The NZ Ministry of Health, which provides selleck Rapamycin a wide range of support for the Project, particularly access to the NZHS data. Other members of our ITC Project (NZ) team (see http://www.wnmeds.ac.nz/itcproject.html) and particularly Dr. Heather Gifford; Roy Morgan Research for conducting the interviews; the Data Management Core at the University of Waterloo, Canada; and the agencies that support the ITC Project internationally (particularly the Canadian Institutes of Health Research (#79551); the Roswell Park Transdisciplinary Tobacco Use Research Center (TTURC-P50 CA111236), funded by the US National Institutes of Health; and many other funding agencies as detailed on the ITC Project Web site: http://www.igloo.org/itcproject/.

Chronic pain, often defined as pain that persists for periods of longer than 3 months and for which there is no biological value (International Association for the Study of Pain, 1986), continues to be a major health concern in the United States and beyond. For example, estimates suggest that chronic pain impacts more than 75 million persons in the United States alone, contributing to more than $60 billion in lost productivity per year (McCarberg & Billington, 2006). Similar findings are evident in other regions of the world (Ohayon & Schatzberg, 2003). Moreover, chronic pain significantly negatively affects physical health, psychological functioning, and social well-being as well as global indices of quality of life, illustrating its clinical significance (Argoff, 2007; Turk & Melzack, 2001).

There is an increasing recognition that persons with chronic pain problems are at an increased risk for certain types of substance abuse and dependence (Denisco, Chandler, & Compton, 2008; Fishbain, Rosomoff, & Rosomoff, 1992). Perhaps the most widely publicized drug of abuse among those with chronic pain are opioids (Compton & Volkow, 2006), although other types of substance use disorders have also received scientific and clinical attention (e.g., alcohol use disorder; Brennan, Schutte, & Moos, 2005; Jamison, Kauffman, & Katz, 2000). There is significantly less empirical information pertaining to linkages between cigarette smoking and chronic pain (Freedman, Saulino, Overton, Holding, & Kornbluth, 2008). Such an oversight is unfortunate, as smoking remains a leading cause of morbidity and mortality in industrialized countries despite systematic efforts to prevent and control the use of tobacco (Centers for Disease Control and Prevention, 2008).

Of the work that has been completed on chronic pain and smoking, a number of intriguing, albeit initial, findings have emerged. In one recent study among a large Danish adult sample (n = 10,916), rates of cigarette smoking were significantly higher for Drug_discovery those with chronic pain compared with those without (Ekholm, Gronbaek, Peuckmann, & Sjogren, 2009).