The Official Journal of the Turkish Society of Algology
ISSN 1300-0012 E-ISSN 2458-9446

Association between tobacco use and central sensitization: A cross-sectional study

Zehra Can Karahan1, Parnian Mohammadrezaei1, Asma Rahmani Tangroudi1, Hatice Bernis Şahin1, Mahtab Rahimikia1, Sana Pourassad1, Zahrasadat Naghdeh Forooshha2, Naime Uluğ3, Nilay Şahan4

1Department of Physiotherapy and Rehabilitation, Atılım University, Ankara, Türkiye
2Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
3Department of Physiotherapy and Rehabilitation, Ankara University, Ankara, Türkiye
4Department of Physiotherapy and Rehabilitation, Çankırı Karatekin University, Çankırı, Türkiye

Keywords: Central sensitization, chronic pain, smoking, tobacco use.

Abstract

Background: This study aims to investigate the association between tobacco use and central sensitization (CS), as measured by the Central Sensitization Inventory (CSI), and to identify demographic and clinical factors associated with CS.

Patients and Methods: In this cross-sectional study, a total of 380 adults were included using a convenience sampling method between December 2024 and January 2025. Data collection was performed through an online survey platform to ensure accessibility and broad participation. The survey was distributed via digital platforms, social media networks, and email lists to reach a diverse adult population across Türkiye. Demographic characteristics, clinical variables, and tobacco product use status were recorded. Central sensitization was assessed using the CSI. Multiple linear and logistic regression analyses were performed to identify predictors of CSI scores.

Results: Of a total of 380 participants, 131 were male and 249 were female with a mean age of 41.21 ± 11.40 (range, 18 to 65) years. Tobacco users had significantly higher CSI total scores compared to non-users (p = 0.029). A higher proportion of individuals with a CSI score ≥ 40 was observed among tobacco users (p = 0.003). In the multiple linear regression model, age (β = −0.295), female sex (β = 6.255), chronic disease status (β = 4.524), chronic pain (β = 12.093), and tobacco use (β = 6.538) were independent predictors (p < 0.001). Logistic regression analysis indicated a significant association between tobacco use and the likelihood of having a CSI score ≥ 40 (odds ratio [OR] = 0.488, 95% confidence interval [CI]: 0.302-0.789).

Conclusion: Tobacco use is positively associated with higher CS symptom severity. Given the cross-sectional design, these findings reflect a correlation rather than direct causality. Nevertheless, screening for smoking habits may provide valuable context during the clinical evaluation of chronic pain.

Cite this article as: Can Karahan Z, Mohammadrezaei P, Rahmani Tangroudi A, Bernis Şahin H, Rahimikia M, Pourassad S, et al. Association between tobacco use and central sensitization: A cross-sectional study. Agri 2026;38(3):181-187. doi: 10.5606/agri.2026.87.