Magnusson
Peter Magnusson
3
Frank Breve
Frank Breve
4
Jo Ann LeQuang
Jo Ann LeQuang
5
Giustino Varrassi
Giustino Varrassi
1 NEMA Research, Inc.

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People with opioid use disorder (OUD) have rates of cigarette smoking approaching 90% and smoking cessation programs are rarely effective. The relationship between long-term opioid exposure and smoking has been epidemiologically observed but not well understood. Nicotine interacts with the nicotinic acetylcholine receptors in the central and peripheral nervous systems, which are involved in anxiety, cognition, sleep, arousal, and pain perception. Cigarette smoking triggers the release of dopamine in the brain. There is equivocal evidence that nicotine may have an analgesic effect, but paradoxically, smokers tend to have higher pain intensity levels than nonsmokers. Pharmacologic treatments for nicotine dependence were often studied in trials that routinely excluded subjects with opioid dependence. Further, the association between smoking and long-term opioid use sometimes includes mental health disorders and/or chronic pain. In fact, smoking may also be comorbid with chronic pain. It has been speculated that smoking, particularly at a young age, may be predictive of OUD. While smoking is also associated with other forms of substance abuse, the association between OUD and tobacco is particularly intriguing and likely involves common neurobiological pathways.

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No external funding was declared for this work.

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The authors declare no conflict of interest.

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No ethics committee approval was required for this article type.

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Joseph V. Pergolizzi. 2026. \u201cThe Close Connection between Opioid use Disorder and Cigarette Smoking: A Narrative Review\u201d. Global Journal of Medical Research - K: Interdisciplinary GJMR-K Volume 22 (GJMR Volume 22 Issue K2): .

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People with addiction and smoking share close links to impulsivity and mental health disorders.
Journal Specifications

Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

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GJMR-K Classification: DDC Code: 616.994061 LCC Code: RC262
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v1.2

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May 20, 2022

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English

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People with opioid use disorder (OUD) have rates of cigarette smoking approaching 90% and smoking cessation programs are rarely effective. The relationship between long-term opioid exposure and smoking has been epidemiologically observed but not well understood. Nicotine interacts with the nicotinic acetylcholine receptors in the central and peripheral nervous systems, which are involved in anxiety, cognition, sleep, arousal, and pain perception. Cigarette smoking triggers the release of dopamine in the brain. There is equivocal evidence that nicotine may have an analgesic effect, but paradoxically, smokers tend to have higher pain intensity levels than nonsmokers. Pharmacologic treatments for nicotine dependence were often studied in trials that routinely excluded subjects with opioid dependence. Further, the association between smoking and long-term opioid use sometimes includes mental health disorders and/or chronic pain. In fact, smoking may also be comorbid with chronic pain. It has been speculated that smoking, particularly at a young age, may be predictive of OUD. While smoking is also associated with other forms of substance abuse, the association between OUD and tobacco is particularly intriguing and likely involves common neurobiological pathways.

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The Close Connection between Opioid use Disorder and Cigarette Smoking: A Narrative Review

Joseph V. Pergolizzi
Joseph V. Pergolizzi NEMA Research, Inc.
Peter Magnusson
Peter Magnusson
Frank Breve
Frank Breve
Jo Ann LeQuang
Jo Ann LeQuang
Giustino Varrassi
Giustino Varrassi

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