Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Nicotine Tob Res. 2011 Oct;13(10):919-25. doi: 10.1093/ntr/ntr097. Epub 2011 May 12.
Smokers are at increased risk of developing chronic pain and suffering higher pain intensity. However, nicotine has analgesic properties, and smokers may view smoking as a means to cope with pain. Smoking cessation is clearly beneficial to the long-term health of smokers. However, it is not known how abstinence from smoking affects pain. The aim of this study was to determine the association between smoking cessation and changes in pain symptoms by secondary analysis of a large longitudinal dataset of older adults.
Secondary analyses were performed of longitudinal biennial survey data (1992 through 2006) from the nationally representative Health and Retirement Study of United States adults older than 50 years. Multivariate logistic regressions were utilized to determine the relationship between the changes in smoking status and changes in pain symptoms, controlling for demographics, depression, self-rated health, history of arthritis, and body mass index.
In multivariate analyses, among the 4,695 smokers who reported no pain or mild pain at enrollment, smoking status was not independently associated with exacerbation of pain (odds ratio [OR]: 0.95, 95% CI: 0.84, 1.08). Among the 1,118 smokers who reported moderate to severe pain at enrollment, smoking status was not independently associated with improvement of pain (OR: 0.87, 95% CI: 0.70, 1.08).
Smoking cessation was not independently associated with changes in pain symptoms in older adults. These results suggest that concerns regarding the effects of abstinence from smoking on pain should not pose a barrier to offering tobacco use interventions to smokers with chronic pain.
吸烟者患慢性疼痛和疼痛加剧的风险增加。然而，尼古丁具有镇痛作用，吸烟者可能将吸烟视为应对疼痛的一种手段。戒烟显然对吸烟者的长期健康有益。但是，尚不清楚戒烟对疼痛的影响。本研究旨在通过对美国老年人的大型纵向数据集进行二次分析，确定戒烟与疼痛症状变化之间的关联。
对具有代表性的美国老年人健康与退休研究的纵向两年一次的调查数据（1992 年至 2006 年）进行二次分析。采用多元逻辑回归分析来确定吸烟状况变化与疼痛症状变化之间的关系，同时控制人口统计学因素、抑郁、自我报告的健康状况、关节炎病史和体重指数。
在多元分析中，在 4695 名在入组时报告无疼痛或轻度疼痛的吸烟者中，吸烟状况与疼痛加重无关（比值比[OR]：0.95，95%置信区间[CI]：0.84，1.08）。在 1118 名在入组时报告中度至重度疼痛的吸烟者中，吸烟状况与疼痛改善无关（OR：0.87，95%CI：0.70，1.08）。
戒烟与老年人疼痛症状的变化无关。这些结果表明，对于戒烟对疼痛的影响的担忧不应成为向患有慢性疼痛的吸烟者提供烟草使用干预的障碍。
