Bastian Lori A, Fish Laura J, Gierisch Jennifer M, Stechuchak Karen M, Grambow Steven C, Keefe Francis J
Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA; Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
Cancer Control and Population Sciences, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA; Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.
J Pain Symptom Manage. 2015 Dec;50(6):822-9. doi: 10.1016/j.jpainsymman.2015.06.012. Epub 2015 Jul 22.
Prior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity.
To determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial.
We recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey.
In unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = -1.07; 95% CI = -1.77, -0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = -0.27; 95% CI = -0.79, 0.25).
Participants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials.
ClinicalTrials.govNCT00448344.
先前的横断面研究报告称，与不吸烟者或曾经吸烟者相比，持续吸烟者的疼痛强度更大；然而，很少有前瞻性研究探讨戒烟如何影响疼痛强度。
确定戒烟对参加戒烟试验的慢性病吸烟者后续疼痛强度的影响。
我们招募了患有慢性病（心脏病、癌症、慢性阻塞性肺疾病、糖尿病或高血压）的老年吸烟者参加一项随机对照戒烟试验，并前瞻性地检查疼痛强度和吸烟状况。参与者（n = 380）在基线和五个月随访时被要求对过去一周的疼痛程度进行0至10分的评分。主要结局指标是五个月随访调查时自我报告的疼痛强度。如果患者在随访调查前七天报告未吸烟，则自我报告的吸烟状况被归类为戒烟者。
在未调整的分析中，如果患者在随访调查前七天报告未吸烟，则自我报告的吸烟状况被归类为戒烟者。在多变量模型中吸烟五个月随访时，戒烟与随后的疼痛强度无关（参数估计值 = -0.27；95%可信区间 = -0.79, 0.25）。
被归类为戒烟者的参与者报告的疼痛强度水平与继续吸烟的患者没有显著差异。未来的研究应该扩展我们的发现，并在戒烟试验中监测疼痛强度。
ClinicalTrials.govNCT00448344。
