The Role of Sleep Impairment in Associations Between Pain and Nicotine/Tobacco Dependence in Wave 6 of the Population Assessment of Tobacco and Health (PATH) Study

Objective Tobacco use is a significant national health concern that frequently co-occurs with chronic pain. Both pain and use of nicotine/tobacco have been linked to greater sleep impairments (i.e., trouble initiating and maintaining sleep), and there is reason to believe that more severe pain may indirectly contribute to greater nicotine dependence via sleep impairments. Therefore, the goal of this study was to examine indirect associations between pain severity and nicotine dependence via sleep impairment severity among adults who use cigarettes and electronic nicotine delivery systems (ENDS).