Chronic Pain Status, Nicotine Withdrawal, and Expectancies for Smoking Cessation Among Lighter Smokers
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ORIGINAL ARTICLE
Chronic Pain Status, Nicotine Withdrawal, and Expectancies for Smoking Cessation Among Lighter Smokers Joseph W. Ditre, Ph.D. 1,2 & Jesse D. Kosiba, B.A. 1 & Emily L. Zale, M.S. 1 & Michael J. Zvolensky, Ph.D 3,4 & Stephen A. Maisto, Ph.D 1,2
Published online: 26 January 2016 # The Society of Behavioral Medicine 2016
Abstract Background Chronic pain and tobacco smoking are both highly prevalent and comorbid conditions, and chronic pain may pose a barrier to smoking cessation. Purpose The objective of this study was to test associations between chronic pain status and several smoking-related factors that have previously been shown to predict cessation outcomes. Method Daily smokers (N = 205) were recruited from the general population to complete an online survey of pain and tobacco smoking. Results Results indicated that smokers with chronic pain (vs. no chronic pain) consumed more cigarettes per day, scored higher on an established measure of tobacco dependence, reported having less confidence in their ability to quit, and endorsed expectations for experiencing greater difficulty and more severe nicotine withdrawal during future cessation attempts. Mediation analyses further indicated that the inverse association between chronic pain and abstinence self-efficacy was indirectly influenced by past cessation failures. Conclusions These findings suggest that individuals with chronic pain may constitute an important subgroup of tobacco * Joseph W. Ditre [email protected]
1
Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
2
Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA
3
Department of Psychology, University of Houston, Houston, TX, USA
4
University of Texas MD Anderson Cancer Center, Houston, TX, USA
smokers who tend to experience lower confidence and greater difficulty when attempting to quit. Future research would benefit from replicating these findings among older and more diverse samples of heavier tobacco smokers, and extending this work to the study of prospective relations between chronic pain status and cessation-relevant processes/outcomes over the course of a quit attempt. Keywords Tobacco . Pain . Chronic pain . Expectancies . Withdrawal . Cessation Tobacco addiction and chronic pain are both highly prevalent and comorbid disorders that together account for greater than $300 billion in annual health-care expenses and lost productivity [1, 2]. The prevalence of tobacco smoking among persons with chronic pain (~42–68 %) may be greater than twice the rate (19 %) observed in the general population [3–5], and a recently proposed reciprocal model of pain and smoking suggests that these conditions may interact in the manner of a positive feedback loop, resulting in greater pain and the maintenance of tobacco dependence [6]. Consistent with this perspective, tobacco smoking has been identified as a unique risk factor in the onset and progression of chronic pain [7, 8], situational pain has been shown to act as a potent motivator of smokin
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