Longitudinal Associations Between Pain and Use of Cigarettes and E-cigarettes in the Population Asse
Thursday, September 15, 2022
Posted by: Natalia Gromov
Powers
JM, Maisto SA, Zvolensky MJ, Heckman BW, Ditre JW.
Longitudinal Associations
Between Pain and Use of Cigarettes and E-cigarettes in the Population
Assessment of Tobacco and Health (PATH) Study.
[published online ahead of print, 2022 Aug 15]. Nicotine Tob Res.
2022;ntac197. doi:10.1093/ntr/ntac197
Introduction. Pain
has been implicated in the onset and maintenance of nicotine addiction, and
there is initial cross-sectional evidence of covariation between pain and
use/co-use of cigarettes and e-cigarettes. The goals of the current study were
to: (1) test pain severity as a predictor of initiating co-use of
cigarettes/e-cigarettes; (2) examine longitudinal associations between pain and
use/co-use of cigarette and e-cigarettes; (3) generate the first prevalence
rate data regarding cigarette and/or e-cigarette use as a function of pain; and
(4) examine gender as a moderator of these associations.
Methods. Data
were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health
(PATH) Study (2013-2018).
Results. Among
exclusive cigarette smokers at Wave 1 (n = 7,719), pain severity was associated
with greater likelihood of and faster trajectory to initiating co-use of
cigarettes/e-cigarettes (ps < .05). A significant pain x gender interaction
(p < .05) revealed this prospective relationship was stronger among women.
Among adult respondents who provided at least three waves of data (n = 24,255),
greater Wave 1 pain severity was positively associated with e-cigarette use,
cigarette smoking, and co-use of cigarettes/e-cigarettes at Waves 2, 3, and 4
(ps < .001). At Wave 4 (n = 33,822), adults with moderate/severe pain
endorsed rates of e-cigarette and cigarette use/co-use almost two times greater
versus no/low pain (ps < .001).
Conclusions. Collectively,
these findings provide evidence that pain likely serves as an important
candidate risk factor for the initiation and maintenance of cigarette and
e-cigarette use.
Implications. This
is the first prospective study to show that pain serves as an important risk
factor for initiation and maintenance of cigarette and e-cigarette use/co-use
over time. Weighted prevalence estimates further demonstrated that individuals
with moderate/severe pain endorsed rates of cigarette and e-cigarette
use/co-use approximately two times greater compared to those with no/low pain.
These findings highlight a subpopulation of nicotine users more susceptible to
greater health-care burden, nicotine dependence, and physical impairment.
Nicotine users with comorbid pain may benefit from integrated interventions
that address pain in the context of cessation.
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