Department of Psychology, Syracuse University.
Department of Psychology, Binghampton University.
Exp Clin Psychopharmacol. 2019 Dec;27(6):552-560. doi: 10.1037/pha0000258. Epub 2019 Feb 4.
The pack-years formula is a widely used estimate of lifetime tobacco smoking exposure, and greater pack-years have been associated with greater risk of chronic pain development and poorer pain-related outcomes among smokers with chronic pain. The pathophysiology underlying these associations is poorly understood. Regular tobacco smoking exposure may dysregulate homeostatic pain processes, producing an allostatic state of pain facilitation. Maladaptive pain mechanisms, such as central and peripheral sensitization, are chronic pain risk factors. Yet no published research has examined the relation between lifetime-smoking exposure and dysregulated pain processing. The current study used hierarchical linear regression analyses to test pack-years of tobacco smoking as a predictor of (a) pain reporting (current pain severity, pain frequency in the last 180 days) among a sample of 228 daily smokers without chronic pain, and (b) experimental capsaicin-induced pain reactivity (pain intensity, area of flare, mechanical pain sensitivity, and area of mechanical hyperalgesia) among 101 daily smokers without chronic pain. As hypothesized, results indicated that pack-years smoking was positively and significantly associated with current pain severity, past 180-day pain frequency, experimental pain intensity, mechanical pain sensitivity ratings, and area of mechanical hyperalgesia. Pack-years smoking was not significantly associated with neurogenic flare. These findings implicate central sensitization as a factor that may underlie the association between chronic tobacco smoking and increased risk for persistent pain. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
包年公式是一种广泛用于估计终生吸烟暴露量的方法，吸烟量越大，患有慢性疼痛的吸烟者发生慢性疼痛的风险就越高，疼痛相关结局越差。这些关联的病理生理学基础理解得还不够透彻。有规律的吸烟暴露可能会扰乱内稳态疼痛过程，导致疼痛促进的适应不良状态。适应性疼痛机制，如中枢和外周敏化，是慢性疼痛的危险因素。然而，目前还没有研究检验终生吸烟暴露与失调的疼痛处理之间的关系。本研究使用分层线性回归分析，检验了 228 名无慢性疼痛的每日吸烟者样本中，吸烟包年数（a）作为疼痛报告（当前疼痛严重程度、过去 180 天的疼痛频率）的预测因子，以及（b）在 101 名无慢性疼痛的每日吸烟者中，作为实验性辣椒素诱导的疼痛反应性（疼痛强度、红斑面积、机械性疼痛敏感性和机械性痛觉过敏面积）的预测因子。正如假设的那样，结果表明，吸烟包年数与当前疼痛严重程度、过去 180 天的疼痛频率、实验性疼痛强度、机械性疼痛敏感性评分以及机械性痛觉过敏面积呈正相关且显著相关。吸烟包年数与神经源性红斑无显著相关性。这些发现表明，中枢敏化可能是慢性吸烟与持续性疼痛风险增加之间关联的一个因素。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
