People with chronic pain are significantly more likely to be cigarette smokers than those without chronic pain. Some smokers with chronic pain report that they use smoking as a pain-management strategy. However, smoking is not an effective coping strategy and has been associated with greater pain intensity, more pain interference and more fear of pain. Research has found that smokers with back pain report more emotional distress, lower activity levels and greater reliance on pain medication than nonsmokers with back pain. Smoking is also linked to increased headaches. While most people already know the dangers of smoking with respect to cancer, cardiovascular disease and other health risks, it turns out that quitting smoking may also improve your ability to manage your chronic pain.

How to Quit

Quitting is a complex process. You may find that you will try to quit a few times before you succeed. There are a number of factors that contribute to success.

1. Create a Plan to Quit. Choose a Quit Day. Put it on your calendar and use it to create your Plan to Quit. List in your Plan all the reasons you want to quit, including better pain management. Spend time picturing how not smoking will change your life and give you a healthier future. Accept that quitting needs to have the greatest priority in your life for a while. As time goes on, it will become easier and easier, until you reach a point where you don’t have to think about it anymore. You will be a non-smoker!

2. Identify smoking triggers. Smoking is often linked to and triggered by, a variety of situations, emotions and people. List all of your smoking triggers. It is important to recognize your triggers so you can prepare for them ahead of time. Avoid as many of these triggers as possible in the early stages of quitting. As your non-smoking skills increase, you will be able to expose yourself to triggers and successfully avoid smoking.

3. Prepare for cravings. You will experience cravings. Don’t be surprised by them, and don’t let them throw you off track. It may help for you to notice that cravings generally increase for a short time and then decline. So when a craving begins, you can count on it not lasting too long, especially if you create a list of coping strategies. Your list will be unique, but here are some examples:

  • Call or text a friend
  • Take a walk
  • Chew gum
  • Listen to music
  • Leave the situation
  • Drink a glass of water
  • Exercise
  • Remind yourself that the craving will soon subside
  • Do a brief breathing or meditation exercise (there are many relaxation apps available)
  • Review your reasons for quitting
  • Read a book
  • Imagine what comforting words you would say to a friend who was trying to quit; say those words to yourself
  • Do a brief household chore
  • Play with a pet or a child
  • Work on a hobby

Keep your list close at hand. When you get the urge to smoke, go straight to your list. As you try different strategies, keep track of those that are most effective. It may be helpful to know that cravings will become less and less frequent the longer you are smoke-free.

4. Talk to your doctor about nicotine-replacement products. Enlist your doctor’s help. Make an appointment to talk about how to quit and whether a nicotine-replacement product may be right for you.

5. Use social support. Quitting is hard! Join an online or face-to-face support group. Tell your friends and family of your intention to quit, and explore ways they can help. If you know people who have quit, talk to them about how they managed. If any of your family or friends smoke, ask them to refrain when they are with you—or plan to leave the room when someone lights up. You will need as much help as you can find. Some important resources are listed below and the titles link to their corresponding websites:

American Cancer Society

The Centers for Disease Control 

The National Cancer Institute (hotline: 1-877-448-7848)

The American Lung Association

Nicotine Anonymous Each state has a toll-free hotline. Call 1-800-784-8669 to be directed to your state program.

6. Review your progress. Take ten minutes each night to review your progress. What coping strategies were most helpful? What situations made it more difficult to stay on track? Use what you learn today to plan for a more successful day tomorrow.

If you make a mistake and smoke a cigarette, don’t give up. Throw the rest of the pack away and start over again. There may be many aspects of your pain problem that are beyond your control. To live well with chronic pain, it is useful to identify areas where you do have control … and then take control. While it is a challenge, quitting smoking is something you can do to control your pain.

About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives as well as Think Clearly about Depression, a self-management program for depression.

DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.