Bagot Kara S, Wu Ran, Cavallo Dana, Krishnan-Sarin Suchitra
University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC 0405, La Jolla, CA 92093, United States.
Yale University School of Medicine, Department of Psychiatry, 300 George St., Suite 901, New Haven, CT 06511, United States.
Addict Behav. 2017 Apr;67:79-85. doi: 10.1016/j.addbeh.2016.12.010. Epub 2016 Dec 26.
We examined sex differences between smokers and nonsmokers in pain threshold, tolerance, and intensity and the effect of pain on cardiovascular measures, withdrawal, and craving during acute smoking abstinence.
Ninety-six (53 smokers, 43 nonsmokers) adolescents completed the Cold Pressor Task (CPT) to assess pain responses after minimal (1h) and 42-hour smoking deprivation. Vital signs and craving were assessed before and after CPT completion.
Smokers, compared to nonsmokers, had significantly lower pain tolerance (p<0.01) and pain threshold (p<0.001). Female smokers had significantly lower pain tolerance prior to, and following, 42-hour deprivation compared to male smokers (p's<0.01), male nonsmokers (p's<0.01), and female nonsmokers (p's<0.001), while male smokers demonstrated significantly decreased pain tolerance following 42-hour deprivation (p<0.05). Additionally, during minimal deprivation, at time of hand removal, female smokers had higher pain intensity compared to female nonsmokers (p<0.05) and male smokers (p<0.01). Withdrawal was not significantly correlated with any CPT measures or subjective pain during or following minimal deprivation or acute abstinence. Craving was associated with pain 15s after hand submersion (p=0.007) at 42-hour deprivation.
Smokers had a lower pain threshold than non-smokers, with female smokers demonstrating lower pain tolerance during minimal deprivation than all comparison groups, and, continuing to have diminished pain tolerance compared to female nonsmokers following 42h of abstinence. Male smokers demonstrated tobacco-deprivation-induced reductions in pain tolerance. Further study of pain-related factors that may contribute to relapse and maintenance of smoking behaviors, and mechanisms of these relationships among adolescent smokers is warranted.
我们研究了吸烟者与非吸烟者在疼痛阈值、耐受性和强度方面的性别差异，以及在急性戒烟期间疼痛对心血管指标、戒断反应和烟瘾的影响。
96名青少年（53名吸烟者，43名非吸烟者）完成冷加压试验（CPT），以评估在最少（1小时）和42小时戒烟后疼痛反应。在CPT完成前后评估生命体征和烟瘾。
与非吸烟者相比，吸烟者的疼痛耐受性（p<0.01）和疼痛阈值显著更低（p<0.001）。与男性吸烟者（p值<0.01）、男性非吸烟者（p值<0.01）和女性非吸烟者（p值<0.001）相比，女性吸烟者在42小时戒烟前后的疼痛耐受性显著更低，而男性吸烟者在42小时戒烟后疼痛耐受性显著降低（p<0.05）。此外，在最少戒烟期间，在手部移出时，女性吸烟者的疼痛强度高于女性非吸烟者（p<0.05）和男性吸烟者（p<0.01）。在最少戒烟期间或之后以及急性戒烟期间，戒断反应与任何CPT指标或主观疼痛均无显著相关性。在42小时戒烟时，手部浸入15秒后的烟瘾与疼痛相关（p=0.007）。
吸烟者的疼痛阈值低于非吸烟者，女性吸烟者在最少戒烟期间的疼痛耐受性低于所有对照组，并且在42小时戒烟后与女性非吸烟者相比疼痛耐受性持续降低。男性吸烟者表现出烟草戒断引起的疼痛耐受性降低。有必要进一步研究可能导致吸烟行为复发和维持的疼痛相关因素，以及青少年吸烟者中这些关系的机制。
