The Role of Pain Avoidance in the Relation Between Pain Intensity and Smoking Cessation Processes



Journal Title

Journal ISSN

Volume Title



Scientific evidence suggests that smokers who experience varying levels of pain are more likely to maintain their addiction to tobacco. The relationship between pain intensity and cognitive-based smoking processes within a mechanistic framework has received relatively little attention. Pain avoidance may influence the association between pain intensity and smoking, as it is a construct that is related to adverse pain and smoking processes. Thus, the current study examined the indirect effect of pain intensity on three clinically significant smoking processes (i.e., prior quit problems, perceived barriers for cessation, and negative affect reduction smoking expectancies) through pain avoidance. Participants included 95 treatment-seeking adult smokers (Mage = 44.99, SD = 10.52; 32% female) who attended a baseline visit for a smoking treatment trial. Results indicated that pain intensity had an indirect association on quit problems and perceived barriers for cessation through pain avoidance. Pain intensity did not have a significant indirect association on the negative affect reduction smoking expectancies through pain avoidance. The current findings provide evidence that pain avoidance may contribute to the maintenance of maladaptive smoking behavior in smokers experiencing pain. This study adds to the extant literature by providing evidence for the role of pain avoidance as a potential transdiagnostic mechanism that contributes to maladaptive smoking outcomes within the larger context of the reciprocal model of pain and substance use.