Center for Behavioral Science Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA.
Department of Behavioral and Social Sciences, Brown School of Public Health, Brown University, Providence, RI.
Nicotine Tob Res. 2021 Jan 7;23(1):179-185. doi: 10.1093/ntr/ntz111.
Smoking and pain are highly prevalent among individuals with mobility impairments (MIs; use assistive devices to ambulate). The role of pain-related smoking motives and expectancies in smoking cessation is unknown. We examined cross-sectional and prospective associations between a novel measure of pain-related smoking motives (how smokers with pain perceive their pain and smoking to be interrelated) and pain and smoking behavior in smokers with MI.
This is a secondary data analysis of a smoking cessation induction trial (N = 263; 55% female) in smokers with MI. Participants did not have to want to quit to enroll. Pain-related smoking motives and expectancies were assessed at baseline with the pain and smoking inventory (PSI) which measures perceived pain and smoking interrelations in three distinct but related domains (smoking to cope with pain, pain as a motivator of smoking and as a barrier to cessation). Other measures included pain occurrence and interference, nicotine dependence, motivation and self-efficacy to quit smoking, and number of cigarettes per day. Biochemically verified smoking abstinence was assessed at 6 months.
PSI scores were significantly higher among smokers with chronic pain occurrence compared to occasional and to no occurrence (p < .002) and were associated with greater pain interference (ps < .01) and lower self-efficacy to quit smoking (ps < .01). In prospective analyses adjusted for age, treatment group, and chronic pain, only expectancies of smoking to help cope with pain predicted lower odds of abstinence.
Targeting expectancies of smoking as a mechanism to cope with pain may be useful in increasing smoking cessation in pain populations.
Individuals with MI have a high prevalence of smoking and pain, yet the extent to which this population perceives pain and smoking to be interrelated is unknown. This is the first article to examine prospective associations between a novel measure of perceived pain and smoking interrelations (PSI) and smoking outcomes. The PSI was associated with greater pain and lower self-efficacy for quitting. Prospectively, the PSI subscale tapping into expectancies that smoking help coping with pain predicted a lower probability of smoking abstinence. In smokers with MI, expectancies of smoking as pain-coping mechanism may be an important clinical target.
在行动障碍（使用助行器进行移动）的个体中，吸烟和疼痛的发生率很高。疼痛相关的吸烟动机和期望在戒烟中的作用尚不清楚。我们研究了一种新的疼痛相关吸烟动机测量方法（患有疼痛的吸烟者如何感知他们的疼痛和吸烟之间的相互关系）与行动障碍吸烟者的疼痛和吸烟行为之间的横断面和前瞻性关联。
这是一项针对行动障碍吸烟者戒烟诱导试验（N=263；55%为女性）的二次数据分析。参与者无需有戒烟意愿即可入组。使用疼痛和吸烟清单（PSI）在基线时评估疼痛相关的吸烟动机和期望，该清单在三个不同但相关的领域测量感知的疼痛和吸烟相互关系（用吸烟应对疼痛、疼痛作为吸烟的动机以及戒烟的障碍）。其他措施包括疼痛的发生和干扰、尼古丁依赖、戒烟的动机和自我效能，以及每天吸烟的数量。在 6 个月时通过生物化学验证来评估吸烟的禁欲情况。
与偶尔发生和不发生疼痛的吸烟者相比，慢性疼痛发生的吸烟者的 PSI 评分明显更高（p<0.002），并且与更大的疼痛干扰（p<0.01）和更低的戒烟自我效能（p<0.01）相关。在调整年龄、治疗组和慢性疼痛的前瞻性分析中，只有吸烟帮助应对疼痛的期望预测了较低的禁欲几率。
针对将吸烟视为应对疼痛的机制的期望可能有助于增加疼痛人群的戒烟率。
患有行动障碍的个体吸烟和疼痛的发生率很高，但尚不清楚该人群如何感知疼痛和吸烟之间的相互关系。这是第一篇研究新型感知疼痛和吸烟相互关系测量方法（PSI）与吸烟结果之间前瞻性关联的文章。PSI 与更大的疼痛和更低的戒烟自我效能相关。前瞻性地，PSI 子量表反映了吸烟有助于应对疼痛的期望，预测了较低的戒烟可能性。在患有行动障碍的吸烟者中，将吸烟作为应对疼痛的机制的期望可能是一个重要的临床目标。
