Brief report: pain and readiness to quit smoking cigarettes.
ABSTRACT This study explored the relationship between smoking and significant pain. It was hypothesized that readiness to quit smoking would be negatively affected by pain issues. A cross-sectional design was used in this phone-based survey with randomly selected adult smokers. A total of 307 adult participants in the control group from a larger Quit and Win Study participated in the interview. Participants were contacted at home and completed a 20-min phone survey including measures of pain, stress, depressive symptoms, social support, tobacco use status, and readiness to quit smoking. A total of 28% reported significant pain in the past week. Participants who experienced significant pain smoked more cigarettes per day than those who did not report significant pain. However, pain was not associated with readiness to quit. More than half (58%) of those with significant pain were in the contemplation stage of change or higher. The fact that smokers with pain were just as likely as those without significant pain to be ready to quit demands that each individual patient with pain be assessed for readiness to quit so that a tailored approach can be adopted either to motivate the patient to quit or to assist the patient with evidence-based tobacco dependence treatment strategies if he or she wants such treatment. Placing formal tobacco dependence treatment programs within pain clinics and addressing pain in smoking cessation programs is recommended.
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ABSTRACT: Pain and tobacco smoking are both highly prevalent and comorbid conditions, and there is reason to believe that pain may pose a barrier to smoking cessation. Although motivation to quit smoking and abstinence self-efficacy have been shown to predict future quit attempts and smoking cessation outcomes, little is known about how these factors may differ as a function of pain status. The goal of the current study was to test cross-sectional relations between past-month pain and self-reported motivation to quit smoking, recent difficulty quitting, and current abstinence self-efficacy. Current daily smokers were recruited from the local community to participate in a laboratory study that included a baseline assessment of recent pain and smoking history. Approximately 59% of 132 smokers endorsed past-month pain. Consistent with hypotheses, smokers who endorsed past-month pain reported lower confidence in their ability to remain abstinent and having experienced greater difficulty during their most recent quit attempt (ps < .03). Smokers in pain also endorsed greater motivation to quit and were more than twice as likely (odds ratio = 2.74, 95% CI = 1.28-5.84) to be classified in the contemplation/preparation (vs. precontemplation) stages, relative to pain-free smokers. To our knowledge, this is the first study to demonstrate an association between positive pain status, recent difficulty quitting smoking, and reduced self-efficacy for future smoking abstinence. These findings support the utility of assessing pain among all smokers and may help to inform future intervention efforts aimed at helping persons in pain quit smoking.Nicotine & Tobacco Research 05/2014; · 2.48 Impact Factor
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ABSTRACT: The primary aim of this study was to assess smoking characteristics and cessation motivation prior to and after initiation of multidisciplinary chronic pain treatment. A secondary aim was to identify predictors of cessation motivation among smokers initiating treatment for chronic pain. We used a prospective, nonrandomized, repeated measures design. The study was conducted in a multidisciplinary specialty pain treatment program at a veterans hospital. Smokers (N = 90) referred to a multidisciplinary pain program for the treatment of chronic pain. Patients completed questionnaires assessing pain-related and smoking-related factors prior to (baseline) and 8 weeks post (follow-up) specialty pain treatment initiation. Primary outcome measures were the Contemplation Ladder and the Stages of Change (SOC) algorithm. At baseline, patients reported moderate levels of cessation motivation, and 69% were in the contemplation stage or higher on the SOC. Motivation to quit smoking was higher at follow-up compared with baseline on both continuous, t(89) = 2.11, P < 0.05, and stage-based, z = 3.69, P < 0.01, measures. At follow-up, participants reported greater interest in receiving cessation interventions, and 7.8% of patients had quit smoking. Pain-related predictors of motivation (e.g., pain intensity) were subsumed by more general predictors (e.g., nicotine dependence). Patients in this sample were more motivated to quit smoking a few weeks after, as compared with before initiating specialty pain treatment. Future research into pain-specific predictors of cessation motivation is warranted to inform the development of interventions that address pain patients' unique needs.Pain Medicine 02/2014; · 2.24 Impact Factor
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ABSTRACT: There is increasing recognition that complex and potentially bidirectional relations between pain and smoking may be relevant to the maintenance of tobacco addiction. Pain-related anxiety has been identified as a mechanism in the onset and progression of painful disorders, and initial evidence indicates that pain-related anxiety may be associated with essential features of tobacco dependence among smokers with chronic pain. However, there has not been an empirical study of pain-related anxiety in relation to tobacco dependence and self-reported barriers to quitting among a community-based sample of daily smokers. The current sample was comprised of 122 daily smokers who were recruited from the local community to participate in a larger study that included an initial assessment of pain, smoking history, and pain-related anxiety. Approximately 17% of our sample endorsed moderate or severe past-month pain, nearly half met criteria for current anxiety or mood disorder, and about 30% met criteria for a current substance use disorder, exclusive of tobacco dependence. Results indicated that pain-related anxiety was uniquely and positively associated with both tobacco dependence severity scores and self-reported barriers to quitting. These findings lend support to the notion that pain-related anxiety may contribute to the maintenance of tobacco addiction among smokers who experience varying levels of pain severity. Copyright © 2014 Elsevier Ltd. All rights reserved.Addictive Behaviors 11/2014; 42C:130-135. · 2.44 Impact Factor