title: Smoking Status and Opioid-related Problems and Concerns Among Men and Women on Chronic Opioid Therapy.
abstract: OBJECTIVE
  Smokers on chronic opioid therapy (COT) for noncancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to nonsmokers. The current study aims to assess whether smoking is associated with problems and concerns with COT from the perspective of the patient.
  
  
  METHODS
  In a large sample (N=972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with COT using regression analyses, adjusting for covariates.
  
  
  RESULTS
  The sample self-identified as 27% current smokers, 44% former smokers, and 29% never smokers. Current smoking (vs. never smoking) was associated with increased odds of an opioid use disorder among males and females, and higher daily opioid dose among males only. Current and former smokers reported significantly fewer problems with opioids relative to never smokers, and this was driven primarily by lower endorsement of problems that are affected by the stimulant properties of nicotine (eg, difficulties thinking clearly, felt less alert or sleepy).
  
  
  CONCLUSIONS
  This study contributes to an understanding of perceived problems and concerns with COT among current, former, and never smokers with chronic noncancer pain. Results suggest that current and former smokers may be a difficult population to target to decrease COT, given that they perceive fewer problems with prescription opioid use, despite higher odds of having an opioid use disorder (males and females) and greater opioid doses (males only).
authors.affiliation: *Division of Research, Kaiser Permanente Northern California, Oakland †Department of Psychiatry, University of California, San Francisco, CA ‡Group Health Research Institute, Seattle, WA.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Young-Wolff
authors.forename: Daniella
authors.initials: D
authors.lastname: Klebaner
authors.forename: Constance
authors.initials: C
authors.lastname: Weisner
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Cynthia I
authors.initials: CI
authors.lastname: Campbell
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009293:Opioid-Related Disorders / Q000150:complications* / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid