Powers Jessica M, LaRowe Lisa R, Garey Lorra, Zvolensky Michael J, Ditre Joseph W
Department of Psychology, Syracuse University, Syracuse, NY 13244, USA.
Department of Psychology, University of Houston, USA.
Addict Behav. 2020 Dec;111:106548. doi: 10.1016/j.addbeh.2020.106548. Epub 2020 Jul 11.
Pain and nicotine dependence are prevalent, co-occurring conditions posited to interact in the manner of a positive feedback loop; however, most research to date has been conducted among tobacco cigarette smokers. Initial evidence suggests that pain is a risk factor for greater e-cigarette dependence, and additional research is needed to examine covariation between pain and e-cigarette use. There is reason to suspect that pain-related anxiety (i.e., the tendency to respond to pain with anxiety or fear) may be associated with greater e-cigarette dependence and difficulty quitting, and that pain intensity and pain-related anxiety may interact to confer greater risk for e-cigarette use. The current study represents the first examination of cross-sectional associations between pain intensity, pain-related anxiety, and e-cigarette dependence, motivation to quit, history of lifetime e-cigarette quit attempts, perceived barriers to cessation, and negative expectancies during abstinence from e-cigarettes. Participants (N = 520 e-cigarette users, 52.1% female, M = 34.85) completed an online survey assessing health behaviors. Results indicated that pain-related anxiety was positively associated with e-cigarette dependence and perceived barriers to cessation (ps < 0.05). Pain-related anxiety was found to moderate relations between pain intensity and primary outcomes, such that pain intensity was positively associated with motivation to quit, likelihood of past failed quit attempt, and negative abstinence expectancies among participants who endorsed high (but not moderate or low) levels of pain-related anxiety. Future research would benefit from examining prospective associations between pain-related anxiety, pain intensity, and e-cigarette use/cessation trajectories among individuals with chronic pain.
疼痛和尼古丁依赖普遍存在，且共同出现，被认为是以正反馈循环的方式相互作用；然而，迄今为止，大多数研究是在吸食卷烟的人群中进行的。初步证据表明，疼痛是电子烟依赖程度更高的一个风险因素，需要更多研究来考察疼痛与电子烟使用之间的共变关系。有理由怀疑，与疼痛相关的焦虑（即对疼痛产生焦虑或恐惧反应的倾向）可能与更高的电子烟依赖程度及戒烟困难有关，而且疼痛强度和与疼痛相关的焦虑可能相互作用，增加电子烟使用的风险。本研究首次考察了疼痛强度、与疼痛相关的焦虑与电子烟依赖、戒烟动机、终身电子烟戒烟尝试史、感知到的戒烟障碍以及电子烟戒断期间的消极预期之间的横断面关联。参与者（N = 520名电子烟使用者，52.1%为女性，平均年龄M = 34.85岁）完成了一项评估健康行为的在线调查。结果表明，与疼痛相关的焦虑与电子烟依赖及感知到的戒烟障碍呈正相关（p值<0.05）。研究发现，与疼痛相关的焦虑调节了疼痛强度与主要结果之间的关系，即对于那些认可高水平（而非中等或低水平）与疼痛相关焦虑的参与者，疼痛强度与戒烟动机、过去戒烟失败的可能性以及消极的戒断预期呈正相关。未来的研究若能考察慢性疼痛患者中与疼痛相关的焦虑、疼痛强度与电子烟使用/戒烟轨迹之间的前瞻性关联，将会有所助益。
