Balayssac D
Université Clermont Auvergne, Inserm U1107 Neuro-Dol, Laboratoire de toxicologie, CHU Clermont-Ferrand, Direction de la recherche clinique et de l'innovation, 63000 Clermont-Ferrand, France.
Rev Mal Respir. 2021 Mar;38(3):269-277. doi: 10.1016/j.rmr.2021.02.005. Epub 2021 Feb 26.
Tobacco smoking and pain have an intimate, complex, two-way interaction. The purpose of this narrative review of the literature is to present what is currently understood about the relationship.
Tobacco smoking (and the associated chronic exposure to nicotine) has been defined as a risk factor for chronic pain, involving nociceptive sensitisation. For people who smoke, pain will be both a motivational factor for tobacco consumption and a barrier to tobacco use cessation. Conversely, nicotine (acute exposure) has clearly demonstrated analgesic properties, mediated in particular by activation of nicotinic acetylcholine receptors.
The management of pain in people who smoke is still largely unaddressed, and further studies will be needed to develop effective strategies for tobacco use cessation in this context. Nicotine and modulators of nicotinic acetylcholine receptors represent innovative strategies for the discovery of new analgesics.
The effects of smoking on pain, chronic nociceptive sensitisation and acute analgesia, serve to maintain tobacco consumption via negative reinforcement. A holistic therapeutic strategy is necessary to maximise the likelihood of successful smoking cessation.
吸烟与疼痛存在密切、复杂的双向相互作用。本叙述性文献综述的目的是阐述目前对这种关系的理解。
吸烟（以及相关的长期尼古丁暴露）已被定义为慢性疼痛的一个风险因素，涉及伤害性感受敏化。对于吸烟者而言，疼痛既是烟草消费的一个动机因素，也是戒烟的一个障碍。相反，尼古丁（急性暴露）已明确显示出镇痛特性，特别是通过烟碱型乙酰胆碱受体的激活介导。
吸烟者的疼痛管理在很大程度上仍未得到解决，需要进一步研究以制定在这种情况下有效的戒烟策略。尼古丁和烟碱型乙酰胆碱受体调节剂代表了发现新型镇痛药的创新策略。
吸烟对疼痛、慢性伤害性感受敏化和急性镇痛的影响，通过负强化作用来维持烟草消费。需要一种整体治疗策略以最大化成功戒烟的可能性。
