Pain experiences among a population‐based cohort of current, former, and never regular smokers with lung and colorectal cancer

Abstract

BACKGROUND: Smoking and pain are prevalent and comorbid among patients with cancer. Limited work has compared pain experiences among current, former, and never (regular) smokers with lung and colorectal cancer. METHODS: We studied pain experiences of patients with lung (n 5 2390) and colorectal (n 5 2993) cancer participating in the multi-regional Cancer Care Outcomes Research and Surveillance study. We examined reports of pain, pain treatment, pain severity, and pain-related interference within each cancer group by smoking status, adjusting for demographic, psychosocial, and cancer characteristics. RESULTS: Among lung cancer patients, current smokers reported pain and receiving pain treatment more often than former smokers. Never smokers 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. There were no differences in pain-related interference. Among colorectal cancer patients, current smokers reported pain and pain treatment more often than former and never smokers; however, the latter 2 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. An identical pattern of findings was observed for pain-related interference. CONCLUSIONS: Many smokers with lung and colorectal cancer experience pain following a cancer diagnosis. Future work should assess if comprehensive smoking cessation treatments that address pain can reduce pain and facilitate smoking cessation among patients with cancer. Cancer 2014;120:3554-61.

Temporal course and predictive factors of analgesic opioid requirement for chemoradiation‐induced oral mucositis in oropharyngeal cancer

“…Nicotine is known to have analgesic properties. However, some evidence in the literature show that among patients with chronic pain, smokers have higher pain intensity scores and a higher consumption of opioids than nonsmokers …”

“…However, some evidence in the literature show that among patients with chronic pain, smokers have higher pain intensity scores 14 and a higher consumption of opioids than nonsmokers. 15 According to some authors, 16 the analgesic effect of nicotine and smoking is lost after their chronic exposure. In this scenario, we would have expected an excess of opioids used in patients with higher smoking history, which was not observed.…”

Association Between Tobacco Use, Symptom Expression, and Alcohol and Illicit Drug Use in Advanced Cancer Patients

“…1 The frequency of patients who were actively using cigarettes at the time of diagnosis was reported to be between 46% and 75%, whereas the frequency of active cigarette use after their diagnosis was between 14% and 58%. 2 In a more recent study, the frequency of patients who were actively smoking was 11.3% in lung malignancies and 11.9% in colorectal cancer, 3 and a frequency of 19.3% in cancer patients seen in a chronic pain clinic. 4 In population-based studies, smokers generally express more intense, widespread pain compared with nonsmokers.…”

Pain Management in Lung Cancer

“…Moreover, younger age, lower perceived health status and higher levels of other cancer symptoms (fatigue, shortness of breath and difficulty eating) were also significantly associated with a higher likelihood of reporting moderate to severe lung cancer pain [19]. Among lung cancer patients, current smokers reported pain and receiving pain treatment more often than former smokers [20]. The coping style has also been reported to affect pain.…”