How can smoking affect fibromyalgia?

Approximately one in four people with fibromyalgia smokes. Using nicotine changes a number of important brain chemicals that affect pain, including endorphins, serotonin, norepinephrine, and dopamine.

These nicotine-induced changes in brain chemicals make you more sensitive to pain. In an interesting study of 984 people with fibromyalgia at the Mayo Clinic, pain and disability were both significantly worse among those who were smokers. In addition, problems with work, sleep, stiffness, anxiety, and depression were all significantly more impaired among participants who used tobacco. A similar Korean study of 336 people with fibromyalgia found a link between smoking status and pain, functional disability, and mood. Although smoking doesn't cause fibromyalgia, it generally worsens the severity of chronic pain conditions, including fibromyalgia.

Smoking can also decrease the effectiveness of pain medications:

• Smokers use more painkillers than do non-smokers.
• When taking the same amount of painkillers, blood concentrations are lower in smokers.
• Smokers get less pain relief from taking pain medication.

Smoking may reduce the effectiveness of antidepressants. Smokers taking antidepressants to treat mood problems experience less of an improvement, as compared with nonsmokers using the same drugs.