Abstract
Smoking cigarettes is prevalent among individuals with chronic pain. Some studies
indicate nicotine reduces pain and others suggest it may cause or exacerbate pain.
Participants in this cross-sectional study were 151 chronic pain patients from a large,
urban VA medical center. Patients were divided into 3 groups: 1) nonsmokers; 2) smokers
who deny using cigarettes to cope with pain; and 3) smokers who report using cigarettes
to cope with pain. Patients who reported smoking as a coping strategy for chronic
pain scored significantly worse compared with the other 2 groups on the majority of
measures of pain-related outcome. Nonsmokers and smokers who denied smoking to cope
did not differ on any variable examined. After controlling for the effects of demographic
and clinical factors, smoking cigarettes as a coping strategy for pain was significantly
and positively associated with pain intensity (P = .04), pain interference (P = .005), and fear of pain (P = .04). In addition to assessing general smoking status, a more specific assessment
of the chronic pain patient’s reasons for smoking may be an important consideration
as part of interdisciplinary pain treatment.
Perspective
This paper describes the relationship between smoking cigarettes as a mechanism to
cope with chronic pain and pain-related outcome. Understanding this relationship may
illuminate the broader relationship between smoking and chronic pain and provide new
directions for effective interdisciplinary pain treatment.
Key words
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Article info
Publication history
Published online: February 13, 2012
Accepted:
November 28,
2011
Received in revised form:
November 22,
2011
Received:
September 29,
2011
Footnotes
This work was supported with resources and the use of facilities at the Portland VA Medical Center. This study was funded by grant K23DA023467 from the National Institute on Drug Abuse, awarded to Dr. Morasco. Dr. Turk has received research support from Endo, Johnson & Johnson, Philips Respironics, and the National Institutes of Health, and consulting fees from Eli Lilly, Empi, Johnson & Johnson, Pfizer, Philips Respironics, and SK LifeScience.
Dr. Turk is a Special Government Employee of the US Food and Drug Administration. No other author reports having any potential conflict of interest with this study. Dr. Patterson is now affiliated with the National Center for Telehealth and Technology (T2). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the National Institutes of Health.
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Published by Elsevier Inc.
