Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida 32610, USA.
J Pain. 2010 Jun;11(6):528-34. doi: 10.1016/j.jpain.2009.09.006. Epub 2009 Dec 16.
Smoking is a risk factor for cancer of the upper aerodigestive tract with recidivism rates high even after diagnosis. Nicotine, a major product in tobacco, is a complex drug with multiple characteristics including analgesic properties. The goal of the study was to examine pain levels in the context of smoking status among patients recently diagnosed with cancer of the upper aerodigestive tract who have not yet received any treatment including radiation, surgery, or chemotherapy. A convenience sample of 112 newly diagnosed head and neck cancer patients (78 men and 34 women) was recruited from clinics at the University of Florida. Smoking rates were: 32% never smoked, 34% former smokers, 34% current smokers. Among current smokers, 62% reported plans to quit in the next 3 months and 38% had tried to quit more than 3 times in the past 5 years. Current smokers reported higher general (sensory and affective) and oral pain levels (spontaneous and functional) and pain-related interference than did never and former smokers (all F's > 8. and P's < .0001) even after controlling for stage of diagnosis. In addition, current smokers reported significantly greater interference from the pain (F(2,73) = 10.5 P < .0001).
This study highlights the importance of understanding self-reported pain in cancer patients who continue to smoke. When pain is elevated, smokers may be motivated to use tobacco as a means of reducing pain, which in turn reinforces smoking behavior. Tobacco cessation programs should include pain management as a component of treatment.
吸烟是上呼吸道和消化道癌症的一个风险因素，即使在诊断后，复发率仍然很高。尼古丁是烟草中的一种主要产品，是一种具有多种特性的复杂药物，包括止痛特性。本研究的目的是在尚未接受任何治疗（包括放疗、手术或化疗）的上呼吸道和消化道癌症新诊断患者中，根据吸烟状况检查疼痛水平。从佛罗里达大学诊所招募了 112 名新诊断的头颈部癌症患者（78 名男性和 34 名女性）作为方便样本。吸烟率为：32%从不吸烟，34%曾经吸烟，34%现在吸烟。目前吸烟的患者中，62%计划在未来 3 个月内戒烟，38%在过去 5 年内尝试戒烟超过 3 次。目前吸烟的患者报告的一般（感觉和情感）和口腔疼痛水平（自发性和功能性）以及与疼痛相关的干扰程度高于从不吸烟和曾经吸烟的患者（所有 F 值>8，P 值<0.0001），即使在控制诊断阶段后也是如此。此外，目前吸烟的患者报告疼痛的干扰程度显著更大（F（2,73）=10.5，P<0.0001）。
本研究强调了理解继续吸烟的癌症患者自我报告疼痛的重要性。当疼痛加剧时，吸烟者可能会因为减少疼痛而使用烟草，这反过来又会强化吸烟行为。烟草戒断计划应将疼痛管理作为治疗的一个组成部分。
