Open AccessAn Assessment of the Association Between Smoking Status, Pain Intensity, and Functional Interference in Patients with Chronic Pain
Author(s) -
Toby N. Weingarten
Publication year - 2008
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2008/11/643
Subject(s) - medicine , brief pain inventory , mood , chronic pain , physical therapy , outpatient clinic , univariate analysis , smoking cessation , nicotine , intensity (physics) , multivariate analysis , psychiatry , physics , pathology , quantum mechanics
Background: This article examines the association between smoking andpain intensity and functional interference in a heterogeneous group of patients evaluated at a tertiary outpatient pain clinic. Current smoking is associated with less favorable clinical presentations.Objective: This study was conducted to determine if the smoking statusof patients seen in an outpatient pain clinic is associated with differences inpain intensity and interference.Methods: Surveys were mailed to 500 consecutive new patients evaluated at an outpatient pain clinic. Measures included the Brief Pain Inventory(BPI) and the Fagerström Test for Nicotine Dependence (FTND). Univariateanalyses compared BPI scores between smokers and non-smokers. Mean BPIscores were compared between smoking status via analysis of covariance(adjusted for demographic variables which differed significantly by smokingstatus). A p value ≤ 0.05 was accepted as significant.Results: Survey completion rate was 46%, and 14.7% were current smokers. Smokers were younger, and more likely to be male and unemployed.Smokers had higher scores on all the pain intensity BPI scales (p < 0.01), andhigher scores (indicating greater functional impairment) on the general activity (p = 0.007), mood (p = 0.003), normal work (p = 0.02), relationships(p = 0.04), sleep (p < 0.001), and life enjoyment (p = 0.03) BPI functionalimpairment scales. Severe nicotine dependence was associated with greater pain now, (p = 0.05), and greater functional interference on mood (p =0.005), normal work (p = 0.02) and life enjoyment (p = 0.04) BPI scales.Conclusion: In patients who completed evaluation in an outpatient painclinic, current cigarette smokers reported significantly greater pain intensityand pain interference with functioning. Symptoms were more pronouncedin smokers with more severe nicotine dependence.Key words: smoking status; outpatient pain management; brief pain inventory; Fagerström test for nicotine dependence