DESCRIPTION (provided by applicant): Chronic pain affects up to 55% of the general adult population. Cigarette smoking, the leading cause of morbidity and mortality, is a frequently co-occurring health risk behavior in individuals with chronic pain. Whereas the overall U.S. smoking prevalence has declined to 22%, smoking rates exceed 50% among treatment-seeking chronic pain patients. High co-occurrence of depression and anxiety with chronic pain presents an additional risk factor associated with higher smoking rates and difficulties with cessation. Therefore, smoking poses a serious health risk for a large proportion of chronic pain patients. Given that pain is among the most frequent presenting problems in the healthcare system, treatment for chronic pain provides an ideal opportunity to deliver smoking cessation interventions. Yet, to date, no cessation interventions for chronic pain patients have been developed, and research on smoking cessation among this high risk population has been largely ignored. Little is known about cessation-related factors among patients undergoing treatment for chronic pain. Identifying factors associated with increased motivation to quit smoking and receptivity to cessation interventions is a necessary step toward the development of effective intervention strategies that address the unique needs of patients seeking chronic pain treatment. Therefore, the overarching goal of this pilot study is to gather data on smoking and cessation-related factors unique to patients undergoing chronic pain treatment, with the ultimate goal of developing and testing a smoking cessation intervention for this population. The first aim is to identify pain-related factors that are predictive of increased cessation motivation and cessation efforts. The second aim is to assess differences in motivation to quit and receptivity to cessation interventions, as a function of chronic pain treatment. Determining whether motivation to quit and receptivity to treatment are greater concurrent with or following pain treatment initiation will inform the optimal timing for the delivery of smoking cessation interventions within the context of chronic pain treatment. The proposed study will use a prospective, longitudinal design to collect the requisite self-report data from 120 patients, at the time of, and 8 weeks following chronic pain treatment initiation. Univariate and multivariable analyses will be conducted to identify significant predictors of increased motivation to quit and cessation efforts, and to determine whether motivation to quit and receptivity to cessation interventions are greater concurrent with or following pain treatment initiation. Findings will be used in a future study to design and test cessation strategies that address the unique needs of chronic pain patients. Efforts aimed at smoking cessation among chronic pain patients can have significant public health implications, including reductions in smoking prevalence and tobacco-attributable morbidity and mortality. The overarching aim of this study is to gather data on smoking and cessation motivation factors among patients undergoing chronic pain treatment, with the ultimate goal of developing and testing a smoking cessation intervention for this population. Considering that chronic pain affects over 50% of adults, and smoking rates among individuals with chronic pain may be double that of the general population, smoking cessation among chronic pain patients has great public health significance. Namely, efforts aimed at smoking cessation among the chronic pain population can contribute to the reduction in overall smoking prevalence and tobacco-attributable diseases and deaths.
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