title: Impact of tobacco use in patients presenting to a multidisciplinary outpatient treatment program for fibromyalgia.
abstract: OBJECTIVE
  This study examined the relationship between the severity of fibromyalgia symptoms and current tobacco use in patients evaluated at a specialized fibromyalgia treatment program.
  
  
  METHODS
  Demographic and clinical data from 984 consecutive patients evaluated at the Mayo Clinic Fibromyalgia Treatment Program including the Fibromyalgia Impact Questionnaire (FIQ) were prospectively collected and stored in an electronic medical record and an electronic database. Univariate analyses were performed comparing tobacco users and nonusers. A post-hoc analysis of covariance was conducted for tobacco use, using group differences of confounding clinical and demographic variables. A P value < or = 0.05 was accepted as the level of significance.
  
  
  RESULTS
  One hundred and forty-five patients were identified as tobacco users (14.7%). Tobacco use was associated with greater pain intensity as measured by pain scales and the pain component of the FIQ. Tobacco users had a greater FIQ composite score 70.0(15.1) versus 61.8(16.8), P<0.001. By univariate analysis, tobacco users had higher scores on all the FIQ components and fewer good days and more days of work missed per week. Tobacco use was associated with several confounding clinical and demographic variables including lower education, higher unemployment, not being married or widowed, and history of abuse. After adjusting for these confounding variables, tobacco users continued to have greater pain intensity, a higher total and component FIQ scores except for fatigue. Smoking was not associated with a higher number of tender points.
  
  
  CONCLUSIONS
  Current tobacco use was associated with more severe fibromyalgia symptoms in patients presenting to a specialized fibromyalgia treatment program.
authors.affiliation: Departments of Anesthesiology and Physical Medicine and Rehabilitation, Mayo Clinic and Mayo Foundation, Rochester, MN, USA. weingarten.toby@mayo.edu
authors.forename: Toby N
authors.initials: TN
authors.lastname: Weingarten
authors.forename: Vikram R
authors.initials: VR
authors.lastname: Podduturu
authors.forename: W Michael
authors.initials: WM
authors.lastname: Hooten
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Thompson
authors.forename: Connie A
authors.initials: CA
authors.lastname: Luedtke
authors.forename: Terry H
authors.initials: TH
authors.lastname: Oh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004493:Education; D004651:Employment; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010147:Pain Measurement; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult