Adam Gonzalez, PhD
July 16, 2014 - A study by Adam Gonzalez, PhD and colleagues published in the journal Cancer sheds new light on the relationship between pain and smoking among patients with lung and colorectal cancer. Previous studies showed that pain and smoking are elevated among cancer patients. The analysis performed by Dr. Gonzalez and colleagues was the first to use data from a large population study to demonstrate that the experience of pain among patients with lung or colorectal cancer varies by smoking status. Their findings highlight the importance of considering pain and pain treatment among smokers with cancer and the potential value of incorporating pain management into smoking cessation programs for these patients.
Analyzing data from a large cohort of patients collected by the Cancer Care Outcomes and Research Surveillance Consortium, Dr. Gonzalez and colleagues found that patients with lung cancer who were current smokers reported being in pain and receiving pain treatment more often than former smokers. Patients who never smoked did not differ from current and former smokers on endorsement of pain; however, they reported pain treatment less often than their counterparts. Current smokers reported greater pain severity than former smokers after adjusting for other contributing factors; however, no differences were detected between current and never smokers. Among colorectal cancer patients, current smokers reported being in pain and receiving pain treatment more often than former and never smokers; however, the latter two groups did not differ. Current smokers also reported greater pain severity than never smokers after adjustments; however, no differences were detected between current and former smokers. were significantly more likely to report being in recent pain than those who had quit smoking; while among patients with colorectal cancer current smokers were significantly more likely to report being in pain that both former smokers and those who had never smoked regularly. They explained that the inability to detect a significant difference between the pain reports of lung cancer patients who were current smokers and those who had never smoked may be due to the small number of respondents who endorsed experiencing recent pain and never smoking.
One explanation for the association between smoking status and pain among cancer patients may be that cancer patients smoke to gain short-term relief from pain, making it more difficult for them to quit. The results of this study suggest that the effectiveness of smoking cessation programs may be improved by incorporating pain management into them.
Although it was not a primary aim of the study, the researchers also found a positive association between depression and experience of pain, suggesting that mood management as well as pain management may be of value in smoking cessation programs for patients with lung or colorectal cancer.
Adam Gonzalez, PhD is an assistant professor in the Department of Psychiatry at Stony Brook University. The article, titled “Pain experiences among a population-based cohort of current, former, and never regular smokers with lung and colorectal cancer,” was published online on July 15, 2014.