Department of Psychology, Syracuse University, Syracuse, NY 13244, USA.
Department of Psychology, University of Houston, Houston, TX 77004, USA.
Nicotine Tob Res. 2023 Feb 9;25(3):404-411. doi: 10.1093/ntr/ntac197.
Pain has been implicated in the onset and maintenance of nicotine addiction, and there is initial cross-sectional evidence of covariation between pain and the use of cigarettes and e-cigarettes. The goals of the current study were to: (1)test pain severity as a predictor of initiating co-use of cigarettes and e-cigarettes, (2)examine longitudinal associations between pain and use/co-use of cigarettes and e-cigarettes, (3)generate the first prevalence rate data regarding cigarette and e-cigarette use as a function of pain, and (4)examine gender as a moderator of these associations.
Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (2013-2018).
Among exclusive cigarette smokers at Wave 1 (n = 7719), pain severity was associated with a greater likelihood of and faster trajectory to initiating co-use of cigarettes and e-cigarettes (ps < .05). A significant pain × gender interaction (p < .05) revealed this prospective relationship was stronger among women. Among adult respondents who provided at least three waves of data (n = 24 255), greater Wave 1 pain severity was positively associated with e-cigarette use, cigarette smoking, and co-use of cigarettes and e-cigarettes at Waves 2, 3, and 4 (ps < .001). At Wave 4 (n = 33 822), adults with moderate or severe pain endorsed rates of e-cigarette and cigarette use almost two times greater versus no or low pain (ps < .001).
Collectively, these findings provide evidence that pain likely serves as an important candidate risk factor for the initiation and maintenance of cigarette and e-cigarette use.
This is the first prospective study to show that pain serves as an important risk factor for initiation and maintenance of cigarette and e-cigarette use over time. Weighted prevalence estimates further demonstrated that individuals with moderate or severe pain endorsed rates of cigarette and e-cigarette use and co-use approximately two times greater compared to those with no or low pain. These findings highlight a subpopulation of nicotine users more susceptible to greater healthcare burden, nicotine dependence, and physical impairment. Nicotine users with comorbid pain may benefit from integrated interventions that address pain in the context of cessation.
疼痛与尼古丁成瘾的发生和维持有关，并且有初步的横断面证据表明疼痛与香烟和电子烟的使用之间存在共变。本研究的目的是：(1)测试疼痛严重程度作为同时使用香烟和电子烟的预测指标，(2)检查疼痛与使用/同时使用香烟和电子烟之间的纵向关联，(3)生成关于疼痛与香烟和电子烟使用之间功能关系的首次流行率数据，以及(4)检查性别作为这些关联的调节剂。
数据来自 2013-2018 年人口烟草与健康评估研究的第 1-4 波。
在第 1 波仅吸烟的人群中(n = 7719)，疼痛严重程度与同时使用香烟和电子烟的可能性更大以及更快的轨迹相关(均为 p <.05)。疼痛与性别之间存在显著的交互作用(p <.05)，表明这种前瞻性关系在女性中更强。在至少提供了 3 波数据的成年受访者中(n = 24255)，第 1 波时的疼痛严重程度越大，第 2、3 和 4 波时使用电子烟、吸烟以及同时使用香烟和电子烟的可能性越大(均为 p <.001)。在第 4 波(n = 33822)，中度或重度疼痛的成年人使用电子烟和香烟的比例几乎是无或低疼痛的两倍(均为 p <.001)。
总的来说，这些发现提供了证据表明疼痛可能是香烟和电子烟使用的开始和维持的重要候选风险因素。
这是第一项前瞻性研究，表明疼痛是随着时间的推移，香烟和电子烟使用的开始和维持的重要风险因素。加权流行率估计进一步表明，与无或低疼痛的人相比，中度或重度疼痛的人使用电子烟和香烟的比例约为两倍，同时使用电子烟和香烟的比例约为两倍。这些发现突出了一个更易受更大的医疗保健负担、尼古丁依赖和身体损伤影响的尼古丁使用者亚群。患有共病疼痛的尼古丁使用者可能受益于在戒烟的背景下解决疼痛的综合干预措施。
