title: Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial.
abstract: BACKGROUND
  Prior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity.
  
  
  OBJECTIVE
  To determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial.
  
  
  METHODS
  We recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey.
  
  
  RESULTS
  In unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = -1.07; 95% CI = -1.77, -0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = -0.27; 95% CI = -0.79, 0.25).
  
  
  CONCLUSIONS
  Participants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials.
  
  
  BACKGROUND
  ClinicalTrials.govNCT00448344.
authors.affiliation: Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA; Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA. Electronic address: Lori.Bastian@Va.gov.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA; Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Fish
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA; Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Gierisch
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
authors.affiliation: Cancer Control and Population Sciences, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain / Q000150:complications*; D010147:Pain Measurement; D011446:Prospective Studies; D057566:Self Report; D012737:Sex Factors; D016540:Smoking Cessation / Q000379:methods; D014029:Tobacco Use Disorder / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans
keywords: Pain; cessation; chronic disease; smoking; tobacco; veterans