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We aimed to assess differences in the prescription and co\u2010prescription rates of opioid analgesics with muscle relaxants and\/or benzodiazepines between tobacco users and non\u2010users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Visit data were obtained from the 2006 to 2009 National Ambulatory Medical Care Survey, an annual cross\u2010sectional survey of visits to office\u2010based physicians in outpatient settings in the United States. Our sample patients were aged \u226518 years and diagnosed with non\u2010cancer back and neck pain. The <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> test and multiple logistic regression analysis were used to assess bivariate and multivariate associations between prescription or co\u2010prescription rates and tobacco use status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed a total of 114,199,536 weighted visits (unweighted number: 3,521). Significant odds ratios (ORs) of tobacco users (vs non\u2010users) for medical prescriptions were as follows: opioid analgesics, OR 2.14, 95% confidence interval (CI) 1.64\u20132.80; muscle relaxants and opioid analgesics, OR 2.57, 95%CI 1.76\u20133.74; benzodiazepines and opioid analgesics, OR 3.66, 95%CI 2.11\u20136.35, and muscle relaxants, benzodiazepines, and opioid analgesics, OR 7.02, 95%CI 2.98\u201316.57.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Scientific Significance<\/jats:title><jats:p>Tobacco users were more likely to receive prescriptions for opioid analgesics with muscle relaxants and\/or benzodiazepines than non\u2010users. Healthcare professionals need to limit co\u2010prescription of opioid analgesics with muscle relaxants and\/or benzodiazepines among tobacco users and provide a comprehensive approach to pain management. 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