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Tobacco smoking may be a risk factor for opioid use

A meta-analysis published in the journal Addictive Behaviors suggests that tobacco smoking is associated with the development of opioid use disorders.

Researchers conducted a meta-analysis of 11 observational studies (7 cohort, 4 cross-sectional) identified through a literature search on Medline, Embase, Scopus, Web of Science and Google Scholar databases.

The findings showed that opioid use/abuse disorders had an overall positive association with smoking (pooled OR, 3.18; 95% CI, 2.37-4.26, Pheterogeneity<.001; I2=80%). The prevalent and incident cases of opioid use/abuse disorders reported a pooled OR of 3.15 (95% CI, 1.42-3.62) and 1.89 (95% CI, 1.39-2.49), respectively. Opioid use disorders had a positive association with early exposure to tobacco smoking, i.e. at <14 years of age (pooled OR, 1.66; 95% CI, 1.34-2.08; Pheterogeneity=.22; I2=31.9%).

According to the authors, the association could be related to the 'gateway hypothesis', which says that drug use often begins during adolescence with a drug legal for adults and proceeds to illegal drugs. However, the findings of this study do not imply a causal relationship between smoking and opioid use disorders.


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