Pain Severity and Alcohol Use Among Daily Tobacco Cigarette Smokers

BACKGROUND AND OBJECTIVES: Pain is associated with hazardous alcohol use. Drinkers have reported using alcohol for pain-coping, and negative affect may be a key mechanism in pain-induced motivation to drink. However, no previous study has examined pain severity in relation to alcohol consumption, dependence, and alcohol-related consequences. Moreover, no studies have examined pain-alcohol interrelations among tobacco cigarette smokers. These secondary analyses tested the hypotheses that greater past 4-week pain severity would be positively associated with indices of hazardous drinking (ie, quantity/frequency, harmful use, and dependence), and that the current pain intensity would be positively/indirectly associated with the urge to drink via negative affect. METHODS: Participants included 225 daily smokers (43% female; MCPD = 22) who completed the baseline session for a larger experimental study. RESULTS: Every one-point increase in pain severity was associated with a 47% increased likelihood of hazardous drinking, and pain severity was positively associated with quantity/frequency of alcohol consumption, harmful patterns of drinking, and alcohol dependence level (Ps < .05). Pain intensity was indirectly associated with urge to drink via negative affect (P < .05). CONCLUSIONS: These findings provide initial evidence that smokers with greater pain severity may also report hazardous patterns of alcohol use. SCIENTIFIC SIGNIFICANCE: This is the first study to demonstrate that past 4-week pain severity may be one factor that maintains three conceptually distinct patterns of hazardous drinking among smokers. The current results also provide the first evidence that greater pain intensity may be associated with an increased urge to drink alcohol, via negative affect. (Am J Addict 2020;29:134-140).