It is reported in the American Journal on addictions that individuals taking tobacco are prescribed or co-prescribed opioid analgesics (OA) with benzodiazepines (BZD) or muscle relaxants (MR) exceedingly as compared to non-users. Co‐prescription of sedative-hypnotics along with tobacco intake, exerts the risk for ill-usage of prescribed opioids among people with non-cancer pain. Although a clear picture of their relationship is not established yet and therefore, this analysis conducted to assess variations in the prescription and co‐prescription measures of opioid analgesics with BZD or MR within tobacco users and non‐users.

The data regarding a yearly cross‐sectional survey of visits to office‐based physicians in outpatient contexts in the United States were collected from the 2006 to 2009 National Ambulatory Medical Care Survey. Patients with ≥18 years old and with non-cancer neck or back pain were included in the analysis. Different types of associations between prescription or co‐prescription rates and tobacco use status were measured by implementing the χ2 test and multiple logistic regression analysis.

A total of 114,199,536 weighted visits were assessed. Tobacco users showed significant odds ratios (ORs) for medical prescriptions; opioid analgesics (OR 2.14), benzodiazepines and opioid analgesics (OR 3.66), muscle relaxants and opioid analgesics (OR 2.57), and benzodiazepines, muscle relaxants, and opioid analgesics (OR 7.02). These OR values explain a considerable opioid misuse among tobacco users, and therefore, healthcare experts should restrict co‐prescription of opioid analgesics with benzodiazepines or muscle relaxants in tobacco users and administer a comprehensive strategy for alleviating pain.