In order to explore the relationship between smoking habits and regional pain in the general British population, researchers KT Palmer and colleagues from the MRC Environmental Epidemiology Unit at the University of Southampton, UK administered a questionnaire to men and women around the country. They asked questions about pain in the low back, neck, and upper and lower limbs during the past 12 months; smoking habits; physical activities at work; headaches; and tiredness or stress.

12,907 men and woman aged 16-64 completed the questionnaire. This included 6,513 people who had smoked at some time, among whom 3,184 were current smokers.

Smoking habits were related to age, social class, report of headaches, tiredness or stress, and manual activities at work. Current and ex-smokers had higher risks than lifetime non-smokers for pain at all of the sites considered. This was especially true for pain reported as preventing normal activities. They found similar results in both sexes, and when analysis was restricted to non-manual workers.

The researchers conclude that there is an association between smoking and the report of regional pain, which is apparent even in non-smokers. They suggest that the association could arise from a pharmacological effect of tobacco smoke (for example, on the brain's ability to process sensory information or nutrition of peripheral tissues), or that people with a low threshold for reporting pain and disability are more likely to take up and continue smoking.