Smoking Status Influences Reporting of Multisite Musculoskeletal Chronic Pain Among Construction Workers

Background/Purpose: The U.S. construction workforce is more likely to smoke and report musculoskeletal pain compared to white-collar workers. Although research shows that smoking can have analgesic effects and reduce pain sensitivity in those with chronic pain, little has been studied about the relationship between smoking status, self-rated quality of life and multisite musculoskeletal pain (i.e., two or more anatomic pain sites) in construction workers.  Data from two pilot studies of commercial construction workers were pooled to examine the association between self-reported smoker status and multisite musculoskeletal pain. 

Methods: A paper-based survey was administered to a total of 440 construction workers at construction jobsites across several U.S. east coast cities in 2013. The participants were asked about their smoking status, self-rated health, and complaints of musculoskeletal pain within the last three months (i.e., chronic pain). Polytomous regression modeling was used to assess the association between multisite musculoskeletal pain and sociodemographic characteristics.

Results/Outcomes: Over 53% of workers reporting multisite chronic musculoskeletal pain were current tobacco smokers of which lower back and knee pain were most commonly cited. Using the no pain as the reference category, the strongest significant associations with report of multisite chronic musculoskeletal pain included those who were current smokers (OR=5.68[95% confidence interval=2.47-13.09], and workers with “fair to poor” general health (0.39;[0.17-0.92]).

Conclusion: Smoking status is a significant predictor of reporting multisite musculoskeletal chronic pain in this sample of construction workers. These findings suggest that worksite-based smoking cessation interventions and policies should consider worker pain status.