Perceived Pain and Smoking Interrelations Among Veterans with Chronic Pain Enrolled in a Smoking Cessation Trial.

Lee M, Bastian LA, LaRowe L, DeRycke EC, Relyea M, Becker WC, Ditre JW. Perceived Pain and Smoking Interrelations Among Veterans with Chronic Pain Enrolled in a Smoking Cessation Trial. Pain medicine (Malden, Mass.). 2022 Oct 29; 23(11):1820-1827.

Related HSR&D Project(s)

• IIR 15-092 – Pain-related Anxiety Intervention for Smokers with Chronic Pain: A Comparative Effectiveness Trial of Smoking Cessation Counseling for Veterans

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Abstract:

INTRODUCTION: The Pain and Smoking Inventory (PSI) measures patients' perceived interrelations of their pain and smoking behavior, and it comprises three conceptually distinct domains: smoking to cope with pain (PSI-Cope), pain as a motivator of smoking (PSI-Motivate), and pain as a barrier to cessation (PSI-Barrier). Associations between PSI scores and pain interference and self-efficacy to quit smoking, two measures that can affect cessation outcomes, remain unclear. METHODS: We conducted a secondary analysis of baseline data from 371 veterans with chronic pain (88% male, Medianage  = 60) enrolled in a randomized smoking cessation trial. We used sequential multivariate regression models to examine associations between the three PSI domains and pain interference / self-efficacy. RESULTS: Of 371 veterans who completed baseline surveys, 88% were male, with a median age of 60?years. PSI-Motivate scores were positively associated with pain interference (beta [B]: 0.18, 95% confidence interval [CI]: 0.02 to 0.34). PSI-Barrier subscores were negatively associated with self-efficacy (B: -0.23, 95% CI: -0.36 to -0.10). CONCLUSION: Findings suggest that individuals who hold maladaptive perceptions of pain-smoking interrelations could be more likely to endorse higher pain interference and lower self-efficacy-two established predictors of cessation outcomes. Moreover, each PSI subscale demonstrated unique relationships with the dependent variables, and our results provided support for a three-factor structure. These findings further demonstrate that the PSI comprises three conceptually and empirically distinct domains; future research should evaluate the clinical utility of assessing each domain in relation to cessation outcomes.