• Svetlana Skurtveit, Kari Furu, Randi Selmer, Marte Handal, and Aage Tverdal.
• Department of Pharmacoepidemiology, Norwegian Institute of Public Health, and Norwegian Centre for Addiction Research, University of Oslo, Norway. svetlana.skurtveit@fhi.no
• Ann Epidemiol. 2010 Dec 1;20(12):890-7.

PurposeThe aim of this study was to evaluate prospectively smoking dependence as a predictor of repeated use of prescribed opioids in non-cancer patients.MethodsWe conducted a prospective population-based study cohort of 12,848 men and 15,894 women 30-75 years of age in health surveys in Norway during 2000-2002 with repeated opioid prescriptions (12+, during 2004-2007) recorded in the Norwegian Prescription Database as the outcome measure. Information on history of smoking and potential confounders was obtained at baseline by self-administered questionnaires. For smoking, participants were divided into categories: never; previously heavy (stopped maximum of 5 years earlier; 10+ cigarettes daily); daily not heavy (1-9 cigarettes); dependent daily smokers (10+ cigarettes), and other (previously and/or not daily). Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression.ResultsDuring follow-up, 335 (1.5%) of survey participants were registered with 12+ prescriptions of opioids during the period 2004-2007. The prevalence of repeated prescription frequency of opioids was higher for men and women with a history of smoking. The adjusted OR for prescribed opioids for dependent daily smokers was 3.1 (95% CI: 2.3-4.1), for daily non-heavy smokers 1.8 (1.2-2.7), and for previous heavy smokers 1.8 (1.1-3.0), compared with never-smokers as reference.ConclusionsResults of the study suggest that smoking dependence may predict more frequent use of opioids.Copyright © 2010 Elsevier Inc. All rights reserved.

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